For Treatment-Resistant Depression and OCD, a New Hope Emerges

A Rutgers Health expert explains how transcranial magnetic stimulation offers an alternative for patients who haven't found relief through conventional medication or therapy

For many adults living with depression, anxiety or obsessive-compulsive disorder, medication and talk therapy provide meaningful relief. But for some individuals, symptoms persist.

Transcranial magnetic stimulation (TMS), a Food and Drug Administration-approved, evidence-based and noninvasive treatment, may help when medications alone haven't provided relief. It is estimated that 70% to 80% of patients will achieve a significant response from a typical 35 session treatment TMS protocol. More than 50% to 60% can achieve complete remission and elimination of all depressive symptoms from TMS. This includes patients who have tried multiple medications and haven't found relief.

TMS, which is offered at Rutgers University Behavioral Health Care, uses magnetic pulses to stimulate specific areas of the brain involved in mood regulation. Unlike medications that circulate throughout the body, TMS directly targets the area of the brain associated with OCD, depression and anxiety.

Cheryl Graber, an associate professor at Rutgers Robert Wood Johnson Medical School and a psychiatrist at University Behavioral Health Care and RWJBarnabas Health, discusses the treatment.

How does TMS treat OCD, depression and anxiety differently than medication? Are there any side effects?
While medications can sometimes be associated with side effects, this procedure is not associated with any pain or memory issues, and most people do not experience significant side effects. If anything, minimal scalp discomfort may be experienced during the first few sessions while getting used to treatments but quickly dissipates.

This treatment has been studied for more than three decades and was first approved by the U.S. Food and Drug Administration for major depressive disorder in 2008.

TMS treatments are typically delivered in a series of about 35 outpatient sessions, usually performed daily over four to six weeks. The treatment sessions are not painful or invasive and are about 20 to 30 minutes long. They consist of individuals sitting with a technician for support and monitoring in a comfortable chair while a specialized helmet delivers brief magnetic pulses to targeted areas of the brain. Once the treatment course is completed, patients generally do not need to return for ongoing sessions.

The treatment does not require anesthesia or sedation, and people remain awake throughout the treatment. It can be scheduled without major disruption to the person's daily schedule and normal activities can be resumed immediately after the session.

TMS is specifically indicated for patients who have tried several medications and still experience significant symptoms.

Cheryl Graber

Associate Professor, Rutgers Robert Wood Johnson Medical School

What are some misconceptions about TMS treatment?
Brain-based treatments such as TMS are sometimes misunderstood due to outdated portrayals of psychiatric care. Increasing awareness about modern treatment options can help reduce stigma so that people seek care earlier and explore alternatives when their current treatments are not providing the results they need.

TMS is not the same as electroconvulsive therapy. Although both treatments target the brain, the procedures themselves are very different.

What would you tell people who are discouraged by previous treatments that have not worked or those who think that brain stimulation treatments are experimental or unsafe?
TMS is specifically indicated for patients who have tried several medications and still experience significant symptoms. Ongoing research is looking into new forms of treatment for depression and anxiety, including neuromodulation and interventional procedures. This treatment provides hope for people who have not had successful results with conventional medications. There is an abundance of evidence that shows TMS to be a safe and effective treatment option.

Call 732-235-4444 or email [email protected]to schedule an evaluation or learn more about available treatment options.