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UCSD Health offers procedure for depression that’s ‘going to revolutionize how we treat mental health’

Dr. Zafiris "Jeff" Daskalakis administers a transcranial magnetic stimulation, or TMS, treatment.
(Courtesy of UC San Diego Health)

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For many people with depression, medication and therapy provide a powerful treatment combination. But for those with treatment-resistant depression, UC San Diego Health offers another option.

It’s called transcranial magnetic stimulation, or TMS, and UCSD Health now boasts the largest and most advanced TMS clinic in the region.

TMS is a non-invasive procedure approved by the U.S. Food and Drug Administration that involves using a handheld coil to apply a series of short magnetic pulses to stimulate nerve cells in areas of the brain known to be associated with major depression.

“It causes neurons to fire in a synchronous way,” said Dr. Zafiris “Jeff” Daskalakis, chairman of UCSD’s Department of Psychiatry. “That synchronization results in neuroplasticity, or the rewiring of the brain.”

With the treatment, Daskalakis said, “people no longer suffer from depression.”

One-third to one-half of patients with treatment-resistant depression become symptom-free following TMS treatment, according to UCSD Health. Others may experience an improvement in mood and then find that antidepressants, talk therapy and lifestyle changes (such as in diet and exercise) provide additional relief.

For most patients, the treatment involves sessions lasting five to 60 minutes, with five sessions a week for four to six weeks, Daskalakis said. He added that 90 percent of patients experience few or no side effects. At worst, he said, some might have a slight headache afterward, which usually goes away within 24 hours.

Treatment is performed in an office and requires no anesthesia or sedation; patients remain awake during the procedure. They can return to normal daily life immediately after treatment, Daskalakis said.

“I think it’s going to revolutionize how we treat mental health and change lives,” Daskalakis said. “[Patients] get a significant quality-of-life boost. They sleep better, their worries are down, it is a very robust response. It’s very reassuring. We get to deliver this very effective, safe, well-tolerated treatment.”

Daskalakis previously was a professor of psychiatry at the University of Toronto and co-director of the Temerty Centre for Therapeutic Brain Intervention, where the treatment was refined.

Before the use of TMS, he said, “people would either suffer in silence or try medication trial after medication trial, with no success.”

Once someone has tried a certain number of depression medications that were ineffective, the person can be considered a candidate for TMS. The process to be considered depends on one’s insurance carrier.

The UCSD facility is looking to embark on an accelerated treatment trial program through which patients would undergo multiple sessions a day for fewer days. “There is very exciting data that suggests multiple bursts in one day will shorten the treatment period,” Daskalakis said. The risks are considered “very remote” and similar to those with anti-depressant medications, he said.

“Depression is a leading cause of illness-related burden worldwide,” Daskalakis said. “It has the most impact on the economy. Cardiovascular disease and cancer affect more people, but those people are often older. Depression affects people in the prime of their life.”

Clinics are at 8950 Villa La Jolla Drive in La Jolla and 16918 Dove Canyon Road in 4S Ranch. Learn more at health.ucsd.edu/specialties/behavioral-mental-health and click on “Depression treatment.”

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