Innovative Treatments for Depression (TMS)

The Victoria Clinic has an innovative program using a number of new treatment tools to offer hope to people with psychiatric disorders such as Depression. There treatments are particularly helpful for individuals who have struggled to achieve wellness with traditional therapies alone. These treatments are available under the supervision of Professor Paul Fitzgerald and some involve the participation of clinical trials.

Transcranial Magnetic Stimulation

Transcranial Magnetic Stimulation (TMS) is a potential new treatment for depression and other psychiatric disorders. TMS has been extensively studied for at least 15 years, with a large number of clinical trials establishing that it is an effective treatment for patients with depression. TMS is now provided in clinical programs in North America, Asia, Europe and increasinly in Australia. 

How does it work?

TMS uses a very focused magnetic field to activate specific areas of the brain. Repeated TMS stimulation progressively alters brain activity improving depression in some patients. TMS requires no anaesthesia or medication and generally you may go about normal activities immediately following the treatment.  Most treatment programs involve daily administration of TMS, Monday to Friday for around four weeks.  Each treatment session typically lasts between 30 to 60 minutes. 

What are the costs?

This treatment is available for inpatients of The Victoria Clinic. Your inpatient stay is generally covered by private health insurance or by Workcover, DVA and TAC. Patients are also welcome to self fund their admission to hospital to receive this treatment.

Who is suitable for TMS?

The main use of TMS is inpatients with depression.  Patients who are suitable for TMS will typically have continued symptoms of depression despite having tried one or more antidepressant medications.  There are a few things that make a patient not suitable for TMS: the main issues are a history of epilepsy or seizures or the presence of a pacemaker or other type of implanted medical device. 

Increasing research is also focusing on the use of TMS in other conditions.  At the Victoria Clinic, in addition to depression, we provide treatment to a small number of patients with schizophrenia who have persistent auditory hallucinations (hearing voices) which have not responded to other medication treatments.  Before the end of 2013 we will also commence a highly innovative program providing TMS teatment for patients with persistent symptoms of Obsessive Compulive Disorder. 

If you would like further information please contact Intake on (03) 9526 0200.  Referrals for TMS treatment can be sent to Professor Paul Fitzgerald at the Victoria Clinic.

 

Other Novel Treatment Options:

Magnetic Seizure Therapy

In conjunction with the Alfred hospital, patients at the Victoria Clinic can have access to another highly novel new treatment for depression: Magnetic Seizure Therapy (MST).  MST is a new treatment possibility for depression that is being evaluated as a potential alternative to electroconvulsive therapy (ECT).

MST, like ECT, involves the induction of a seizure to produce therapeutic changes in depression.  However, seizures induced with MST are produced through the use of rapidly applied transient magnetic fields rather than electrical current which is used for ECT. Avoiding the application of an electrical current appears to avoid some of the memory related side-effects that are experienced with ECT.

Currently, MST is under clinical evaluation, comparing responses to MST and ECT; further information about MST is available on the MAPrc website: http://www.maprc.org.au/depression-trials

Further information about TMS and other innovative depression treatments can be found on the Monash Alfred Psychiatry Research Centre information website.

Groundbreaking treatment for Depression Article- The Pulse Winter 2010

Groundbreaking treatment brings new hope for depression


Groundbreaking studies at The Victoria Clinic in Transcranial Magnetic Stimulation (TMS) bring hope for one in three sufferers of depression who do not get better with standard treatments.

Professor Paul Fitzgerald, Director of the TMS program at The Victoria Clinic, has been conducting clinical trials of the treatment since 2002. The current trial is the third in a series involving a number of Healthscope hospitals including Northpark Private, Geelong Private, Mosman Private and Pine Rivers Private. Across the five hospital sites 200 patients will be treated with TMS for five days every week over a period of a month.

One patient who can talk about the effectiveness of TMS from experience is Christine Clement. Christine lived with debilitating depression for years, trying antidepressants and electroconvulsive therapy with no results. She made the decision with her psychiatrist to begin treatment with TMS and was referred to Professor Fitzgerald. Christine’s condition began to improve after 12 treatments. “It just clicked one day and I got better and better from there,” she said.

By applying a simple coil externally, TMS stimulates the flow of electrical currents within brain cells. TMS sessions take about 30 minutes - no anaesthetic is needed and memory is not affected. The patient is awake and experiences minimal side effects. “It’s totally non-invasive and doesn’t take long. My mood level lifted significantly which is a great relief,” said Christine.

“Commonly patients notice improvements in their mood after two weeks. This continues over the four weeks of treatment and sometimes afterwards,” said Professor Fitzgerald. Professor Fitzgerald was first introduced to TMS during his fellowship in schizophrenia research at the University of Toronto in Canada twelve years ago.

“A group of physiologists and neurologists developed the first TMS machine and discovered they could influence brain activity. At around the same time, researchers found areas of the brain were either under or over active in depression,” he said.

By putting the two together, TMS was proven to affect mood, prompting worldwide investigations into its use as a treatment for depression. More than 30 studies have been completed using TMS in adults with depression and almost all reported improvement in the illness. Over 150 American hospitals and clinics have been using TMS as a standard treatment since its approval by the Food and Drug Administration. It is also being evaluated for use in anxiety, eating disorders, Parkinson’s disease, and has been recommended in the US as a viable treatment for auditory hallucinations (hearing voices) in people with schizophrenia.

“Studies have found that applying TMS to the area of the brain that processes speech and hearing can reduce auditory hallucinations,” said Professor Fitzgerald. “Treatment with TMS is most typically used in people with depression or schizophrenia who are treatment resistant”. Professor Fitzgerald said it is important for patients to continue other recommended psychological treatment and support for their illness.

The Victoria Clinic is also implementing a novel program using ongoing TMS treatment for patients to maintain their recovery. “We have a constant stream of referrals from psychiatrists whose patients have responded well to treatment,” Professor Fitzgerald said.

Christine is just one of those. After completing the initial full course of 20 treatments, she has continued having treatment with TMS one weekend in four. “To compare what I was like before TMS and now, there is a big difference. It has been life changing,” she said.