Treatment-resistant depression, also known as refractory depression, is one of the most crippling and emotionally devastating mental health conditions there is. The lack of hope in ever recovering from an illness that does not respond to conventional treatment can lead some into a deadly downward spiral. Many good medications have been developed to treat Major Depressive Disorder (MDD) over the years, but sometimes the disorder is too severe for any medication to work. Intensive treatments, such as ECT (electroconvulsive therapy), are very effective but have severe side effects. This leaves many patients seeking a better solution. This dire need for a better solution led to the FDA approval of TMS in 2008. Deep TMS was approved by the FDA in 2013, taking a really good thing and making it even better.
Deep Transcranial Magnetic Stimulation, also known as Deep TMS or dTMS, refers to a more effective and deeply penetrating form of TMS treatment, now possible using the newer generation of TMS technology. The Brainsway® Corporation, developer of dTMS, has engineered the H1 dTMS coil that was approved by the FDA for the indication of treatment-resistant depression. The H1 coil produces a magnetic pulse that stimulates a larger area than the traditional figure-8 coil used in regular TMS. The stimulation also penetrates deeper, reaching 1.7 centimeters into the cortex. The greater benefits of this therapy are connected to both the more complete stimulation of the target area, as well as some stimulation of the neighboring areas of the brain that interconnect with the target area. The risk of dramatically losing efficacy from deviating even just 1 mm from the target area is greatly diminished using a Brainsway® Deep TMS device, as compared to a traditional figure-8 coil, due to the larger and deeper area of stimulation. This helps yield higher rates of both response and remission for treatment-resistant depression.
Conventional Transcranial Magnetic Stimulation therapy is performed using a “Figure-8” shaped coil, that delivers a focused magnetic pulse that reaches 0.7 cm beneath the surface of the skull. TMS machines using this coil are manufactured by Neuronetics, Magstim and Magventure. A TMS session using a traditional “Figure-8” coil takes approximately 40 minutes.
Deep TMS is performed using a Brainsway® dTMS machine equipped with an H1 coil instead of the “Figure-8” coil. The magnetic pulse produced by the H1 coil is focused, but covers a broader area that a “Figure-8” coil. The H1 pulse also reaches 1.7 cm below the surface of the skull. A dTMS session using the H1 coil takes approximately 9-12 minutes in most cases, depending on the dose necessary.
TMS therapy involves a series of 36 treatment sessions. Deep TMS using the advanced H-coil can deliver a complete depression treatment session in only 9-12 minutes. Advanced protocols that involve treating more than one location of the brain, including the increasingly popular theta burst technique, may take an additional 2 to 6 minutes. A very effective and frequently used treatment course protocol for Deep TMS includes treatments administered 5 days a week for the first 6 weeks and then twice a week for 3 weeks.
All potential TMS candidates must undergo a psychiatric evaluation and initial brain-mapping before starting TMS therapy. To start your depression treatment journey, contact our office today at 888-551-6281
For appointment requests please text 561-287-5042 or if you have medication concerns please text 561-409-7296.