Is TMS Right for Me?


"Patients addicted to cocaine reportedly experienced fewer cravings for the drug after undergoing eight sessions of the experimental treatment over a month."


This quote is about a recent pilot study from a US News and Health Report: HealthDay News article written by reporter Tara Haelle on December 3, 2015. The post is about treating cocaine addiction with Transcranial Magnetic Stimulation (TMS), and it should be noted that the findings from the pilot study, while promising and exciting are preliminary and that further studies are planned.

TMS-Therapy-Cocain-addiction.jpg

While the heading above states that TMS is experimental in the treatment of cocaine, NeuroStar TMS Therapy® is not an experimental procedure.  In 2008 the FDA cleared the therapy and device "as a safe and effective non-drug depression treatment for patients who are not satisfied with the results of standard drug therapy."  "With well over 650 NeuroStar physicians providing therapy, and more than 25,000 patients treated, this novel ( not experimental) treatment option provides benefits without the side effects often associated with antidepressant medication." While "TMS is currently indicated for the treatment of Major Depressive Disorder (MDD) in adult patients who have failed to receive satisfactory improvement from prior antidepressant medication in the current episode".TMS Therapy has been found to also help with Post Traumatic Stress Disorder (PTSD), Anxiety Disorder, and Postpartum Depression, with additional clinical studies planned for depression in adolescents.  One key difference in the the use of TMS for depression and the TMS/Cocaine pilot study is the length and duration of typical TMS depression treatments, which are about 37 minutes long, administered five days a week over a six week span, or 30 treatments in all, as compared to the 8 treatments of 13 minutes each, which were administered over a 30 day period in the pilot study.

According to the U.S. National Institute on Drug Abuse, it is estimated that 1.4 million Americans suffer from cocaine addiction. In the article, Dr. Lorenzo Leggio states, “Unlike smoking, alcoholism and other addictions, however, cocaine addiction has no approved treatments.” Dr.Leggio.jpg Doctor Leggio, frequently quoted in Halle's article, is one of the six authors of the study entitled “Transcranial magnetic stimulation of dorsolateral prefrontal cortex reduces cocaine use: A pilot study.” Published on-line November 30, 2015, by Terraneo, Lorenzo Leggio, Marina Saladini, Mario Ermani, Antonello Bonci, Luigi Gallimberti. Dr. Leggio serves as the Chief of the Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, a joint NIAAA and NIDA laboratory. chief of clinical psychoneuroendocrinology and neuropsychopharmacology at the U.S. National Institutes of Health.

Dr. Leggio goes on to say, "Addiction is a brain disease, not so different from schizophrenia and not so different from diabetes," When reading this article from a TMS Practitioner’s viewpoint, one of the biggest takeaways was this quote, "One reason we [the study's authors] are excited about these findings is that this could open up the possibility for the first time to have a biological basis for a treatment to help patients with cocaine addiction." 

Leggio distinguishes addiction as a chronic relapsing medical disorder, and not as bad behavior. He said. "People who use cocaine and other drugs know when they use drugs that it could be dangerous for them and that they can die, but they use in spite of the consequences."

According to the study no serious side effects occurred. Dr. Leggio said "This is important because it's telling us TMS is safe when used with cocaine-addicted patients, and it shows that it may be effective in reducing cocaine use”. As far as how TMS works, one of the leading companies providing TMS Therapy is NeuroStar®, whose device uses a targeted pulsed magnetic field, the procedure is similar to what is used in an Magnetic Mesonance Imaging (MRI) machine. All this while the patient is awake and alert; TMS Therapy stimulates areas of the brain that are underactive in depression." 

According to the Halle’s article the next step identified by Leggio “is to test the treatment with a larger group of patients over a longer period.”

“TMS can treat other psychiatric disorders as well”, said Dr. Alan Manevitz, Alan Manevitz, M.D. is a Psychiatrist in New York City, where he maintains a private practice. Dr. Manevitz is a clinical associate professor at Payne Whitney-Weill Cornell Medical Center, an attending psychiatrist at New York Presbyterian and Lennox Hill Hospitals, and teaches at the Weill-Cornell Medical School. In addition, Dr. Manevitz has been named amongst the Top Doctors in America by Castle Connolly Medical Ltd., New York Time’s Super Doctors, New York Magazine’s Best Doctors, and Best Doctors of America

According to the HealtDay news article, “Manevitz said he and his partner were the first doctors in New York to use the [TMS] therapy clinically, first for depression and then for anxiety and post-traumatic Cocaine-Craving-Chart.pngstress syndrome. It has been used to treat smoking addiction in other countries, and researchers are investigating its effectiveness to treat chronic pain and obsessive compulsive disorder, he said. This study excluded patients with major depression disorder, schizophrenia, bipolar disorder and alcoholism, which strengthens the results, Manevitz said.”

"Considering the poor results of conventional treatment right now, this is very exciting," Manevitz said. "You can treat patients and monitor their sobriety, and do all this on an outpatient basis."

 

It should be noted that TMS Therapy is offered on an outpatient basis. The side effects are few, with some minor discomfort for the first week or so of treatment. Patients can drive themselves to and from the appointments.

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Topics: TMS Therapy In The News, Addiction

TMS Solutions Staff

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