Reporter's Notes: Depression Advancements

This radio story tries to cram a lot into five minutes, so if you don't find what you need here, put a comment on the blog, below and I'll see if I can't provide a lead to more information.

Transcranial magnetic stimulation interested me, in part, because of how non-invasive it is. Dr. Bret Schneider, who offers TMS from his private practice in Portola Valley, was one of several experts to suggest that TMS machines might one day be available for home use. Of course, that's a long way off. TMS is expensive: about $5,000 for an initial round of treatment. It's still much easier and cheaper to simply pop a pill each morning. And researchers are still working out how effective it can be.

Studies show that TMS brings a remission in depression to about a third of patients to try it. Another third experience some improvement, and a final third are unaffected. Dr. Schneider says he sees much better success rates on patients who combine TMS with antidepressant drugs (TMS without drugs, he says, is like "trying to drive a car with no gas.") Finally, the FDA approval covers only one TMS machine on the market, Neurostar, although some physicians use other techniques, off-label.

You can find links to the abstracts of clinical studies performed on TMS and depression through a search at This meta-analysis compares 30 double-blind studies, covering a total of 1164 patients (606 received TMS, 558 received sham treatments).


But TMS is just one in a class of "brain stimulation" depression treatments -- an important fact that didn't make it into the story. Others include vagus nerve stimulation, deep brain stimulation and, of course, electroshock convulsive therapy -- which is offered here in the Bay Area at the UCSF Langley Porter Psychiatric Institute to severely depressed patients (as well as, less commonly, people suffering from manic depression and schizophrenia).

Quest TV will cover TMS and other depression treatments in greater depth later this season, so stay tuned. For a sneak peak at some of what you'll find on the show, check out Stanford scientist Karl Deisseroth's groundbreaking work using light-sensitive proteins to stimulate neural circuits -- work that could someday help treat not just depression, but other brain diseases as well.

Listen to the Depression Advancements radio report online or check out the slideshow below of Dr. Bret Schneider, a consulting assistant professor at Stanford University and a practicing psychiatrist in Portola Valley, discussing depression and the brain.

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