Photo by Jay Paul
Debbie Denny receives a TMS treatment from TMS NeuroHealth Centers technician Bryce Neumann
These days, we all know someone who struggles with depression or has taken antidepressants. But when Debbie Denny, now 60, realized she had a problem, it wasn’t the kind of thing that was talked about. Although she didn’t see a psychiatrist until she was 37, Denny believes she has been depressed since age 17.
Denny saw therapists who prescribed pill after pill. But antidepressants required exhausting trial-and-error periods and came with unwanted side effects — or she would become tolerant. “Even when I was at my best with antidepressants, I still was not where I wanted to be,” she says.
Three or four years ago, Denny’s depression became severe, leading her to take disability leave from work. “I don’t think I knew how bad I was until I started getting better,” she says.
But she did get better, with the help of a relatively new treatment called transcranial magnetic stimulation (TMS). Denny began treatments at TMS NeuroHealth Centers in Glen Allen, which Dr. William Sauvé opened as Virginia Interventional Psychiatry in 2012. The center specializes in TMS therapy and does not practice general psychiatry. “Our goal is not to compete with general psychiatric practices in town,” Sauvé says, “but to provide TMS and ultimately be a resource to many psychiatric practices.”
VCU Medical Center uses TMS as one element in a team approach to depression treatment. Margaret Spivey, a nurse practitioner who works with Dr. Ananda Pandurangi, says TMS patients also see a dedicated psychiatrist with each treatment. “We also incorporate some cognitive behavior therapy techniques,” adds Spivey, explaining that the technique pairs well with TMS. The treatment, which was approved by the FDA in 2008, is also available locally at other clinics, including Tucker Psychiatric Clinic. Anyone who suffers from depression and has had at least one trial of medication and not gotten better may be eligible.
During each treatment, a patient relaxes in a chair while the overhead TMS system delivers highly focused magnetic pulses to their left frontal cortex. The magnetic field generates tiny electric charges inside the brain’s neurons, stimulating the mood-regulating parts of the brain that are underactive in depressed people. A typical treatment course is five 40-minute periods for six weeks. It’s an expensive therapy, running $300 to $400 per treatment. There is no anesthesia required, no alteration of consciousness, no pain and no recovery period.
According to Sauvé, most practices are observing a complete remission rate of about 40 percent, with people describing themselves as being no longer depressed and without any significant residual symptoms. Another 20 percent of patients see some improvement.
Denny began TMS treatment last July and first noticed results about three weeks later. She now considers herself to be in complete remission. “I remember now what it feels like to be happy,” she says. “I don’t have that cloud hanging over me.”
Sauvé, who practiced psychiatry for about six years before being introduced to TMS therapy, enjoys the increased success rate. “For the first time in my career, I had the ability to talk to people on a regular basis who are just feeling well,” he says. “It’s a wonderful thing.”
How long does TMS remission last? Because of the severity and longevity of her depression, Denny still receives monthly maintenance treatments, but this is atypical. Long-term data is scarce because the treatment is relatively new, but a recent American Psychiatric Association study found that 68 percent of TMS patients in remission remain that way for 12 months — better results than antidepressants.
Denny hopes to make more people aware of these numbers: “I wish everyone who either is depressed or knows someone who is would know that this option exists.”