NEURO WELLNESS SPA

TMS FOR ADOLESCENT DEPRESSION

Learn how Transcranial Magnetic Stimulation can help your adolescent loved one with depression.

NEURO WELLNESS SPA

TMS FOR ADOLESCENT DEPRESSION

Learn how Transcranial Magnetic Stimulation can help your adolescent loved one with depression.

TMS FOR DEPRESSION IN ADOLESCENTS

Depression in adolescents is a major public health problem affecting millions of youth in America. In 2017, an estimated 3.1 million adolescents aged 12 to 17 experienced at least one major depressive episode. “Pediatric (depression) is arguably the most important risk factor for suicide and, in fact, accounts for more than half of adolescent suicides” (Seedat, 2014, p. 1). Additional treatment options are urgently needed. Increasing evidence supports repetitive transcranial magnetic stimulation (rTMS) is an alternative treatment for adolescents.

TMS FOR DEPRESSION IN ADOLESCENTS

Depression in adolescents is a major public health problem affecting millions of youth in America. In 2017, an estimated 3.1 million adolescents aged 12 to 17 experienced at least one major depressive episode. “Pediatric (depression) is arguably the most important risk factor for suicide and, in fact, accounts for more than half of adolescent suicides” (Seedat, 2014, p. 1). Additional treatment options are urgently needed. Increasing evidence supports repetitive transcranial magnetic stimulation (rTMS) is an alternative treatment for adolescents.

VEERING AWAY FROM TRADITIONAL DEPRESSION TREATMENTS

Currently, treatments for depression in adolescents are limited to one class of antidepressant medication and/or cognitive behavioral therapy. However, even the combined remission rate for these two methods is only 30-45%. At best, at least two million adolescents remain depressed, and this number does not include those who do not present for treatment. Antidepressants do not represent a clear advantage for treating depression in adolescents, and there remains significant concern regarding possible antidepressant-induced suicidality in this age group.

VEERING AWAY FROM TRADITIONAL DEPRESSION TREATMENTS

Currently, treatments for depression in adolescents are limited to one class of antidepressant medication and/or cognitive behavioral therapy. However, even the combined remission rate for these two methods is only 30-45%. At best, at least two million adolescents remain depressed, and this number does not include those who do not present for treatment. Antidepressants do not represent a clear advantage for treating depression in adolescents, and there remains significant concern regarding possible antidepressant-induced suicidality in this age group.

HOW DOES TMS WORK ON DEPRESSION?

WHAT IS TRANSCRANIAL MAGNETIC STIMULATION?

TMS is a noninvasive technique using magnetic fields to stimulate nerve cells in the brain. It gained FDA indication for the treatment of major depressive disorder in 2008. Since then, science has continued to explore the countless ways TMS will benefit the mental health community. In August, 2018, the FDA added an indication of TMS for the treatment of OCD.

 

During a TMS treatment, a specialized coil is placed on the patient’s head and calibrated to target specific neurocircuitry. TMS cannot be used on patients with metallic objects or implanted stimulator devices in or near the head, including cochlear implants, deep brain stimulators, stents, etc. The most common TMS side effect reported is a headache.

TMS FOR OTHER MENTAL HEALTH DISORDERS

More studies utilizing TMS in conjunction with youth are necessary given the urgent need to treat their depression. It is worth mentioning that TMS has also been used in studies on children with attention-deficit/hyperactivity disorder (ADHD), Tourette’s syndrome, ADHD with Tourette’s, and autism spectrum disorder. As is the case with depression, the studies are limited but do not report significant adverse effects. Clearly, further research is warranted and, when it comes to mental health, time is always of the essence.

TMS CLINICAL STUDIES

Clinical studies suggest that youth respond as well, if not better, to TMS when compared to adults. In fact, a recently published study concluded “symptomatic improvements and response/remission rates were more significant in adolescent patients than in adults. TMS is feasible, tolerable, effective and more applicable to adolescents with mood or anxiety disorders” (Zhang TianHong-g et al., 2018, p. 1). The same study went a step further saying it regarded the findings as “preliminary evidence for applying TMS as an acute method in adolescents with mood or anxiety disorders” (Zhang TianHong-g, et al., 2018, p. 6) rather than exclusively for treatment resistant patients. Currently, TMS is only FDA indicated for depression in adults 18 years and older with treatment resistant depression. A study published in the Pediatric Neurology journal performed a systematic review of literature from 1985-2016 relating to children and any adverse effects from TMS. The study concluded the risks from TMS were similar to the risks in adults. The study further recommended that the guidelines for treating adults with TMS be used when treating youth until specific pediatric guidelines become available. Authors from the Neuroscience Institute of Georgia State University and Department of Neurology, University of Colorado agreed, “While many people have worries regarding the safety of TMS in the child population, our literature review adds to previous ones showing that most adverse events are mild and overall uncommon” (Allen et al., 2017, p. 5).

SOURCES

Major Depression. (n.d.). Retrieved November 17, 2018, from https://www.nimh.nih.gove

Soraya Seedat, (2014) Controversies in the use of antidepressants in children and adolescents: A decade since the storm and where do we stand now?, Journal of Child & Adolescent Mental Health, 26:2, iii-v, DOI: 10.2989/17280583.2014.938497

Rajapakse, T., & Kirton, A. (2013). Non-invasive brain stimulation in children: applications and future directions. Translational neuroscience, 4(2), 10.2478/s13380-013-0116-3.

Zhang TianHong-g, et al., Add-on rTMS for the acute treatment of depressive symptoms is probably more effective in adolescents than in adults: Evidence from real-world clinical practice, Brain Stimulation (2018)

Safety of Transcranial Magnetic Stimulation in Children: A Systematic Review of the Literature Allen, Corey H. et al. Pediatric Neurology , Volume 68 , 3 – 17

Manuel Casanova, (2017) The FDA and safety of rTMS in children

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