Brain_devices - Articles - Page 3

Transcranial Magnetic Stimulation is Approved. Now What?

January 1, 2009

Daniel Carlat, MD

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.

The New Brain Devices in Psychiatry: A Brief Review

January 1, 2009

Dhwani Shah, MD

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.

EXPERT Q&A

Practical Issues in Using Transcranial Magnetic Stimulation

January 1, 2009

John O'Reardon, MD

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John O'Reardon, MD. Associate Professor of Psychiatry, University of Pennsylvania Health System.

Dr. O’Reardon has disclosed that he has received research grants from Neuronetics, Cyberonics, Cerex Biopharma, and Pfizer, and is on the speaker's bureaus of Eli Lilly and Bristol-Myers Squibb. Dr. Carlat has found that there is no evidence of commercial bias in this educational activity.

Dr. O’Reardon, the FDA recently approved TMS for depression. Can you clarify exactly what this approval was for?

Transcranial Magnetic Stimulation: The Saga Continues

January 1, 2008

Daniel Carlat, MD

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 magnetic coils over our patients’ heads as early as 2006.

Using EEG to Predict Medication Response

January 1, 2008

Daniel Carlat, MD

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?

Vagus Nerve Stimulation: A Brief Update

January 1, 2008

Daniel Carlat, MD

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.

Update on ECT

January 1, 2008

Max Fink, MD

Max Fink, MD. Professor of Psychiatry and Neurology Emeritus School of Medicine, SUNY Stony Brook.
Disclosures: Dr. Fink has disclosed that he has no significant relationship or financial interests in any commercial companies pertaining to this educational activity.

Dr. Fink, recently you and your colleague, Michael Taylor, reviewed the latest studies of electroconvulsive therapy in patients with major depression in JAMA (Fink M and Taylor MA, JAMA 2007;298(3):330-332). I thought we might start by talking about ECT efficacy. How effective is it?

TMS for the treatment of auditory hallucinations

May 1, 2007

James Ellison, MD, MPH

In the February issue of TCPR, we reported a recent FDA panel’s opinion that rTMS (repetitive transcranial magnetic stimulation) was relatively ineffective for treatment-resistant depression. The type of rTMS that has been tested for depression generally involves 10 Hz (ten pulses per second).

Vagus Nerve Stimulation: Is the Evidence Convincing?

January 1, 2006

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 the FDA flip-flopped on the issue, see “FDA Approval of VNS,” this issue.) In this article, we scrutinize the two pivotal studies leading to approval.