Beyond the Numbers: TMS Depression Outcomes Registry
The NeuroStar® Advanced Therapy depression outcomes registry was recently announced with 500+ patients, and 62% of patients experienced significant improvement in their depression symptoms.
Why is this important?
FDA-cleared in 2008, TMS uses MRI-strength magnetic field pulses to treat depression in patients who have not benefited from prior antidepressant medication. The registry is a way to assess how TMS (specifically NeuroStar TMS Therapy) works in the real world outside of clinical trials. The registry de-identifies patients that have been treated with NeuroStar Advanced Therapy TMS system at providers who have agreed to participate.
A rating scale, the PHQ-9, evaluates patients before and after the treatment course. A reduction of 50% in the rating counts as a response. The registry looked at data from 503 patients who received NeuroStar® TMS at more than 50 sites across the United States. Of these patients, 64% were female, and the mean age was 48 years old. (1)
4.5 million people in the United States are being treated for depression but do not benefit from antidepressant medication. (2) TMS offers these people a treatment option that is free from the side effects often associated with antidepressants. This is significant because the STAR*D study reported that when patients do not respond to one antidepressant, the rate of response decreases and side effects increase with each subsequent antidepressant trial. This study looked at 4,000+ patients at 41 sites through a series of four levels of antidepressant treatments including medications and psychotherapy. (3)
Ineffective medication leaves many people struggling as they deal with life with depression. Depression affects relationships and work, and it increases the risk of physical illness. Depression costs U.S. businesses $35 billion a year in reduced productivity. Fatigue, irritability, as well as decreased concentration, are symptoms of depression that can interfere with work productivity. Many times employees do not want to be public about depression due to stigma. However, this must change for people to get the help that will enable them to be more productive at work and in all areas of their lives. (4)
Research in academic settings continues to show positive results from TMS, and five companies now manufacture TMS systems with FDA clearance. Those in private practices that utilize TMS have numerous stories of the positive changes seen as a result of TMS. This includes patients feeling better and functioning better in both their family and work.
These initial findings from the registry are just the beginning of data collection. Over time we will have more evidence to educate and enlighten patients, families, businesses and insurance companies about the value of TMS in the treatment of depression.
As TMS therapy progresses, challenges include figuring out what can be done to enhance this treatment and find ways to improve the numbers. After all, getting patients better is the goal. The more that is understood about how TMS works, the better doctors’ decisions will be in the future.
(1) National Center for Biotechnology Information, U.S. National Library of Medicine (https://www.ncbi.nlm.nih.gov/pubmed/12813115)
(2) National Center for Biotechnology Information, U.S. National Library of Medicine (https://www.ncbi.nlm.nih.gov/pubmed/22689344)
(3) National Institute of Mental Health (https://www.nimh.nih.gov/funding/clinical-research/practical/stard/allmedicationlevels.shtml)
(4) EHS Today (http://ehstoday.com/safety-leadership/presenteeism-costs-business-10-times-more-absenteeism)