I think this is a great alternative to brain damaging E.C.T.

I personally I am not convinced that ECT damages the brain. There is also literature to the fact that ECT stimulates neurogenesis. I do know it has the potential to cause serious memory and cognitive side-effects but then too I’ve found memory and cognitive side-effects in those who suffer MDD (Major Depressive Disorder) both untreated and treated without the use of ECT.

What I am glad to learn is that there is another potentially helpful therapy choice exhibiting far less side-effects for those who do suffer MDD.

The current financial question for those patients interested in the therapy is whether or not CMS and the health insurance industry will reimburse the patient or provider for the treatments. The therapy does not come cheap and from my readings and knowledge the effectiveness is not long-lasting.

Warmly,
Herb
VNSdepression.com

I believe this started with some trials at Duke more than four years ago....

It's interesting because some of the other, more eye-catching uses of rTMS were strictly temporary (ostensibly).

There's a decent enough overview of TMS at the Center for Cognitive Liberty, and an abstract of a recent controlled depression study in Nature.

From reports I have read, I got the impression it was not considerably more effective than placebo. As Carlat says, "the amount of improvement was not robust". This was in January 2008. He did not believe it would be accepted by the FDA. I guess the FDA is not opposed to approving something that is not much better than placebo.

Herb, I'm sure if you were force-electroshocked as so many of us have been, you'd be convinced. Even the earliest proponents of electroshock have now changed their minds. And the electroshock causes neurogenesis crap belongs in the trash can along with the similar garbage about antipsychotics.

I think this is an expensive alternative to E.S.T.

When pills or ECT cause neurogenesis please do not necessarily assume this is a good thing. Strokes and other examples of trauma to the brain also cause neurogenesis. There is no evidence that the neurons that "sprout" as a result of these insults to the brain are healthy neurons. The "scientists" that claim neurogenesis is evidence of some "neuroprotective" effect are making a big leap of logic that's based on some nice sounding assumptions but no real proof of what's going on.

Professional experience:

I have seen patients who are moreso characterologically impaired than truly mood disordered impaired do terribly with ECT.

As per this transcranial technique, it is truly hit or miss with patients; the lowdown I am privy to is there are a lot more post procedural headaches depending on length of time with the magnet exposure.

Is less invasive than ECT, so in this regard should be considered an earlier intervention with some types of patients. NOT geriatric, profoundly suicidal, psychotic, or anorexic type symptoms with depression though; ECT is effective in these groups.

By the way, ECT is NOT what is shown in movies like Cuckoo's Nest in the past 25 years. It is humane and appropriately applied.

Will not bite on debates here. Just offering another opinion/perspective to readers. Like the Lamictal posting.

therapyfirst (b.c. pdoc)

acts can be done in a humane manner that are not, themselvs, humane.

ECT with or without anesthesia causes the same effects so the only difference is that it's painless during the process.
I don't see anything, repeat, anything new on depression treatment as well as on any other mental illness diseases.
It's amazing that researchers keep on doing clinical trial with the drugs that are on the market, keep on with treatments based on old hypothesis and no new discover on mental illness has been done in many decades.
We are still on the mapping the brain era. It's nothing.

"characterologically impaired"

TF, what the hell does this phrase mean? You assess people's characters for defects? Who do you use as the gold standard? What a pile of crap psychology and psychiatry are!

Also, electroshock is not "humane and appropriately applied." It is usually done without the informed consent of the patient. It can be used coercively and it can be forced. Having invasive brain procedures done against one's will is hardly "humane" or "appropriate." Give me a break.

...and if we eliminate the prefrontal cortex of the patient, we no longer have the signs, symptoms, and behaviour of mental illness... and if we eliminate the memory and personality of the patient we no longer have the signs, symptoms, and behaviour of mental illness. But we do still have the patients body to give back to their family, so it is a success. and we get paid.

I am not here to argue with those who suffered lasting effects from ECT or who want it banned. In a flimsy armamentarium of "therapies" let me merely say that both my children, whether profoundly suicidal or acutely psychotic, benefitted from ECT. Personally, I think the benefit was short term memory loss in the case of suicidality; i.e., they forgot they were going to kill themselves.

Spoken by a person whose father was killed by ECT in the early forties - the early, riskier days of ECT.

As I have asked others leading the parade to ban this "treatment", I ask again - if not this in a critical situation, then what?

Sorrowful, you pose a good question. All I know is that many people who are considered to have treatment resistant depression are told that ECT is their only hope, the only thing left to try - when it's not true. I think it's important to consider how powerful those kinds of statements are to someone who is already at the end of his/her rope. I can tell you that hearing my pdoc make statements like this only fed my hopelessness. ECT was not my only hope, not even close.

I'm not sure there was any one thing that changed my life for the better, but getting away from my pdoc who reinforced my feelings of hopelessness was probably a big part of it.

"Will not bite on debates here. Just offering another opinion, perspective to readers." Just that reminder; i.e., comment speaks as written.

I do appreciate what Sorrowful offers above though. Thank you, for what it is worth to you.

Interesting word, armamentarium. Will have to look it up when I get home. Got to have that dictionary at the house when I am commenting there.

Sorrowful, your father and two of your children were all electroshocked? That's unbelievably sad.

You ask "if not this in a critical situation, then what?" I'm afraid I don't have an answer for you (every person is different) but no answer is better than brain damage.

And if consent is informed, by all means, zap away. My problem is when electroshock is coerced or forced and this does happen.

If TMS is classified as an experimental treatment that some people might choose to try for themselves after studying what's known about it, then it might be a less destructive alternative to ECT. Psychiatric treatments (like ECT) do more damage when they are regarded as commonly accepted procedures, because then it is easier to force them on people who don't want them. Or people can be misled into having them because the service providers are so sure that the results can only be positive.

When people talk about only whether one or not a psychiatric treatment is effective, they ignore half the issue - what kind of damage the treatment may do, and the destructiveness of forcing it on someone who doesn't want it.

I don't know what changes may have been made in how ECT is administered today compared to two or three decades ago, but I suspect that even 25 or so years ago psychiatrists were probably saying that it was improved over what it had been in the decades before that. Defenders of any psychiatric treatment are much more willing to admit to abuses in the past than in the present.

In the mid-1970s I had forced ECT treatments, about eight to ten times, and I have quite a bit of permanent memory loss as a result. Not that memory loss is necessarily always a bad thing, but I think people should always be able to choose and to know about the likely effects - I take it that most psychiatrists and other mental health professionals disagree. I doubt that any psychiatric treatment is always "humane and appropriately applied" (as therapyfirst said of ECT), but I suppose it could be relatively more that way now than in the past.

I don't know if it is possible for any treatment given forcibly to be humane, but if it is I think it is very rare for that to be the case. The people who make their livings from administering treatments that are sometimes given forcibly will always minimize the inhumaneness of what they do.