UCSD Health offers procedure for depression that’s ‘going to revolutionize how we treat mental health’

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For many people with depression, medication and therapy provide a powerful combination of treatment. But for those with treatment-resistant depression, UC San Diego Health offers another option.

It’s called transcranial magnetic stimulation, or TMS, and UCSD Health now boasts the largest and most advanced TMS clinic in the region.

TMS is a noninvasive procedure approved by the US Food and Drug Administration that involves the use of a handheld coil to apply a series of short magnetic pulses to stimulate nerve cells in areas of the brain that are known to be associated with major depression.

“It causes neurons to fire synchronously,” said Dr. Zafiris “Jeff” Daskalakis, chairman of the UCSD Department of Psychiatry. “That synchronization results in neuroplasticity, or the rewiring of the brain.”

With treatment, Daskalakis said, “people no longer suffer from depression.”

According to UCSD Health, one-third to one-half of patients with treatment-resistant depression are symptom-free after TMS treatment. Others may experience an improvement in mood and then find that antidepressants, talk therapy, and lifestyle changes (such as diet and exercise) provide additional relief.

For most patients, treatment involves sessions that last from five to 60 minutes, with five sessions a week for four to six weeks, Daskalakis said. He added that 90 percent of patients experience few or no side effects. In the worst case, he said, some might get a slight headache afterwards, which usually goes away within 24 hours.

The treatment is performed in an office and does not require anesthesia or sedation; patients remain awake during the procedure. They can return to normal daily life immediately after treatment, Daskalakis said.

“I think it’s going to revolutionize the way we treat mental health and it’s going to change lives,” Daskalakis said. “[Patients] get a significant boost in quality of life. They sleep better, their worries have lessened, it’s a very robust response. It’s very reassuring. We can offer this very effective, safe and well-tolerated treatment.”

Daskalakis was previously a professor of psychiatry at the University of Toronto and co-director of the Temerty Center for Therapeutic Brain Intervention, where the treatment was refined.

Before the use of TMS, he said, “people suffered in silence or tried one medication trial after another without success.”

Once someone has tried a certain number of medications for depression that were not effective, the person may be considered a candidate for TMS. The process to consider depends on the insurance company.

The UCSD facility is looking to embark on an accelerated treatment trial program through which patients would undergo multiple sessions a day for fewer days. “There is very exciting data suggesting that multiple bursts in one day will shorten the treatment period,” said Daskalakis. The risks are considered “very remote” and similar to those of antidepressant medications, he said.

“Depression is one of the leading causes of disease-related burden worldwide,” Daskalakis said. “It has the biggest impact on the economy. Cardiovascular disease and cancer affect more people, but those people are often older. Depression affects people in the prime of their lives.”

The clinics are at 8950 Villa La Jolla Drive in La Jolla and 16918 Dove Canyon Road in 4S Ranch. Learn more at health.ucsd.edu/specialties/behavioral-mental-health and click on “Treatment of depression”.

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