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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by SLS on January 28, 2003, at 10:19:20
Hi.
I live in New Jersey.
Does anyone know locations where rTMS is available? (transcranial magnetic stimulation)
If anyone has had success with this treatment, can you please describe your disorder and treatment history?
Input from anyone - good or bad?
Thanks.
- Scott
Posted by susan C on January 29, 2003, at 13:39:19
In reply to rTMS - Where is it available? Any opinions?, posted by SLS on January 28, 2003, at 10:19:20
Hi Scott, Mouse here,
Have no direct experience, just that it is a treatment in reserve (I have insurance) should things go south for me in the future. The closest place to me is on the West Coast, (no help to you), and just started accepting patients on Depakote, so I will now qualify. I believe Judyl has had some, you might look back and see what the archives say. Like you, I am now going to keep tabs on people's experiences. Thanks for bringing this up.Mouse looking at magnets instead of pills
"You never know where the answers will come from" -S.I.Clark
Posted by Craig on January 30, 2003, at 3:39:09
In reply to rTMS - Where is it available? Any opinions?, posted by SLS on January 28, 2003, at 10:19:20
Hi Scott. Check out http://www.dr-bob.org/babble/20030106/msgs/135267.html because Pfinstegg says, "I am receiving TMS at North Atlanta Psychiatric Associates with Dr. Mark Hutto. Even though I am feeling great now, I fully expect to need continued monitoring, and am prepared in case I require retreatment with TMS and/or medications- I can obtain all of that here."
************************************
> Hi.
>
> I live in New Jersey.
>
> Does anyone know locations where rTMS is available? (transcranial magnetic stimulation)
>
> If anyone has had success with this treatment, can you please describe your disorder and treatment history?
>
> Input from anyone - good or bad?
>
> Thanks.
>
>
> - Scott
Posted by Dave1 on January 30, 2003, at 12:41:59
In reply to rTMS - Where is it available? Any opinions?, posted by SLS on January 28, 2003, at 10:19:20
HI,
We were talking about TMS and some other stuff a few sections back. Someone was doing in Atlanta non-experimentally, and had success. Someone else said they didn't think it worked. You should look for the discussion. Sorry I can't give you more info. on how to find it. If you find any places that do non-experimentally let me know.
Dave
Posted by Otherworldly on February 1, 2003, at 11:03:17
In reply to Re: rTMS - Where is it available? Any opinions?, posted by Dave1 on January 30, 2003, at 12:41:59
Hello --
I was part of a clinical trial of rTMS at NIMH a few years ago. I received a record number of treatments -- 100. I experienced some slight improvement; most notably, I slept soundly for the first time in years. But there was no real remission of my depression, and the positive effects, such as they were, only lasted a few weeks.
In subsequent conversations with the doctor conducting the trial, he told me that some of the initial studies showing robust effects from rTMS had been largely discredited. Studies being done now at NIHM use much higher frequencies, to the point where the procedure is not that different from ECT.
But even if the procedure is succesful for a given individual, the benefits can only be sustained through medication. Which brings you back to the usual dilemma: What drug will work for you, with side effects you can tolerate.
Posted by SLS on February 1, 2003, at 13:19:42
In reply to rTMS - Where is it available? Any opinions?, posted by SLS on January 28, 2003, at 10:19:20
> Hi.
>
> I live in New Jersey.
>
> Does anyone know locations where rTMS is available? (transcranial magnetic stimulation)
>
> If anyone has had success with this treatment, can you please describe your disorder and treatment history?
>
> Input from anyone - good or bad?
>
> Thanks.
rTMS Research Centers:
http://www.ists.unibe.ch/Centers.html- Scott
Posted by Pfinstegg on February 1, 2003, at 19:11:50
In reply to Re: rTMS - Where is it available? Any opinions?, posted by Otherworldly on February 1, 2003, at 11:03:17
Hi! I'm the person who had TMS in Atlanta. I had an eight-year suicidal depression, unipolar, and resistant to many AD's. I had 15 high frequency treatments, just below the threshold for a seizure- essentially, it was like ECT, except that I remained awake, could drive myself to and from the sessions, and never had any memory impairment. I just finished two weeks ago, so I can't say how lasting the effect of the TMS will be, but so far, I'm in complete remission. If needed, I'll return to Atlanta for "boosters"- you stay two or three days, and receive two treatments a day 6 hours apart.
Somewhere in the archives, there is a lot of discussion about TMS- it was what helped me decide to do it. I also posted a lot of details about the treatment while I was having it. (Showing my computer ignorance), I am afraid I don't know how to put them in here.
I think the big variables with TMS are how intense they make the electromagnetic pulses, and what frequency they use. Dr. Hutto in Atlanta uses the highest intensity and frequency that he can. He has had 20 years experience with ECT, and is basically offering it as a closely comparable treatment- and one with essentially no side effects or risks.
Hope this helps! I feel so glad that I did it.
Pfinstegg
Posted by jumpy on February 1, 2003, at 20:51:38
In reply to rTMS - Where is it available? Any opinions?, posted by SLS on January 28, 2003, at 10:19:20
> Hi.
>
> I live in New Jersey.
>
> Does anyone know locations where rTMS is available? (transcranial magnetic stimulation)
>
> If anyone has had success with this treatment, can you please describe your disorder and treatment history?
>
> Input from anyone - good or bad?
>
> Thanks.
>
>
> - ScottHey Scott,
I finished a study on ECT at Columbia 6 weeks ago. One of the other studies going on there was TMS. Call Dr Sarah H. Lisanby at the New York Psychiatric Institute (212) 543-5825 or go to the web site http://www.nyspi.cpmc.columbia.edu/Kolb/index.htm click on Research then Novel treatments for depression to find out more information. I know it was free(treatment, food, room and board, the whole works), but you have to be inpatient to be part of the study. Good Luck.
Jumpy
Posted by SLS on February 1, 2003, at 23:45:19
In reply to rTMS for free » SLS, posted by jumpy on February 1, 2003, at 20:51:38
Many thanks to Pfinstegg and Jumper.
In a communication that I had with her yesterday, Dr. Lisanby said that there were no positions available and that the study was complete. However, she said that another investigation will be started in spring or summer.
Pfinstegg - I am very excited to know how well you have responded to TMS. Which drugs are you currently taking? Were you allowed to be on antidepressants during the course of TMS treatments?
Jumper - how are you feeling now, and what kind of depression do you have? Will you need maintenance treatments or drug continuation? Were you allowed to remain on antidepressants during the study?
This is exciting.
Do either of you know how MST (Magnetic Seizure Therapy) compares to rTMS as far as efficacy and side effects are concerned?
- Scott
Posted by jumpy on February 2, 2003, at 0:22:03
In reply to Re: rTMS for free - Thanks., posted by SLS on February 1, 2003, at 23:45:19
> Jumper - how are you feeling now, and what kind of depression do you have? Will you need maintenance treatments or drug continuation? Were you allowed to remain on antidepressants during the study?
Hey Scott,
I have panic disorder with melancholic depression. My current job requires lots of reading, concentration and memory. ECT did give me temporary difficulties with this, and thus I did not pursue maintenance ECT treatment. So now I am debating going back to nardil (many side effects), ritalin or pamelor + lithium (also cognitive dysfunction). I really am suck in between a rock and a hard place.
Good luck with the TMS.
Jumpy
PS Staying at Columbia for the ECT was a trip. I felt a bit humiliated ... some of the nurses and doctors were patronizing. I hated having to write requests to leave the floor and sit every morning at the desk and ask for a razor to shave. There also are alot of providers (nurses, medical students, social workers, etc.)there "in training", basically learning their trade with you. But, it will be all worth it if you respond. Unforunately, I relapsed back into the depression within 4 weeks.
Posted by Pfinstegg on February 2, 2003, at 14:25:41
In reply to Re: rTMS for free - Thanks., posted by SLS on February 1, 2003, at 23:45:19
Hi Scott..because I was given TMS by a psychiatrist in private practice, I was allowed to keep taking my regular medications. They are: synthroid and cytomel, hormone replacement therapy twice weekly ( my gynecologist and I are trying to follow the new hormone guidelines, but found that the depression worsened a lot when the estrogen was completely discontinued- I don't know if men can have a comparable situation with testosterone, but I think it's possible if your levels are low), lots of fish oil and vitamins, especially B12 and folic acid - and tianeptine. This last one is kind of an experiment; because I never found a good AD in any of the classes, I thought I would give tianeptine a try. It has been shown to prevent stressed baby tree shrews from developing small hippocampuses with abnormal cell structure (German Primate Center and Rockefeller University). On MRI, I do have the typical PTSD- depressive presentation of a small left hippocampus. I am not using it as an AD (it doesn't seem to be very good for that) but rather as a way of protecting my hippocampus from further cortisol damage, and MAYBE allowing it to recover some. Time will tell!
You raised such an interesting question about using TMS at an intensity which actually causes a seizure. I know there are researchers investigating this in various centers; my doctor simply said that he was giving me maximal intensities, and that I might have a seizure, but to quote him, "so....!" Obviously, TMS and ECT are getting pretty close; the electromagnetic impulses don't scatter when they pass through one's skull as regular electricity does, so they are giving an intense dose to a precise area- the left dorsolateral prefrontal cortex. There is supposed to be some spread to the amygdala, hippocampus and basal ganglia, but not as much as one would get with ECT. This means you can take it as an outpatient, and drive yourself home without difficulty.
One thing I feel I should mention: because it's not FDA-approved, insurance will not cover the TMS if you are given it privately. My insurance did cover the medical, neurological and psychiatric work-up, but I did have to pay for the TMS myself. It cost $170 per treatment, but my doctor did have a sliding scale for it- how far down he would actually slide I don't know!
I am amazed at what a complete remission I got from the TMS, but not much time has passed since my last treatment, so I have no idea if it will last. But I will keep posting to let anyone who might be thinking of it know what happens longer-term.
The very best of luck to you- I'd be so interested to hear what you decide to do.
Pfinstegg
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