In some cases, depression isn’t adequately relieved by pills and talk therapy—a condition called “treatment-resistant depression.” That name might sound scary, as if there’s nothing you can do about it. But other alternatives are available—and now, one decades-old therapy for treatment-resistant depression has been tested in a new form that promises to help more people than ever.
Treatment-resistant depression is surprisingly common, striking an estimated 30 to 50 percent of all people who have depression. One treatment that may help control it is a type of brain stimulation therapy called repetitive transcranial magnetic stimulation (rTMS). It sends magnetic pulses into the brain that seem to reset key neural circuits, relieving depression symptoms. Experts don’t completely understand how rTMS works, but it has proven its worth in numerous studies.
During an rTMS treatment, a magnetic-coil device is held near the forehead. The magnetic field it creates is about as strong as what you’d get from a magnetic resonance imaging (MRI) scan. Treatments take about half an hour and are usually repeated 20 to 30 times over several weeks. There’s no need for an anesthetic; patients remain awake.
A Better Way?
The new version of rTMS is called intermittent theta burst stimulation (iTBS). It sends more powerful magnetic pulses into the brain while mimicking the brain’s natural rhythms. And it does the job in just three minutes.
Putting iTBS To The Test
Researchers wondered whether the shorter magnetic treatments would work as well as the longer ones. To find out, they divided 414 volunteers who had treatment-resistant depression into two groups. Over six weeks, one group got standard half-hour rTMS treatments while the other got three-minute iTBS treatments. The shorter treatments more than held their own:
- 49 percent of the people who got three-minute iTBS treatments found their depression symptoms were significantly reduced.
- 32 percent said their depression went into remission, compared to 27 percent of those who got the longer rTMS treatments.
The benefits of iTBS therapy continued for an average of four to six months. These improvements are especially impressive because they were achieved in people who have depression that doesn’t respond well to traditional treatments.
This Canadian study was co-led by the Centre for Addiction and Mental Health (CAMH) and the University Health Network’s Krembil Research Institute, in collaboration with the University of British Columbia.
The Bigger Picture
Growing public awareness of brain stimulation therapy has increased demand, causing some people to face long waits for appointments. Shorter treatments would enable more individuals to get the care they need for hard-to-treat depression.
“The number of people who are able to be treated using theta burst stimulation compared to the standard form of rTMS can be increased by three- to four-fold,” said lead author Dr. Daniel Blumberger, co-director of the Temerty Centre for Therapeutic Brain Intervention at CAMH, in a news release.
Should You Try Magnetic Brain Stimulation?
More research is needed to better understand how magnetic brain stimulation works and the safest and most effective ways to use it. There’s no word yet on how soon the shorter iTBS treatments might be widely adopted. For now, it may be easier to find rTMS therapy.
If you have treatment-resistant depression, talk with your doctor or therapist about these and other therapy options. And be sure to ask your health insurance provider whether they’re covered.