A new device acquired by Yale Interventional Psychiatry Service (IPS) has dramatically reduced the amount of time patients have to sit while undergoing transcranial magnetic stimulation (TMS) for major depressive disorder.
The MagVenture TMS Therapy system has shortened the TMS delivery time for most patients with depression from 39 to three minutes per day. Rachel Katz, MD, assistant professor of clinical psychiatry at Yale School of Medicine and co-director of the TMS service, said the new delivery method – known in the industry as “Intermittent Theta Burst Stimulation” – is equally efficacious to standard TMS but is delivered much more efficiently.
“In terms of patient experience and logistics it makes it much more feasible for patients,” said Katz, adding the shorter treatment time is more convenient and better tolerated.
TMS is one of the many services offered by IPS for patients with complex psychiatric illnesses for whom traditional psychotherapies and medications have not been effective. With TMS, magnetic pulses are delivered from a coil placed on the head to stimulate nerve cells in the part of the brain thought to be dysregulated in mood disorders or obsessive-compulsive disorder (OCD).
Repeated stimulation to certain brain regions can have antidepressant effects or provide relief from OCD symptoms.
TMS does not require hospitalization, anesthesia, or a drug regime, and uses brief magnetic fields, not unlike those used in diagnostic magnetic resonance imaging (MRI).
Katz said TMS is highly effective, safe, and tolerable, but remains an underutilized treatment for people who suffer from the most serious forms of depression or OCD.
Unlike some drug treatments, people who undergo TMS – which is covered by many insurance companies – can eat and drink as usual, drive themselves to appointments, and will experience very few side effects.
“People are getting better. We’ve had good results so far,” Katz said. “People definitely find the shortening of the (treatment) time more appealing.”
IPS, located at Yale New Haven Psychiatric Hospital, is among the first hospitals in Connecticut to offer treatment using standard TMS and the more efficient Theta Burst method.
Katz said the hospital bought the MagVenture device to significantly upgrade the technology in the IPS suite so it can serve more patients more efficiently. The device has the capability to perform accelerated TMS protocols, which may lead to a faster response.
The hospital also bought a special coil for the machine that will enable technicians to offer TMS for patients with OCD, a separate stimulation pattern and protocol than is used for patients with major depressive disorder. The coil is designed to target the area of the brain dysregulated in OCD, and the protocol includes behavioral priming individualized to each patient’s symptoms.