Magnetic pulses might lift depression's 'cloud'

TRANSCRANIAL STIMULATION | New technique an option if drugs fail

For 20 years, depression dogged Stan Dowery. "It always felt like there was a cloud over me," says Dowery, who lives in the South Side Kenwood neighborhood. "I never felt that I would get better."

He'd seen multiple psychiatrists and tried several antidepressants. Nothing worked. And each new pill came with "terrible" side effects, like weight gain and sexual dysfunction.

So Dowery decided to try a new treatment approach that involves beaming magnetic pulses into the brain to relieve depression. It's called transcranial magnetic stimulation, or TMS. It's the first non-invasive brain-stimulation procedure available to patients who don't respond to standard treatments for depression.

Dowery says he noticed a difference in his mood within a week of starting TMS therapy in August. "There was this energy in me like I hadn't felt in a long time," he says. "It was like something inside of me changed."

Dowery was treated at Rush University Medical Center, one of a half dozen Chicago area providers that began offering the treatment after its approval by the federal Food and Drug Administration last fall. The Northwestern Medical Faculty Foundation also provides TMS therapy and plans to open a clinic next spring.

Magnetic pulses -- about the same strength as those produced by magnetic resonance imaging, or MRI -- are aimed at the brain's prefrontal cortex, stimulating nerve cells in the part of the brain linked to depression, according to Dr. Philip Janicak at Rush, who was among the first to test the NeuroStar TMS device in clinical trials.

Patients undergo daily 40-minute sessions for four to six weeks. No anesthesia or sedation is required. Many patients experience tension headaches and temporary pain or discomfort at the application site. Still, it's less invasive than electroshock therapy, still widely used as a last resort for depression. Antidepressants don't work for about one-third of patients, according to the National Institutes of Health.

Experts say there's not enough evidence yet to prove that TMS works as well as electroshock. Data presented last month at a conference in Philadelphia showed that half of patients who received TMS saw significant improvement, 30 percent showed a slight change and 20 percent saw no effect, according to Janicak.

The treatment can be costly. Five weeks of TMS costs about $7,000 to $8,000 -- thousands less than electroshock, but most insurance companies don't cover the newer therapy.

Dowery took out a loan to pay for his treatment. He says it was worth it.

"I haven't told anybody, but people look at me differently now," he says. "They ask did I change something."