What is major depression?
Depression is a serious medical illness that lasts two or more weeks and interferes with a person’s ability to carry out daily tasks and enjoyed activities that previously brought pleasure.
What causes major depression?
The exact cause of depression is not known, but the leading scientific theory is that depression is caused by an imbalance in the brain’s neurotransmitters. Neurotransmitters are chemical messengers that send signals between brain cells. A person’s genetic make-up and life history may also determine a person’s tendency to become depressed.
How prevalent is depression?
From 2001-2003, a study conducted by the Department of Health Care Policy at Harvard Medical School reported that Major Depressive Disorder will affect approximately over 14 million American adults (about 6.7 percent of the US population) in a given year.(1)
Is depression a serious disease?
Yes. The National Institute of Mental Health(NIMH) maintains that “Depressive illness can often interfere with normal functioning and cause pain and suffering not only to those who have the disorder but to those who care about them. Serious depression can destroy family life as well as the life of the ill person.”
In 2000, the economic burden of depression was estimated at $83.1 billion in the US2 and researchers estimate that by the year 2020, depression will be the second-leading cause of disability worldwide.(3) Depression can also be a lethal disease. Each year in the US, over 30,000 people die by suicide, 60% of whom suffer from depression.(4)
Is there a depression cure?
There is no known cure for depression. However, with effective treatment, many patients can remain symptom-free and can lead healthy lives.
Are some people more likely to become depressed than others?
Yes, depression is known to be hereditary so depression may occur in some individuals who have a particular genetic makeup that makes them more likely to develop depression. However, the exact nature of these genetic characteristics is not known. Other factors may contribute to an individual’s likelihood of experiencing depression. Some of these risk factors include:
- Heart attack
- Parkinson’s disease
- Hormonal disorders
- Individuals suffering severe personal losses, difficult relationships, financial problems, or any stressful changes in life pattern
- Individuals taking certain medications that may increase their vulnerability to depression
What are the symptoms of depression?
According to the standard diagnosis guide (DSM-IV-TR) published by the American Psychiatric Association, depression is diagnosed when an individual is experiencing either a depressed mood or a loss of interest or pleasure plus four or more of the following depression symptoms during the same two-week period:
- Significant weight loss (when not dieting) or weight gain (a change of more than five percent of body weight in a month)
- Significant increase or decrease in appetite
- Excessive sleepiness or insomnia
- Agitation and restlessness
- Fatigue or loss of energy nearly every day
- Feelings of worthlessness or excessive and inappropriate guilt nearly every day
- Diminished ability to think, concentrate, or make decisions
- Recurrent thoughts of death or suicide
If you feel you are experiencing any of these depression symptoms, contact your doctor and ask about your depression treatment options.
What are the currently approved treatments for depression?
Depression is often initially treated with psychotherapy (talk therapy) and antidepressant medications administered together. Although antidepressants can be effective for some patients, they do not work for everybody. Additionally, antidepressants often result in unwanted side effects.
More than 4 million patients do not receive adequate benefit from antidepressant medications and/or cannot tolerate the side effects caused by them.(1) For these patients, new depression treatments that involve the use of a medical device are available. These treatments include transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT) and vagus nerve stimulation (VNS).
What is transcranial magnetic stimulation (TMS)?
Transcranial magnetic stimulation (TMS) uses short pulses of a magnetic field to stimulate nerve cells in the area of the brain thought to control mood. The pulsed magnetic field may have a positive effect on the brain’s neurotransmitters levels. Treating depression with transcranial magnetic stimulation, also referred to as NeuroStar TMS Therapy® with this new therapy, provides a breakthrough depression treatment for those who have not benefited from initial antidepressant medication.
What is NeuroStar TMS Therapy®?
Neurostar TMS Therapy® is an FDA-cleared proven no drug treatment for depression that is now available throughout the US. NeuroStar TMS Therapy is specifically for patients with depression who have not benefited from initial antidepressant medication.
How does NeuroStar TMS Therapy® work?
NeuroStar TMS Therapy® uses pulses of magnetic energy, precisely targeted at a critical area of the brain known to be underactive in depression sufferers. This area is called the prefrontal cortex.
By stimulating this local area, neurons in the prefrontal cortex communicate to deeper brain neurons causing a secondary effect on remaining areas of the brain involved in mood. These effects are intended to restore normal function and lift the symptoms of depression.
What are the side effects?
The most common side effect associated with TMS Therapy is pain or discomfort during treatment at or near the treatment area. This pain or discomfort is generally mild to moderate and typically diminishes after the first week of treatment.
In clinical trials, less than 5% of patients discontinued NeuroStar treatment due to side effects. NeuroStar treatment also showed no negative effects on thinking or memory.
Because NeuroStar TMS Therapy® acts directly on the prefrontal cortex, it lacks the systemic side effects experienced with antidepressant medication.
There is a rare risk of seizure associated with TMS Therapy. The risk of seizure in general clinical use is 1 in 30,000 treatments.
Will NeuroStar TMS Therapy® help with my depression?
Many people with major depression who were treated with NeuroStar experienced significant benefits. In clinical trials, including a trial of patients receiving the new depression treatment with NeuroStar TMS as part of their medical care, after six weeks of treatment, 1 in 2 patients improved significantly, and 1 in 3 patients was completely free of depression symptoms.(1)
Efficacy was established in a controlled clinical trial comparing active treatment with the NeuroStar TMS Therapy® System to an inactive device. Patients treated with active NeuroStar TMS Therapy received an average reduction in their depression symptom score of 22.1% compared to a 9% average reduction in patients receiving inactive treatment.(2)
What is treatment with NeuroStar TMS Therapy® like?
During treatment, patients recline comfortably and are awake and alert throughout the TMS Therapy session. No anesthesia or sedation is needed. Treatment involves placement of the magnetic coil against the patient’s head. Patients will hear a clicking sound and feel a tapping sensation on their head during treatment.
Each NeuroStar TMS Therapy® session takes less than an hour to complete and is conducted right in the doctor’s office, five days a week, for approximately four to six weeks. After treatment each day, patients can immediately return to normal activities.
Who should not receive NeuroStar TMS Therapy®?
NeuroStar TMS Therapy® may not be used for patients with implanted metallic devices or non-removable metallic objects in or around the head – this excludes dental fillings.
There may be other considerations that could prevent you from receiving TMS Therapy that your doctor will need to determine.
Is NeuroStar TMS Therapy® covered by insurance?
Neuronetics, the company that developed Neurostar Therapy, recognizes the importance of patient access to NeuroStar TMS Therap®y. TMS therapy is widely covered at this time; however some insurance companies have issued coverage policies, and many are covering the treatments, by exception, on a case-by-case basis. Most insurance companies will cover the cost of the initial consultation with a NeuroStar TMS Therapy doctor to see if this treatment is right for you.
We encourage you to consult with your insurance company regarding their willingness to cover NeuroStar TMS Therapy for you. To help with this process, we have a team devoted to providing general support regarding the reimbursement process.
1. Kessler, RC, et al. Prevalence, severity, and co-morbidity of twelve-month DSM-IV disorders in the National Co-morbidity Survey Replication (NCS-R). Archives of General Psychiatry, 2005 Jun: 62 (6):617-27.
2. Greenberg, PE, et al. The economic burden of depressive disorders in the United States: How did it change between 1990 and 2000? Journal of Clinical Psychiatry. 2003; 64 (12): 1465-1475.
3. Murray CJ, Lopez AD. Evidence-based health policy – lessons from the Global Burden of Disease Study. Science. 1996; 274 (5288): 740-743.
4. Heron, Melonie, et al. Deaths: Final Data for 2006. National Vital Statistics Reports, 57 (14). April 17, 2009.
NeuroStar TMS Therapy references:
1. Neuronetics, Inc. Data on file
2. Demitrack MA, Thase, ME. Clinical significance of transcranial magnetic stimulation (TMS) in the treatment of pharmacoresistant depression: synthesis of recent data. Psychopharm Bull. 2009, 42(2): 5-38