Deep Transcranial Magnetic Stimulation (dTMS) for Depression and OCD Treatment

Dr. Oscar Morales, Senior Medical Advisor at Achieve TMS East, discusses deep TMS (Transcranial Magnetic Stimulation) a non invasive procedure for the treatment of depression, with no known side effects. It has also been FDA approved (August 2018) for the treatment of OCD.

Dr. Morales is a psychiatrist and Senior Medical Advisor at Achieve TMS East. For almost two decades, he has served and continues to be the Director of TMS at McLean Hospital, the Psychiatric Affiliate Hospital at Harvard Medical School.  

Transcript

Neal Howard: Welcome to the program, I’m your host Neal Howard here on Health Professional Radio. Joining us in the studio today is Dr. Oscar Morales, Senior Medical Advisor at Achieve TMS East and he’s joining us to talk about Deep TMS – a non-invasive procedure for treating depression. Welcome to the program Dr. Morales, thank you so much for taking the time.

Dr. Oscar Morales: Thank you very much for inviting me, it’s a pleasure being with you.

Neal: Now as Senior Medical Advisor at Achieve TMS East, what type of a company, a business is this – Achieve TMS?

Dr Morales : Achieve TMS is an organization, is the nation’s largest provider of Deep TMS services. So they opened the first Deep TMS clinic in December 2016 in Northampton,  Massachusetts and 15 months later, they celebrated their eleventh clinic. So eventually they plan to have sites in Connecticut and other states, probably New York, New England and the Northeast.

Neal: So exactly what is TMS?

Dr Morales: Well TMS is a technology, this Deep TMS therapy is FDA cleared by FDA. It’s a therapy developed for the treatment of major depressive disorder and Deep TMS is a non-invasive treatment which stimulates the brain regions responsible for depression and brings significant improvements to patients. It is an outpatient treatment procedure which doesn’t require admissions, hospitalizations or anesthesia. It also entails no memory loss or systemic side effect.

Neal: So there are absolutely no pharmaceuticals involved when dealing with TMS or transcranial magnetic stimulation. Do you put magnets on the head or something like that?

Dr Morales:  That’s right. The magnetic field is delivered directly to the brain in a non-invasive way while the patient is fully awake, fully alert, is relatively comfortable in these magnetic field pulses that affect the left prefrontal cortex and this is the part of the brain that is thought to control depression stimulating nerve cells, neurons and is believed to activate neuro chemical events including the release of neurotransmitters helping to normalize neurotransmitter function.

Neal: Is there a difference between major depressive disorder or MDD and regular depression? Is there such a thing as regular depression or does all of it fall under MDD?

Dr Morales: Well it’s a great question because and people may suffer from sadness, sometimes mild symptoms of depression but Major Depressive Disorder is a clinical condition that requires Treatment. It’s a condition that affects really many people, 15 million at adults in the United States is estimated to suffer from depression. Sixteen percent of the population will have what we consider the clinical condition Major Depressive Disorder during their lifetime and up to two-thirds of the patients suffering from major depressive disorder will not respond to the first medication prescribed and up to 34 percent of the patients will not respond to antidepressant medication at all.

Neal: Is there a method by which these magnets are administered to the patient? I mean do you just lie the patient down and stick some magnets on their head or is there some type of apparatus or device that imposes these magnets to be able to be used?

Dr Morales: Yes, it is a helmet. It’s a cushion helmet, it doesn’t involve any invasiveness in the skin, in the patient’s body, nothing at all. The magnetic field penetrates from the coil, this  cushion helmet stimulates the prefrontal cortex of the brain with brief magnetic fields at an amplitude that is very similar to that using x-rays, MRI’s technology.

Neal: Does it work on children adolescents as well as adults and do you see any differences between men and women when utilizing this technology?

Dr Morales: Most of the studies had been conducted in adults in fact FDA approved the treatment for adults from 22 years of age to 68 years old. However, there is intensive investigation in younger people and the necessity to develop this type of technology for children,  it is important. So you ask about how these different other responses may be different from men to women and the answer is the responses rate are the same. So we can tell with property, it does regardless of your gender, you have 70% chances of response to Deep TMS technology.

Neal: What about keeping your depression at bay using this technology? Are we talking after the first treatment or second treatment total elimination of depressive symptoms or do these symptoms tend to come back with the same frequency as if a person were using medication?

Dr Morales: Neal thank you for asking, this is a great question because assuming that our patients get better and 70% of them will recover. So what is going to happen later, is depression gone forever? And I have to explain and tell the audience that this is a chronic condition. Major Depressive Disorder is a chronic condition that may eventually come back. This return or relapse episodes of depression needs to be prevented and psychiatrists in the medical field is doing everything possible to prevent patients from developing symptoms again. Therefore, now we have a technology that is not only going to treat patients offering them 70% recovery but hopefully, preventing them from developing symptoms again. Some studies have shown that pages may achieve stability for prolonged periods of time up to one year and some other stories longer.

Neal: How long does a session normally last with this helmet on?

Dr Morales:  Typically this session is a 20 minute session and happens in a psychiatrist office and we recommend patients receiving treatments for up to five weeks. After each session patients can return home independently and they carry out normal routines so there’s no restriction before the treatment, no restrictions after the treatment.

Neal: Now is this five weeks of daily sessions or five weeks of weekly sessions? How frequently do they have to wear the helmet?

Dr Morales:  It is a 20-minute session. They are awake, they are able to communicate, we are making sure that the patient feels comfortable and they don’t have to wear anything after the 20 minutes. They just go back to regular activities, work, business, school and we ask them to come back next day for another 20 minutes session. They sit and they receive the Deep TMS stimulation with the helmet expected.

Neal: So it’s it’s everyday for five weeks.

Dr Morales: After a week, things will start changing. Every day from Monday and Friday.

Neal: Well is this treatment currently available only in the United States?

Dr Morales: It’s currently available in the country, in the United States but it’s also available in Europe and South America so it’s widely available at this time.

Neal: Where can we go online and get some more information about TMS and about Achieve TMS East specifically?

Dr Morales: The audience can access at the web and just by clicking on achievetmseast.com is they quickly will have the option of accessing the organization if they want to learn more about brains wave Deep TMS, the same thing applies. They can always type brainsway Deep TMS and they will have the brainsway company website at brainsway.com. That will offer many options regarding information and especially information about studies and trials.

Neal: Dr. Morales thank you for joining us here on Health Professional Radio today. I’m hoping to speak with you again,

Dr Morales: Thank You Neal. It’s great and I had no doubt in my mind that this will help many patients and open opportunities for people that didn’t have access in the past.

Neal: You’ve been listening to Health Professional Radio, I’m your host Neal Howard. Transcripts and audio of this program are available at hpr.fm and healthprofessionalradio.com.au. You can subscribe to the podcast on iTunes and be sure and visit our Affiliate Page at hpr.fm and healthprofessionalradio.com.au

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