Transcranial Magnetic Stimulation is Approved. Now What?

Topics: Brain Devices | Depressive Disorder

One year ago we reviewed the status of transcranial magnetic stimulation for depression, and concluded with the following TCPR Verdict: “TMS for depression: Approval is highly unlikely.” We were wrong. On October 10, 2008, the FDA approved the Neuronetics Neurostar TMS machine for the treatment of patients with major depression who have failed on

The New Brain Devices in Psychiatry: A Brief Review

Topics: Brain Devices | Depressive Disorder

In this issue of TCPR, we focus on TMS (Transcranial Magnetic Stimulation), which has just been approved for treatment resistant depression. There are also other brain devices in various stages of research and development. Here is a quick run-down of four of them. VNS (Vagus Nerve Stimulation) VNS is a surgically implanted device that is FDA-approve

Practical Issues in Using Transcranial Magnetic Stimulation

Topics: Brain Devices

Transcranial Magnetic Stimulation: The Saga Continues

Topics: Brain Devices

The last time we took a close look at transcranial magnetic stimulation (TMS) was three years ago (TCPR, Jan 2005), and we concluded that it had promise as a treatment for major depression. In that article, we reported that the company making the device, Neuronetics, would apply for FDA approval as early as Fall of 2005, and that we could be passing mag

Using EEG to Predict Medication Response

Topics: Brain Devices

Many psychiatrists are already hearing from patients about “this new technique” of using EEG to predict whether a given antidepressant will work. How good is this technology? Is it even remotely ready for prime time? First, let’s review a little background on EEG. First developed in the 1920s, EEG entails applying electrodes to the scalp’s surfa

Vagus Nerve Stimulation: A Brief Update

Topics: Brain Devices | Depressive Disorder

VNS (vagus nerve stimulation) was initially developed and approved for treatment-refractory epilepsy. Cyberonics conducted one sham-controlled study for treatment-resistant depression, and while this double-blind study showed no statistical benefit over placebo, an open-label extension showed enough benefit to impress someone at the FDA. In a controvers

Update on ECT

Topics: Brain Devices

TMS for the treatment of auditory hallucinations

Topics: Brain Devices

Vagus Nerve Stimulation: Is the Evidence Convincing?

Topics: Antidepressants | Brain Devices

The Cyberonics brochures have been leaping into your mailboxes. “A new strategy for the challenge of treatment-resistant depression,” they proclaim. Vagus nerve stimulation (VNS) is certainly new—but is it effective? It took the FDA a long time to make up its mind, but eventually it approved the treatment in May 2005. (For more details on why t

FDA Approval of VNS: The All-Too-Human Side of a Bureaucracy

Topics: Antidepressants | Brain Devices

First they said yes to VNS, then no, then yes. And now they’re trying desperately to explain their final answer. On June 15, 2004, the Neurological Devices Panel of the Medical Devices Advisory Committee voted by a 5-2 margin to recommend VNS for approval for TRD. We encourage our readers to go to the transcript of this meeting, at http://www.fd

VNS: Some Practical Information

Topics: Antidepressants | Brain Devices | Practice Tools and Tips

If, after reviewing our admittedly lukewarm evaluation of the VNS data, you decide that you want to offer it to your patients, here’s some useful information. The procedure is being done primarily at major tertiary medical centers now, but this will change over time. Currently, insurance plans pay for the procedure for depression only on a case-by-