Blog | Friday, October 10, 2008

A new, and somewhat puzzling, depression treatment

So the FDA just approved this new gadget that looks like a dentist chair, but in fact is a device to treat depression. The NeuroStar Transcranial Magnetic Stimulation device delivers a magnetic pulse to a specific part of your brain-- sort of like a much milder version of electroconvulsive therapy, and one that doesn't involve seizures.

The device is only indicated in patients who have tried one antidepressant. You may have tried that drug four different times at four different dosages, but you must have tried just that one drug.

The company-sponsored study didn't test the device against switching to another antidepressant, but only to placebo. (And it did twice as well as placebo.) One advantage the TMS offers is that it doesn't have the nasty side effects one can get with pills, like weight gain and loss of libido.

I do wonder, though, how many patients are going to decide, after failing to get any response from one antidepressant, that they want to strap themselves into a scary-looking chair and have their brains zapped, rather than just trying a different drug. Especially since the TMS treatment requires that you be awake when you get it, and the normal therapy course is 40 minutes every day for 4-6 weeks.

What do you say? Would you recommend this kind of treatment to patients?