Friday April 23 5:48 PM ET

Magnet therapy helps severe depression

NEW YORK, Apr 23 (Reuters Health) -- A magnetic coil used to stimulate the brain appears to ease some patients' severe depression with few side effects, and may eventually replace electroconvulsive treatment, according to researchers in Israel.

``Our findings are very exciting, since they provide clear evidence for the effectiveness of rTMS (repetitive transcranial magnetic stimulation), at least over the short term,'' explained Dr. Ehud Klein, head of the department of psychiatry at Rambam Medical Center in Haifa, Israel in a press statement. ``The treatment holds the promise of eliminating the need for ECT (electroconvulsive treatment) therapy in many cases,'' he added.

Electroconvulsive therapy stimulates the entire brain and must be performed under general anesthesia. It can cause memory impairment that can last for months.

Repetitive transcranial magnetic stimulation focuses a small current produced by a strong magnetic field only on one area of the brain. The procedure, which involves placing an electromagnetic coil on the scalp, can be done on an outpatient basis and causes only a slight headache in a small number of patients, say the researchers.

Klein based his conclusions on a study of 67 patients suffering from severe depression. Half of the patients received 10 daily sessions of rTMS for two weeks, while the other half received a ``sham'' or phony version of the same treatment. Neither patients nor psychiatrists who regularly evaluated the participants' levels of depression knew which group was receiving true rTMS therapy. Both groups of patients continued to receive antidepressant medication.

``A clear difference between the two groups was noted after the first week, and became robust after the second week, with the rTMS group showing a greater reduction in depression scores,'' Klein writes in the April issue of Archives of General Psychiatry.

At the end of two weeks, half the patients in the rTMS groups showed a 50% improvement in their depression ratings compared to only 25% improvement among those receiving the sham treatment.

In an editorial in the journal, Dr. Mark George of the Medical University of South Carolina, and two doctors from the New York State Psychiatric Institute, Dr. Sarah Lisanby and Dr. Harold Sackeim, suggest that rTMS might also be useful for patients with newly diagnosed severe depression and for whom antidepressant medications will not take effect for several weeks.

``Given the substantial delay in symptomatic improvement seen with traditional antidepressant medications, another potential use of rTMS may be as an augmentation agent to hasten clinical response in pharmacologically treated patients,'' they write.

They note, however, that although transcranial magnetic stimulation appears to have great potential, ``at the practical level, rTMS research is not supported with the resources devoted to pharmaceutical development.''

``It is still too early to know whether we are at the threshold of a new era in physical treatments and noninvasive regional brain modulation,'' write the authors. ``Regardless of its potential therapeutic role, the capacity of rTMS to noninvasively and focally alter functional brain activity should lead to important advances in our understanding of brain-behavior relationships and the pathophysiology of neuropsychiatric disorders.''

SOURCE: Archives of General Psychiatry 1999;56:300-311, 315-320.