Treatment Resistant Depression
What is treatment resistant depression? If you have been receiving extensive treatment for depression and still no improvement, you may have treatment resistant depression. It may take some time for your psychiatrist to reach this diagnosis. However, during treatment it is likely that you would have trialled two or more antidepressants with no improvement. You may have also visited a psychologist or counsellor to help ease depression symptoms. Unfortunately, for some people, standard treatments are usually not enough to overcome treatment resistant depression.
Patients who have been diagnosed with major depression by a psychiatrist may be a suitable candidate for TMS therapy. As mentioned above, the patient will have trialled and failed two or more medication treatments previously with no success. While anti-depressants are commonly used for depression, some patients do not respond or experience side effects from them. For patients who have treatment resistant depression, TMS may offer an alternative treatment. Research has been conducted with TMS for other psychiatric conditions. However, at this stage TMS in Australia is approved only for those with treatment resistant depression.
There are a lot of positives when considering TMS as the side effects are considered to be relatively minor. It is also a treatment that does not require hospitalisation or anaesthetic. There are many benefits, particularly for those who are high functioning with demanding roles that need to keep going.
So what is the alternative to TMS?
Electro convulsive therapy is a completely different treatment to TMS. It is sometimes offered to those with treatment resistant depression. It is only recommended when everything else has failed to work. There are significant side effects and risks associated with ECT and they need to be carefully considered. You can compare TMS and ECT on our website.
TMS may not suitable for everyone…
Research in TMS is limited to adults, so patients under the age of 18 are not recommended to have TMS at this time. Sydney TMS will continue to monitor the research in younger patients. The service will be extended when the approved research becomes available. Similarly there is limited research about the safety of TMS in pregnant women. At this stage we do not offer TMS to those during pregnancy. To read more please refer to our those who are suitable to receive TMS on our website.
Because TMS requires the generation of electromagnetic fields it is not suitable for some patients with metal implants. This includes electronic medical devices or implants particularly near the head region. Patients with active or inactive implants (including device leads). As well as deep brain stimulators, cochlear implants, and vagus nerve stimulators. It is considered safe to offer TMS to patients with cardiac pacemakers. This is because it is sufficiently far away from the magnetic field to be effected.