TMS at the 2010 APA Meeting in New Orleans

I just returned from New Orleans where I attended the 163rd annual meeting of the American Psychiatric Association. As expected, New Orleans was hot and humid but every bit as fun as I remembered from my last visit before Katrina. It was great to see old friends and colleagues and to meet new ones for the first time.

This year I participated in several important events.  On Sunday, I had the honor of giving a brief presentation about my TMS experience to everyone who attended the 60 Million Pulse dinner hosted by Neuronetics. That was a fun event, but on Monday I was part of a more serious panel discussion about the use of TMS in clinical practice with my esteemed colleagues Dr. Timothy Derstine of State College, PA; Dr. Carl Wahlstrom of Chicago, IL; and Dr. Todd Hutton of Pasadena, CA. 

All of us have been using TMS since shortly after it was cleared by the FDA and we had the opportunity to share some of our clinical experiences thus far. Although all of us have had the satisfaction of seeing our patients respond to TMS, it was interesting to see how our experiences differed in certain ways. For instance, I was the only one on the panel to have had the experience of treating adolescent and geriatric patients. Many in the audience were psychiatrists who have been thinking about adding TMS to their practice but some had more experience with TMS than any of us on the panel. I was especially pleased to meet Dr. Alexander Lyford-Pike from Montevideo, Uruguay. 

On Monday evening I demonstrated the use of the Neurostar TMS Therapy device at a press briefing and throughout the meeting I had the opportunity to introduce colleagues to TMS through brief presentations at the Neuronetics information booth. 

Among the scientific papers presented at the meeting, Drs. Mark George, Sarah Lysanby, and Ziad Nahas reviewed the findings from a major study published in this month’s Archives of General Psychiatry, which demonstrated that patients with treatment resistant depression are more than 4 times as likely to respond to TMS as they are to another medication trial. This study was noteworthy for several reasons. First of all, it was one of the largest, multisite, randomized controlled studies of TMS to ever be performed. It was sponsored by the National Institutes of Health. It used a much more sophisticated sham TMS control than any previous TMS studies. And it was published in one of the most important peer reviewed psychiatry journals in the world.  

All in all, this year’s APA meeting was an interesting and rewarding time. When I started doing TMS back in January 2009, I was only one of about a dozen doctors in the country using the newly approved Neurostar device. Now there are 190 Neurostars around the country. I am glad that this important and highly effective treatment is now available to so many people. Although routine insurance coverage is still probably about a year away, more and more insurance companies are paying for TMS as it becomes increasingly clear that TMS is, in fact, a major advance in modern psychiatric medicine.

Beginning with my next post, I will describe in detail how TMS was developed and how it evolved to become a truly revolutionary treatment for depression and how it may one day revolutionize the treatment of a range of other neuropsychiatric conditions.