When the Most Common Depression Therapies Don't Work

New Non-invasive, Non-systemic Treatment Option Gaining Momentum —NeuroStar TMS Therapy Live Expert Demonstration

Despite the increasing popularity of antidepressants, 70% of patients will not respond to their first antidepressant, and 30% will not benefit from additional antidepressants or will not be able to tolerate medication side effects even after trying multiple options (http://jama.ama-assn.org/cgi/content/abstract/289/23/3095; http://ajp.psychiatryonline.org/cgi/content/abstract/163/11/1905). This fact lies at the center of an ongoing debate about the extent to which depression can be treated and to what treatments work. Does drug therapy last? Is remission possible?

In 2008, the FDA cleared the NeuroStar Transcranial Magnetic Stimulation (TMS) Therapy System as a treatment option for adults with major depression who have not had success with prior antidepressant medications.* Since then, NeuroStar TMS Therapy has been utilized in the United States at more than 190 treatment centers.

Newly published scientific evidence confirms NeuroStar TMS may be an effective option for patients for whom antidepressant medications have not worked. The May edition of Archives of General Psychiatry includes a large independent study on TMS as a depression treatment, sponsored by the National Institute of Mental Health and Using the NeuroStar TMS Therapy system. The study found that patients receiving TMS treatment were more than four times more likely to achieve remission versus those receiving sham treatment (http://archpsyc.ama-assn.org/cgi/content/abstract/67/5/507). These data were presented at the American Psychiatric Association’s annual meeting in New Orleans during a press briefing May 24 from 6:30-8:00PM, at which experts provided an overview of TMS research to-date and physician and patient perspectives were presented.

The following were presented:

Is Remission of Depressive Symptoms a Realistic Goal?

An overview of the challenges clinicians face when treating depression

Linda Carpenter, MD, Associate Professor, Department of Psychiatry and Human Behavior, Brown Medical School, Brown University

Understanding How TMS Therapy Works

Exploring the field of TMS therapy from 1830s concept to 21^st century clinical practice

Mark A. Demitrack, MD, Chief Medical Officer, Neuronetics, Inc.

View from the Clinic: Finding a Direct Route to Getting Patients Well

Breaking the cycle of multiple medications; NeuroStar demonstration

Karl Lanocha, MD, The TMS Center of New England, Portsmouth, NH

A Battle on Two Fronts: My Struggle with Depression

A patient’s story of discovering, overcoming, and successfully treating her depression with NeuroStar TMS despite denial from her insurance company

The following summarizes some of the information attendees were presented with.

TMS therapy uses highly focused, pulsed magnetic fields to restore function in the brain regions believed to be linked to depression. It is an outpatient procedure performed daily in a physician’s office for 4-6 weeks. There are no systemic side effects, such as sedation, cognitive-blunting, weight gain, sexual dysfunction, or nausea (www.psychiatrist.com/abstracts/abstracts.asp?abstract=200802/020807.htm). The most common adverse events related to TMS treatment are scalp pain or discomfort at the treatment area. NeuroStar TMS Therapy is contraindicated in patients with implanted metallic devices on non-removable metallic objects in or around the head.

In clinical trials, patients treated with active NeuroStar TMS Therapy experienced an average reduction in their depression symptom score of 22.1% compared to a 9% reduction in patients receiving inactive treatment (Neuronetics data on file). In a Neuronetics-sponsored, open-label clinical trial, approximately one in two patients experienced significant improvement in symptoms, and one in three experienced complete symptom resolution. NeuroStar TMS Therapy has not been studied in patients who have not received prior antidepressant treatment; efficacy has not been established in patients who failed to benefit from two or more antidepressant medications at minimal effective does and duration in the current episode (Demitrack, MA, Thase, M. Psychopharmacology Bulletin. 2009;42(2), 5-38).

“Having patients reach remission should be the goal for every physician,” said Demitrack in regards to sham-controlled study noted above (http://archpsyc.ama-assn.org/cgi/content/abstract/67/5/507). “We are encouraged to see that the odds of patients achieving remission with TMS were four times greater when compared to the sham group. This data confirms and replicates our prior clinical data for NeuroStar TMS Therapy and we look forward to further exploring additional benefits of TMS Therapy for patients.”

*NeuroStar TMS Therapy is indicated for the treatment of major depressive disorder in adult patients who have failed to achieve satisfactory improvement from one prior antidepressant medication at or above the minimal effective dose and duration in the current episode. For full prescribing and safety information, see www.NeuroStarTMS.com.

Adapted from materials provided onsite at the APA Annual Meeting by Neuronetics.