Dr. Weeks’ Comment: A very great friend of mine who has received very disappointing and tragic psychiatric care over the years recently told me, to my delight, that his doctors had FINALLY allowed him to have trans-cranial magnetic stimulation (TCMS) after years of electroconvulsive shock therapy and mind-numbing tranquilizing drugs. I have long endorsed corrective psychiatry and recommended TCMS since 2006 when I published a literature review and now it seems to have arrived. Back in 2006, I had to send people to Canada for this safe and effective “centsible” TCMS treatment which, in combination with corrective protocols restored mental health to thousands of grateful patients.
Trans Cranial Magnetic Stimulation
What is Transcranial Magnetic Stimulation (TCMS)?
TCMS is a safe and effective therapy for treatment resistant depression, bipolar depression, OCD, anxiety, psychosis and PTSD. So why have you not heard of it? Because the standard or care is to give medications which, while not always so helpful are, of course, a recurring income stream for Big Pharma which, truth be told, dictates the what doctors are allowed to offer (i.e. the standard of care).
Electroconvulsant therapy (ECT) also the standard of care for treatment resistant psychiatric disorder was a modality I was trained in during my psychiatric residency at Dartmouth Hitchcock hospital in New Hampshire in the late 1980s. It was astonishingly ineffective and damaging to the brain and to cognitive function and all of my career, I have actively discouraged patients from allowing themselves to be subjected to ECT.
For the past 20 years I have taught psychiatric patient to follow Corrective Psychiatry by replenishing what they are deficient in (b vitamins, amino acids like tryptophan etc.) while helping them to detoxify any mood and cognitive disturbing agents (heavy metals like mercury and lead, dysfunction fatty acids etc.) and allowing the liver and endocrine system to create hormone harmony.
Where did I learn this corrective protocol which is superior to the standard of care by being far more effective while offering less side-effects?
From a two-time Nobel laureate Linus Pauling and his teacher, my mentor Abram Hoffer. Linus wrote this brilliant paper on orthomolecular psychiatry and this one published in SCIENCE in 1968 after studying with Dr. Hoffer described here – who was so effective at treating psychiatric patient that the British Columbia College of Medicine stole his medical license when he refused to stop offer vitamins and amino acids in the treatment of psychiatric patients.
Now we have a new technology, TCMS which is safe and effective and which, while currently proven to be superior to the standard of care, will not be endorsed by conventional psychiatrist for another decade or more.
But you are reading about it now. So availal yourself of “tomorrow’s medicine today” and get help from an integrative medical doctor who can help you get safely off those toxic psychiatric drugs. If you don’t know how toxic they are STUDY HERE:
CURRENT SCIENTIFIC ARTICLES ON TCMS
Prim Care Companion J Clin Psychiatry. 2009;11(5):226-30. doi: 10.4088/PCC.08m00663.
Ruffini C1, et al
The orbitofrontal cortex (OFC) plays a major role in the pathophysiology of obsessive-compulsive disorder (OCD); functional neuroimaging studies indicate that OCD symptoms are associated with increased activity in the OFC, caudate nucleus, thalamus, and anterior cingulate gyrus. The goal of our single-blind study was to assess whether repetitive transcranial magnetic stimulation (rTMS) over the left OFC would influence OCD symptoms in drug-resistant patients.
Twenty-three consecutively admitted right-handed inpatients with DSM-IV-TR-diagnosed drug-resistant OCD were given rTMS (80% motor threshold, 1 Hz seconds per minute for 10 minutes every day for 15 days) to the left OFC parallel (active: n = 16) or perpendicular (sham: n = 7) to the scalp. The patients’ OCD symptoms, mood, and anxiety were rated at baseline, at the end of treatment, and once every 2 weeks for 3 months after treatment. Data were gathered from June 2006 to November 2007.
Considering changes in Yale-Brown Obsessive Compulsive Scale (YBOCS) scores with 2-way analysis of variance for repeated measures for a total of 8 observations (before rTMS, after treatment, and every 2 weeks for 12 weeks’ follow-up), we found significant reduction of YBOCS scores comparing active versus sham treatment for 10 weeks after the end of rTMS (P < .02), with loss of significance after 12 weeks (P < .06). We also found a reduction of anxiety and depression symptoms but not a significant difference in the 2 groups.
Low-frequency rTMS of the left OFC produced significant but time-limited improvement in OCD patients compared to sham treatment.
Depress Anxiety. 2009;26(7):682-8. doi: 10.1002/da.20486.
Cohen RB1, et al
Several studies have shown that repetitive transcranial magnetic stimulation (rTMS) treatment is associated with a significant antidepressant effect that can last for several months.
To investigate the mean remission time and the predictors associated with its duration; we performed a large retrospective, naturalistic study with 204 patients who underwent treatment with rTMS. During the periods from 2000 to 2006, we identified and collected the data on 204 patients who underwent rTMS treatment for major depression and who remitted their depression (defined as Hamilton Depression Rating Scores less or equal to 7). Patients were followed up to 6 months after this therapy.
Event-free remission with the end point defined as relapse (Hamilton Depression Rating Scores higher than 8) was 75.3% (73.7) at 2 months, 60.0% (74.5) at 3 months, 42.7% (74.8) at 4 months, and 22.6% (74.5) at 6 months. According to a multivariate analysis, only the age and number of sessions were independent predictors of outcome. Although depression severity and use of tricyclics also showed a significant relationship with remission duration, the model including these variables was not adequate to explain our data.
The results of this study suggest that young age and additional rTMS sessions are associated with a long duration of rTMS effects and therefore future trials investigating the effects of maintenance rTMS treatment need to explore further the implication of these factors for depression remission.
Curr Opin Psychiatry. 2008 Nov;21(6):640-4. doi: 10.1097/YCO.0b013e3283136a0c.
López-Ibor JJ1et al
PURPOSE OF REVIEW:
To present state-of-the-art transcranial magnetic stimulation (TMS) therapy, especially when it is used in psychiatric disorders, on the basis of an exhaustive literature search from 2006 to date (June 2008) on TMS papers published in Medline and Embase. Other references and comments from our own experience started 8 years ago have also been taken into account.
The mechanism of action of TMS is now better understood. There is strong evidence of the safety and tolerability of TMS when standard protocols are used. The efficacy of the stimulation of the dorsolateral prefrontal cortex in depression is well documented, and there is evidence of the utility of TMS in posttraumatic stress disorder, in persistent auditory hallucinations in schizophrenia and in attention-deficit disorder with hyperactivity.
There is enough evidence of the efficacy and safety of TMS in depression to include this technique in the therapeutic protocols of major depression. However, more research is needed on the use of this technique in other psychiatric and nonpsychiatric disorders such as posttraumatic stress disorder, persistent auditory hallucinations, attention-deficit disorder with hyperactivity and tinnitus.
4. Int J Neuropsychopharmacol. 2008 Feb;11(1):119-30. Epub 2007 Mar 5.
Xia G1, et al
This review focused on the treatment-emergent mania/hypomania (TEM) associated with repetitive transcranial magnetic stimulation (rTMS) treatment of depression. English-language literature published from 1966-2006 and indexed in Medline was searched. Ten of 53 randomized controlled trials on rTMS treatment of depression specifically addressed TEM. The pooled TEM rate is 0.84% for the active treatment group and 0.73% for the sham group. The difference is not statistically significant. Along with case reports, a total of 13 cases of TEM associated with rTMS treatment of depression have been published. Most of these patients were diagnosed with bipolar disorder and the majority of patients experiencing TEM took medication concurrent with rTMS. The parameters of rTMS used in these cases were scattered over the spectrum of major parameters explored in previous studies. Most train durations and intervals were within the published safety guidelines of the field. Reducing the frequency of sessions from two per day to one per day might be associated with a lower likelihood of TEM recurrence. The severity of manic symptoms varied significantly, but all cases responded to treatment that included a decrease or discontinuation of antidepressant and/or rTMS treatment and/or use of anti-manic medication. Current data suggests that rTMS treatment carries a slight risk of TEM that is not statistically higher than that associated with sham treatment. More systematic studies are needed to better understand TEM associated with rTMS. Special precautions and measures should be adopted to prevent, monitor, and manage TEM in research and practice.
Ir J Med Sci. 2006 Oct-Dec;175(4):82.
O’Connell H, et al
J Clin Psychiatry. 2006 Dec;67(12):1870-6.
So far no convincing answer has emerged to the question of whether transcranial magnetic stimulation (TMS) can make a clinically useful contribution to the treatment of depression. Here we examine whether multiple sensitivity analyses can highlight parameters that predict a favorable treatment response.
Medline, Embase, and the Cochrane database for controlled trials were searched for relevant randomized controlled trials using the expression (transcranial magnetic stimulation or TMS) and depression.
Thirty-three studies were identified and included in the random-effects meta-analysis, and between 17 and 31 studies were included in the secondary analyses comparing outcome of studies with different parameters.
Study data were extracted with a standardized data sheet. A meta-analysis based on Cohen d effect size measure was done for all studies and various subsets. Regression analysis of effect sizes with study parameters was done in 24 studies.
Active TMS treatment was more effective than sham, but variability was too great to take any single study design as paradigmatic. No significant predictors of study effect size were found. Mean effect sizes were reduced, although still significant, in studies with stimulation intensity below 90% of motor threshold and new medication starting within 7 days before to 7 days after start of TMS.
The absence of significant outcome predictors in the presence of significant variability of outcome measures can be interpreted in 2 ways: either study sizes and numbers and designs are insufficient to afford the power necessary to detect such predictors or TMS has a nonspecific effect on depression that is not influenced by study parameters. Large-scale comparative trials are necessary to decide between these interpretations.
Newsweek. 2006 Dec 11;148(24):62-4.
Psychol Med. 2007 Mar;37(3):341-9. Epub 2006 Dec 19.
Loo CK1, et al
Studies of repetitive transcranial magnetic stimulation (rTMS) in depression have mostly involved once-daily treatment, with positive but modest clinical results. This study tested the efficacy and safety of twice-daily rTMS over 2 weeks.
Thirty-eight depressed subjects enrolled in a double-blind, sham-controlled trial of twice-daily rTMS (left prefrontal cortex, 10 Hz, 110% intensity, 1500 stimuli per session) over 2 weeks. Mood and neuropsychological functioning were assessed weekly by blind raters, using the Montgomery-Asberg Depression Rating Scale (MADRS) as the primary outcome measure, plus the Hamilton Rating Scale for Depression (HRSD) and self-report measures. After the blind period, 22 subjects continued with once-daily rTMS to receive a total of 6 weeks of active rTMS.
Subjects were moderately treatment resistant. Active treatment resulted in significantly greater improvement than sham over the 2-week blind period on one outcome measure only (MADRS p<0.05). Subjects showed further improvement over the 6 weeks of active rTMS. Neuropsychological test scores did not change significantly.
rTMS given twice daily was effective and safe, with no adverse neuropsychological effects.
J ECT. 2006 Dec;22(4):233-4.
Isenberg KE, et al
Acta Neuropsychiatr. 2006 Dec;18(6):287. doi: 10.1017/S0924270800031185.
Fitzgerald P1, et al