Recently, the incidence of depression has been growing, the World Health Organization (WHO) compares depression with an epidemic, according to WHO, by 2020, depression will take first place in the ranking of all diseases, ahead of the pathology of the cardiovascular system and infectious diseases.
Today, depression has become the most common disease among women. In addition, depression has become “younger”, if earlier the peak incidence was in the period from 30 to 40 years old, now people younger than 25 years old are increasingly getting sick. All this forces scientists around the world to develop new effective
ways to deal with this disease.
Despite the fact that today the most effective treatment for depressive disorders is cognitive-behavioral therapy, in a large number of cases in combination with drug therapy aimed at the production of serotonin in the brain, but despite the success of psychopharmacology and the abundance of drugs on the antidepressant market, approximately 20 – 40% of cases (Mosolov S. N., 1995; Smulevich A. B., 2002) this method does not work, and this is where an alternative method of non-drug exposure comes to the rescue – stimulation of the cerebral cortex through TMS.
Transcranial magnetic stimulation allows you to perform non-invasive stimulation of the substance of the brain by means of magnetic impulses, that is, the magnetic field penetrates the skin, muscles, aponeurosis, cranium and does not change their characteristics, having reached the goal (brain neurons), excites them. The method was developed in 1980 and previously had very few indications and was used mainly as an additional diagnostic in neurology.
As a drug-free therapy for depression, TMS began to be used in 1985 ( Barcer A., et al ., 1985). The method has been proposed as an alternative to electroconvulsive therapy (ECT). Transcranial magnetic stimulation has significant advantages over electroconvulsive therapy:
- impulses do not reach the seizure threshold
- no decrease in cognitive functions after the procedure
- more precise and targeted impact on the brain regions that are involved in the development of depression (hippocampus).
There have been many studies on the effectiveness of TMS in depression, including placebo-controlled ones, and 2 meta-analyses have been published .
As a result, TMS is a registered treatment for depression in many countries.
Description of the procedure.
The patient sits down in a chair or lies down on a couch; before starting, the doctor conducts a test to assess the patient’s response to the device. A device for TMS is brought to the head, which is a coil generating a magnetic field, the device moves as necessary. During the session, clicks are heard when current pulses pass through the coil.
After the procedure, the patient can continue to go about their business. In the non-drug treatment of depression, TMS is performed in courses of 10-15 sessions, each lasting about 30 minutes, usually stimulation is given every other day. As a rule, even after the first TMS procedure, you can feel the result –
relaxation, anxiety is less pronounced, sleep improves.
Transcranial magnetic stimulation is rarely prescribed as monotherapy , in most cases it is used as part of complex treatment.
Contraindications for TMS:
- the presence of a pacemaker
- built-in insulin pumps in diabetic patients
- operations for the treatment of aneurysms and other anomalies of cerebral vessels in history
- the presence of metal implants in the cranial cavity, including implants in the inner ear
Usually the procedure of magnetic stimulation is well tolerated, in rare cases there are side effects:
- nausea and stomach pain
- redness of the face
- minor headache
- contraction of the muscles of the face or head
Summarizing the above, we can conclude that a new method of non-drug treatment of depression has appeared with proven effectiveness, which has a minimum of contraindications and side effects, which can be used both for the treatment of depression resistant to pharmacotherapy and at the initial stage of depressive disorders.