Magnetic therapy for chronic depression is in such high demand in the Twin Cities that Allina Health is doubling its capacity with the opening of a new mental health center in Fridley.
While antidepressants and talk therapies remain first-line options, Arena psychiatrist Dr. Bennett Poss said that increasingly more patients are not helped by those treatments alone and alternatives are needed. Transcranial magnetic stimulation has been an option in the US for 15 years, but it has emerged as more people seek treatment for depression in the post-pandemic era and more research demonstrates its potential.
“The evidence is that this is one of those things that actually works, or at least what’s advertised,” said Poss, who provides TMS at Abbott Northwestern Hospital in Minneapolis. “We’ve seen a lot of things that work well in clinical trials, but then when you actually use it to treat patients, it doesn’t work so well.”
TMS involves placing a magnetic coil on the scalp for about 30 minutes, sending pulses to golf-ball-sized targets in the brain that normally regulate mood. After one to two months of five-day-a-week treatment, about half of patients report some benefit, and a third see a reduction in their depression symptoms. the study I showed it.
Poss likened it to weightlifting or running, saying it stimulates parts of the brain that are underutilized in people with depression.
“We’re working out more frequently than we normally would, and over time, the same changes occur in our bodies that you would see if you actually exercised,” he said.
More than 23% of Minnesota adults reported having suffered from depression in 2022, up from 15% in 2011. Survey data According to the Centers for Disease Control and Prevention, Minnesota has improved from below the national average during that period to now be at or slightly above the national average.
TMS is only recommended for a small percentage of patients diagnosed with major depression, a condition characterized by severe and long-lasting sadness and hopelessness. But clinicians say the number of patients diagnosed with major depression is on the rise.
“The great thing about (TMS) is that once you get it and you respond to it, you don’t necessarily have to continue the treatment, so in some ways it’s different from medication,” said Dr. Sophia Albot, director of the division of adult mental health at the University of Minnesota.
The treatment originated in the US, where Dr Ziad Nahas was involved in the clinical trials that persuaded the Food and Drug Administration to approve it for the treatment of severe depression in adults in 2008.
The treatment was originally limited to patients who had tried at least four antidepressant medications without success or who had serious side effects, Albot said. The federal Medicare program recently expanded coverage for TMS, allowing patients to receive it after trying just two medications, which has contributed to the recent increase in Minnesota.
Coverage in Minnesota varies by insurance plan and employer. HealthPartners typically uses prior authorizations within its plans to ensure patients have tried other treatments first, but Medica doesn’t use that limit.
Albot said he hopes the therapy will soon be used as a first-line treatment, but that the time it takes and the cost, about $10,000 shared by patients and insurance companies, will remain barriers. Recent U studies have sought to predict which patients will respond best to TMS, whether they would experience a greater interest in everyday life and less suicidal urges, and whether TMS could also be applied to adolescents and neurological disorders such as stroke.
The treatment is already approved to treat smoking and obsessive-compulsive disorder, and some researchers believe it could also treat ringing in the ears, a condition known as tinnitus, which has also reportedly increased during the COVID-19 pandemic.
Becky Stephens, 39, of Coon Rapids, said she’d suffered from depression for 15 years but didn’t think it would work. Her success at the U Clinic for treatment-resistant depression came when her doctor switched sides and applied magnetic pulses to the right side of her brain. Research has found that some patients need stimulation on that side to regulate another part of the brain that fuels negative thoughts.
The treatment was not easy, she said, because it interfered with her work, was noisy and uncomfortable: “It felt like a bird was pecking at the same spot on my head over and over for 50 minutes.”
And the treatment wasn’t a one-and-done affair — two sessions were required, plus weekly maintenance treatments, in addition to other depression medications — but TMS gave Stephens complete relief for several months, and reduced her symptoms for the rest of the time, allowing her to find joy in life, like painting and volunteering.
“It gives me a sense of baseline that I’m not necessarily happy and joyful and everything is fine, but I’m not sad or stuck,” she says. “It feels like a place where I can have emotions, feel them, and then come back to that baseline… and not get bogged down in negative, troubling thoughts.”
Poss said other treatments will likely be needed, such as the more powerful but highly effective electroconvulsive therapy, which induces a patient into a seizure and “resets” the brain without causing depression.But he said he’s especially optimistic about TMS now because it’s garnering interest and its growing use at Allina’s Mercy Hospital campus in Fridley.