tms - Page 1 | CARLAT PUBLISHING

Flow Device: FDA Approval vs Real-World Effectivenes

February 9, 2026

In December 2025, Flow did in fact receive FDA Approval, based on data from the Empower trial. Before that, it had been marketed under FDA clearance—a lower evidentiary bar. That correction matters—and it sharpens the question many subscribers have been asking me: How much does FDA approval tell us about real‑world effectiveness?

How to Identify and Treat Apathy and Late-Life Depression

October 1, 2022

Rehan Aziz, MD and Julia Cromwell, MD

Rehan Aziz, MD. associate program director, geriatric psychiatry fellowship program, Jersey Shore University Medical Center; associate professor of psychiatry and neurology, Hackensack Meridian School of Medicine, Nutley, NJ. Julia Cromwell, MD. Inpatient geriatric psychiatrist, Mass General Brigham Salem Hospital, Salem, MA. Dr. Aziz and Dr. Cromwell, authors of this educational activity, have no relevant financial relationship(s) with ineligible companies to disclose.

We provide tips on distinguishing between apathy and depression, as well as recommendations on how to manage these disorders.

EXPERT Q&A

Treatment-Resistant Depression

September 25, 2022

Charles DeBattista, MD

Charles DeBattista, MD

Professor of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA.

Dr. DeBattista has reported receiving research funding from Relmada, Compass, Janssen, Biolite, Myriad, Neurocentia, Beckley, and Sage, and has served as a consultant for Abvie, Sage, and Corcept. This article was reviewed by Dr. Aiken, Editor-in-Chief, who has concluded that there is no evidence of commercial bias in this educational activity.

Charles DeBattista offers tips for working with patients with treatment-resistant depression.

Can TMS Turn on the Switch?

June 1, 2022

Edmund S. Higgins, MD.

Edmund S. Higgins, MD. Dr. Higgins has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Most antidepressant therapies can induce mania, and this study looks at whether TMS belongs on that list. We report on the latest findings.

Electroconvulsive Therapy: A Primer

March 23, 2022

Stephen J. Seiner, MD

Stephen J. Seiner, MD Director of neurotherapeutics, McLean Hospital. Belmont, MA. Dr. Seiner has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Dr. Seiner runs one of the busiest ECT programs in the country and speaks to us about recent innovations in the procedure. He also tells us which patients are the best candidates and shares tips for how to prolong ECT’s benefits.

The Role of rTMS in Poststroke Depression

January 7, 2022

Susan L. Siegfreid, MD

Susan L. Siegfreid, MD Dr. Siegfreid has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Repetitive transcranial magnetic stimulation appears to be a safe and effective treatment for poststroke depression, according to this small study.

Pros and Cons of Using TMS for Kids

August 13, 2020

There’s been some promising research for Transcranial Magnetic Stimulation (TMS), but can it be used for treatment-resistant depression in children and adolescents? Here’s a summary of the pros and cons presented in this 2019 article in The Carlat Child Psychiatry Report. Pros:It seems to work. An open-label trial of TMS for...

Getting Uncomfortable with Esketamine

January 13, 2020

Nolan Williams, MD

Nolan Williams, MD

Director of the Brain Stimulation Lab and Interventional Psychiatry Clinical Research Program; Assistant Professor of Psychiatry at Stanford University, CA. Dr. Williams has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

The FDA approval of esketamine (Spravalto) left some unanswered questions, including suicide, addiction, withdrawal, neurotoxicity, and bladder inflammation. Nolan Williams addresses those risks and looks at where esketamine fits among other options like TMS and ECT. Dr. Williams directs the Interventional Psychiatry Clinical Research Program and Brain Stimulation Lab at Stanford University.

TMS: Deeper is not Better

January 13, 2020

Edmund S. Higgins, MD.

Edmund S. Higgins, MD. Dr. Higgins has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Two devices are available for transcranial magnetic stimulation (TMS). Neurostar came first with the figure-8 coil, which is now off-patent, while Brainsway’s H-coil which claims to reach deeper into the cerebral cortex. See how they compare in the first head-to-head controlled trial, undertaken without industry support.

Should You Consider TMS for Kids?

October 7, 2019

With concerns about both safety and efficacy surrounding antidepressant use in children and adolescents, we are always looking for safe, effective treatments for our patients. Transcranial Stimulation (TMS) has been around for many years, and its use in youth is expanding. In this episode, we examine the evidence of efficacy...