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TMS (Transcranial Magnetic Stimulation)

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cmusic

_______________________________________________________________________

 

MOD NOTE:  Before trying TMS I suggest you read this member's experience.

_______________________________________________________________________

 

Hi everyone,

 

Again not sure if this is the right forum for this topic, but I couldn't find any discussion on it through search so thought I'd start a topic. I was told by my primary care today that an option to look into could be TMS (Transcranial Magnetic Stimulation). When I let him know I was going off drugs because they weren't working, he consulted with the head of psychopharm in his network and got the following information:

 

  • The patient could look into TMS as an option
  • It's got the same success rate as AD's
  • For some people it can be like a light switch going on
  • You need to do it every day for three weeks
  • It's not cheap (and usually not covered by insurance)

Knowing what I do about these types of treatments, I told him no thanks for now. He's a great doc, trying to help and using the tools he has at his disposal, but my feeling is they have no idea what this actually does to someone.

 

So I thought I'd throw the idea up here for discussion. I'm sure I'm not the only one being presented with this 'option'.

 

Anyone come across this?

 

Thanks.

 

Edited by ChessieCat
Added Mod Note

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Altostrata

It's not going to do anything for withdrawal symptoms. It may be irritating.

 

You can't treat withdrawal as though it were ordinary depression or other so-called psychiatric disorder (as though they know how to treat that!).

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spidey

Is there any evidence to support TMS having no effect on withdrawal symptoms?

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alexjuice

I don't know any one who has ever tried it, for any reason.

 

I looked into bio-magnetic therapy but never tried it.

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Altostrata

Emilee, what exactly was your TMS treatment like?

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Cdav

Are there any more people out there who have had relief from Withdrawal depression through TMS? 

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HopeNeeded

My psychiatrist just brought this up as an idea to treat the withdrawal symptoms. I'd love to hear of any and all experiences in trying TMS (good or bad). Thanks, all. 

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Cdav

Hi Jaclyn, I received TMS. By the third week I felt it helped a little bit with my severe depression, but then the depression came back. My brain zaps didn't stop, and many other withdrawal symptoms didn't stop. What did improve was akathisia, but I'm not sure if it was related to TMS or just had a window, because the akathisia came back after I had to take some antibiotics. 

 

In general, it didn't help me, I don't think it will help with WD symptoms, possibly it can help depression. I know people who have responded very well to TMS for depression. Sadly, I did not respond. 

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oskcajga

Early on in WD from cymbalta, I went through 38 TMS treatments at like 3000-5000 pulses or whatever.  It's kind of a long story about how I came to go through TMS treatment and all, so I won't go into the details, but I was one of the few people who did this treatment.  It was a doctor in Newport Beach CA, and he dealt with a bunch of rich people who could afford to pay 30K for this new and fancy FDA treatment.  He was a psyciatrist in Fashion Island, I won't go into the details about his name, because I don't feel like getting sued by his rich ass, but he and his wife basically convinced me to do this treatment after I was made more suggestable from taking cymbalta for 3.5 months or so.  Initially I would have said, no way, but when I was manic from the medication, I was willing to do stupid things like experiment with strong electrical stimulation into a region of my brain (that was responsible for emotions and important administrative tasks).

 

I'm not sure if it was the withdrawal from cymbalta or the combination of cymablta and TMS, but I was more ****** up after completing all of this than I was 5 months earlier when I presented with moderate anxiety and depression.  It definitely DID NOT help with withdrawals whatsoever.  TMS did nothing for me, it just cost  my insurance company blue cross blue sheild like 30K, and made my doctor a wealthier person, and wasted my time and humiliated me.  I did the neurostar treatment, where you just have a somewhat skilled, but not really, lab tech who sits there, adjusts the helmet thing with the magnet, and then just lets it proceed for 30 minutes or so.   they would occasionally "calibrate" the machine by going to my motor cortex and stimulating my thumb to move, they did this from time to time.  It was a rightprfrontal cortext stimulation, and it hurt like hell and made me feel depersonalized/derealized.  I think, but I can't say for sure, that TMS caused my severe DP/DR, and exacerbated the cymbalta withdrawal symptoms.  

 

I should also mention that they never did an MRI or anything to figure out where my right prefrontal cortext was located - I had full faith in the FDA and the doctor that nothing would go wrong with an unskilled, generally uneducated woman sitting there adjusting this thing on my brain.  I'm not sure if an MRI would have made much of a difference though, this guy was fairly well reputed and seemed to know what he was doing for the most part - though I'm not sure exactly.

 

So that's my 2C, ask me any questions, I'd be more than happy to answer them. 

Edited by mammaP
Edited language

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bruno2016

"It's got the same success rate as AD's." In other words it has little to no benefit compared to a placebo lol

 

I did nexalin therapy which isnt the same but similar due to its transcranial effects. It did help however wd will typically show its ugly head eventually so imo this could provide some relief but the wd syndrome will not go away. Also, keep in mind we all respond differently so it may help or it may hurt. The drugs do a number on our brains and bodies. I also recommend not throwing hard earned money at this and def do not go into debt bc of it. If you can easily afford, go for it. Highly unlikely imo it will provide long lasting benefits to help with wd syndrome bc of the powerful changes that have occured as a result of using the drugs. Time heals us along with diwt, lifestyle, etc

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mammaP

Early on in WD from cymbalta, I went through 38 TMS treatments at like 3000-5000 pulses or whatever.  It's kind of a long story about how I came to go through TMS treatment and all, so I won't go into the details, but I was one of the few people who did this treatment.  It was a doctor in Newport Beach CA, and he dealt with a bunch of rich people who could afford to pay 30K for this new and fancy FDA treatment.  He was a psyciatrist in Fashion Island, I won't go into the details about his name, because I don't feel like getting sued by his rich ass, but he and his wife basically convinced me to do this treatment after I was made more suggestable from taking cymbalta for 3.5 months or so.  Initially I would have said, no way, but when I was manic from the medication, I was willing to do stupid things like experiment with strong electrical stimulation into a region of my brain (that was responsible for emotions and important administrative tasks).

 

I'm not sure if it was the withdrawal from cymbalta or the combination of cymablta and TMS, but I was more ****** up after completing all of this than I was 5 months earlier when I presented with moderate anxiety and depression.  It definitely DID NOT help with withdrawals whatsoever.  TMS did nothing for me, it just cost  my insurance company blue cross blue sheild like 30K, and made my doctor a wealthier person, and wasted my time and humiliated me.  I did the neurostar treatment, where you just have a somewhat skilled, but not really, lab tech who sits there, adjusts the helmet thing with the magnet, and then just lets it proceed for 30 minutes or so.   they would occasionally "calibrate" the machine by going to my motor cortex and stimulating my thumb to move, they did this from time to time.  It was a rightprfrontal cortext stimulation, and it hurt like hell and made me feel depersonalized/derealized.  I think, but I can't say for sure, that TMS caused my severe DP/DR, and exacerbated the cymbalta withdrawal symptoms.  

 

I should also mention that they never did an MRI or anything to figure out where my right prefrontal cortext was located - I had full faith in the FDA and the doctor that nothing would go wrong with an unskilled, generally uneducated woman sitting there adjusting this thing on my brain.  I'm not sure if an MRI would have made much of a difference though, this guy was fairly well reputed and seemed to know what he was doing for the most part - though I'm not sure exactly.

 

So that's my 2C, ask me any questions, I'd be more than happy to answer them. 

Oscajga I edited out your colourful word, it missed the sensor somehow! Swearing is not allowed but there is a cursing thread where you are welcome to let it all out here,  http://survivingantidepressants.org/index.php?/topic/1081-the-cursing-thread/ What is considered mild swearing in one country can be extremely offensive to others so it is not allowed. 

 

See what can get you warned or banned....... http://survivingantidepressants.org/index.php?/topic/1598-what-will-get-you-warned-or-banned/

 

 

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wantmyhubbyback

hi, all. hubby has so far (after about 12 of a planned 30 treatments) done fabulously well with TMS.  it has made a huge positive difference in his recovery.  he was extremely anxious and nervous @ the first session, but starting with the second session and every session after that he has literally fallen asleep in the chair for at least 20 of the 40 minute treatment. he gets about 8 minutes of right brain treatment for anxiety and about 35 mins or so of left brain treatment for depression.  he did not experience headaches nor any other discomfort. they give him earplugs to make the noise a little less disturbing, and they allow him to hook his computer to their flat screen tv so he can watch sports or whatever (although it really doesn't make a difference since he's asleep anyway. :))

 

it is not inexpensive (we're paying $6k of the $12k cost; the other half is covered by insurance) but it'd be worth it even if we had to pay the entire bill. i haven't heard hubby sing in 2 years, and he often comes back from the treatments humming a happy tune.

 

i will say that the effect doesn't always last the entire day -- sometimes he gets anxious/upset later in the day or evening -- but on the whole he believes (and i can confirm) that TMS is doing something beneficial for him.  the psychiatrist who runs the practice is also very accommodating and has offered to make treatments available at a reduced cost in the future if we need them (although he says most of his patients require none or perhaps 1 treatment a year as a "tune up".)

 

from his comments and the research i've read that's been published by physicians not affiliated with neurostar or other mfrs, it seems nobody gets worse (due respect to those here who have reported differently), about 1/3 of the people who undergo TMS have no symptom relief, 1/3 have mild relief and 1/3 have very positive results.

 

note... this is post reinstatement of zyprexa so we are not treating w/d here -- this is treating what i believe are the anxiety and depression that are being caused by the meds themselves because hubby did not have any underlying psych symptoms when all of this started -- but whatever the case, he is for sure better than he was before the TMS.  my hope is that this treatment will make it easier for him to get back to his life.

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oskcajga

hi, all. hubby has so far (after about 12 of a planned 30 treatments) done fabulously well with TMS.  it has made a huge positive difference in his recovery.  he was extremely anxious and nervous @ the first session, but starting with the second session and every session after that he has literally fallen asleep in the chair for at least 20 of the 40 minute treatment. he gets about 8 minutes of right brain treatment for anxiety and about 35 mins or so of left brain treatment for depression.  he did not experience headaches nor any other discomfort. they give him earplugs to make the noise a little less disturbing, and they allow him to hook his computer to their flat screen tv so he can watch sports or whatever (although it really doesn't make a difference since he's asleep anyway. :))

 

it is not inexpensive (we're paying $6k of the $12k cost; the other half is covered by insurance) but it'd be worth it even if we had to pay the entire bill. i haven't heard hubby sing in 2 years, and he often comes back from the treatments humming a happy tune.

 

i will say that the effect doesn't always last the entire day -- sometimes he gets anxious/upset later in the day or evening -- but on the whole he believes (and i can confirm) that TMS is doing something beneficial for him.  the psychiatrist who runs the practice is also very accommodating and has offered to make treatments available at a reduced cost in the future if we need them (although he says most of his patients require none or perhaps 1 treatment a year as a "tune up".)

 

from his comments and the research i've read that's been published by physicians not affiliated with neurostar or other mfrs, it seems nobody gets worse (due respect to those here who have reported differently), about 1/3 of the people who undergo TMS have no symptom relief, 1/3 have mild relief and 1/3 have very positive results.

 

note... this is post reinstatement of zyprexa so we are not treating w/d here -- this is treating what i believe are the anxiety and depression that are being caused by the meds themselves because hubby did not have any underlying psych symptoms when all of this started -- but whatever the case, he is for sure better than he was before the TMS.  my hope is that this treatment will make it easier for him to get back to his life.

 

I had similarly positive experiences at 12 treatments.  At some point it got to be too much and I had an adverse reaction.

 

My only recommendation is this:  if at any point your husband starts to feel "out of it" or there are any changes in his personality that are not ideal - stop the treatment immediately.

 

I'd also caution any "success" that isn't coming directly from your husband himself.  Often times the patient's spouse will say things like "wow it's helped him wonderfully", while the patient him/herself does not feel the same way him/herself.

 

So I don't want to discount anything you're saying - and I'm glad you're getting a benefit - but considering that your therapist is doing some strange things, like claiming that right side treatment is for depression (that's complete nonsense, I hope you understand), I'm hesitant.  In fact I'd run away full speed from a doctor so foolish as to think that zapping a small part of the right and left prefrontal cortex is going to treat "anxiety" and "depression". 

 

Even my doctor wasn't that fool-hearty and full of nonsense - he basically said that he doesn't understand how it works, but it can help some people and not others - but it would never do any damage.  That's basically what the literature says.  Sounds like your doctor is completely misleading you and taking your hard earned $ - there's absolutely, 100% no scientific evidence backing up his claims.   Depression is a manifestation of multiple brain regions - stimulating one tiny cubic centimeter section with a very powerful magnetically induced electrical current can only do one thing:  disrupt brain function.  The right side and left sides of the brain do not control "anxiety or depression".  That's one of the more obsurd thing's I've read in a long time.  Anxiety is caused by numerous physiological systems interacting with complex feedback loops and responses.  The prefrontal cortex is just one small part of anxiety - and NO ONE knows whether or not the right or left side of the brain is responsible for that part of the feedback loop.  Sometimes if you disrupt brain function sufficiently, you can score "lower" on the depression rating scales - which is basically the only way that the FDA saw that this treatment was effective.  I think you're taking a huge risk. 

 

I got my insurance company to pay for 100% of the treatment - I'd never spend 6-12 grand on something that may only work as good as the placebo no one understands how it works.  Doctors will CLAIM they know - but they will also claim that they know how psycotrophic drugs work too.  They're charlatans - and they want your $.  I was foolish, and should have never done that to my brain - electrical shocks for 40 minutes per day to the brain is a wonderful way to get some lasting damage - as I think I experienced myself.  It caused, at the very least, worsened depersonalization/derealization.  It may have also worsened my memory considerably.

 

I should note that it wasn't until about treatment #30 before I started feeling quite a bit off.  By treatment #38 I was in rough shape. 

 

I apologize if I sound a bit...antagonistic - but the more I learn about "mental illness" the more I realize that treatmens like TMS are no better than psych meds and can only really just disrupt normal brain functioning.  In someone with a brain that has been adversely affected by something as powerful as zyprexa, which has been demonstrated to cause all sorts of issues (so to speak), adding electrical stimulation into the mix seems like a futile endevour.  

 

I honestly hope your husband isn't adversely affected - it sounds like he's been through enough already.

 

Love and hugs.

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wantmyhubbyback

tx, oskcajga. just to clarify... right side is for anxiety. left side is for depression. there are some studies out there (double-blind, sham controlled, etc.) so not sure your claim about "no science" is correct, along with characterizing magnetic resonance as "electrical shocks," which i believe is completely untrue.  if you have data/links supporting that claim, pls post here so i can review them.

 

here is a citation from the mayo clinic website re MRI http://www.mayoclinic.org/tests-procedures/mri/basics/risks/prc-20012903. the only risk associated with magnetic resonance is the presence of metal in the body.

 

i'm sorry TMS didn't work for you, and will heed your caution.

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oskcajga

tx, oskcajga. just to clarify... right side is for anxiety. left side is for depression. there are some studies out there (double-blind, sham controlled, etc.) so not sure your claim about "no science" is correct, along with characterizing magnetic resonance as "electrical shocks," which i believe is completely untrue.  if you have data/links supporting that claim, pls post here so i can review them.

 

here is a citation from the mayo clinic website re MRI http://www.mayoclinic.org/tests-procedures/mri/basics/risks/prc-20012903. the only risk associated with magnetic resonance is the presence of metal in the body.

 

i'm sorry TMS didn't work for you, and will heed your caution.

 

1).  That's not how the brain works - if it was a simple as "left or right" for depression or anxiety, I don't think we'd all be in this mess to begin with.  It's NOT that simple, and yet that's the very foundation that TMS is based on:  stimulate one "potential" region of the brain thats supposed to be "related to depression" and expect this ridiculously reductionist principle to manifest in real-world results.  Considering that much of the researching into TMS is based on the subjective scale of depression (I can't remember the name of the questionnaire) - similar to how psych meds are tested - I hold very little esteem into the current research that has been completed on the subject.  That is, there's no blood test or objective test whatsoever to evaluate whether or not depression has been eradicated or limited - the same limitation exists for most psychiatric treatments that I can think of.

 

Like an above poster mentioned, TMS is about as effective as a course of antidepressants - which is basically MARGINALLY better than placebo, at best.

 

Moreover, I spoke to a professor of psychiatry at a well renowned University in the US about TMS, and he basically told me that "TMS is NOT a bona-fide treatment - it's still very much in the early stages of testing and research".

 

2.  As for the electric current that TMS does produce, here's a wikipedia article for your consumption that explains the physics:

 

TMS uses electromagnetic induction to generate an electric current across the scalp and skull without physical contact. A plastic-enclosed coil of wire is held next to the skull and when activated, produces a magnetic field oriented orthogonal to the plane of the coil. The magnetic field passes unimpeded through the skin and skull, inducing an oppositely directed current in the brain that activates nearby nerve cells in much the same way as currents applied directly to the cortical surface.[37]

The path of this current is difficult to model because the brain is irregularly shaped and electricity and magnetism are not conducted uniformly throughout its tissues. The magnetic field is about the same strength as an MRI, and the pulse generally reaches no more than 5 centimeters into the brain unless using the deep transcranial magnetic stimulation variant of TMS.[38] Deep TMS can reach up to 6 cm into the brain to stimulate deeper layers of the motor cortex, such as that which controls leg motion.[39]

Mechanism of action

From the Biot–Savart law

6fcdf7562220f3283c4395015d36e449.png

it has been shown that a current through a wire generates a magnetic field around that wire. Transcranial magnetic stimulation is achieved by quickly discharging current from a large capacitor into a coil to produce pulsed magnetic fields between 2 and 3 T.[40] By directing the magnetic field pulse at a targeted area of the brain, one can either depolarize or hyperpolarize neurons in the brain. The magnetic flux density pulse generated by the current pulse through the coil causes an electric field as explained by the Maxwell-Faraday equation,

9cab6787646062d6e658cd1e83ad468f.png .

This electric field causes a change in the transmembrane current of the neuron, which leads to the depolarization or hyperpolarization of the neuron and the firing of an action potential.[40]

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starcontrol2

I backed out last moment out of TMS, it was approved and insurance was going to cover.

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LisasLove

Any positive results for tinnitus?

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Newbeginning

My symptoms are all emotional (depression) from withdrawal (after dose decrease), but also apathy that started before tapering and doesn't seem to be affected by tapering. The withdrawal depression has resolved in the past when I updosed a little, but after this last reduction, updosing made me worse. It's been 3 months since the last minuscule (5%) cut and I'm still deeply depressed.

 

I wonder if in my case TMS might be a good alternative? Maybe to treat the apathy once withdrawal depression resolves. Or even for the withdrawal depression since it's not going away. I'm desperate.

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wantmyhubbyback

hi, new.  hubby has tried tms twice -- the results the first time were better  than the 2nd time ... but the first time he was both coming off a really high dose of zyprexa and hospitalization so maybe that's why?  he also is apathetic most of the time, although i can see small glimmers of the return of interest in some things... sports, the daily paper, more sports, bridge, etc.

 

i think the bottom line is that tms works moderately well for 30% of the people who try it, and 30%very well. so in my view, you have a better-than-not chance of getting some improvement with no downside risk (assuming that your insurance will pay for at least some of it.  if you have to foot the entire bill... that might be a different story).

 

someone in this forum had purchased some kind of home-use thing -- not tms, but some kind of electrical scalp stimulator thing -- i recall it being about $200-$300.  maybe you could try that first and see if it does anything?

 

i'm also a big fan of the paul david book and website -- these are more for anxiety than depression -- but i think he covers apathy in both places pretty well.  http://anxietynomore.co.uk/the_book.html

 

hope some of this helps. wishing you peace.

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JanCarol
11 minutes ago, JanCarol said:

My take on TMS is that it's a bad idea to do it anywhere near withdrawal.

 

Members have had a heckuva time doing concurrent TMS and withdrawal, some of whom claim that the TMS impaired their healing and recovery.

 

 

It's the same as with detoxing and neurofeedback - it might be helpful at another time, but not when your brain is scrambled by withdrawal.  In fact, I would worry that TMS would "toughen" the scrambled eggs and solidify a state that should be transitory and is undesirable.

 

It may be a helpful alternative to drugs - but once you've been on the drugs, all bets are off.  You have to deal with the drugs first, then consider brain altering alternatives later.

 

That's my stance on it, anyway, and I would strongly suggest you save your money and wait until you have been drug free for a number of years before trying this.

There are milder ways of creating a similar effect, see: 

 

As you read the thread you will see that people react to these mild electrical interventions.

 

I would be hesitant to put magnets over my brain on a good day.

 

 

 

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Why

Why , why , why keep messing with your brain, with this pseudo-science?

 

This seems just like a more accurate electroshock, where you smash your brain with an hammer , or a small hammer in this case, hoping it will fix something. just like when your tv stops working and you punch it to make it work again.

And human brain is thousand times more complex than a tv. chances you damage more than fix is close to 100% .

 

Sorry for the rant, but this "science as magic" mindset infuriates me, because is what led to modern psichiatry.

 

Of course everyone is free to "treat" himself as he please, but be careful please and look if there is strong factual evidence behind something. And not, some random study from literature is not enough evidence. peer reviews is full of BS 

 

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wantmyhubbyback

well —  i read all of the available independent research and did not think of it as “science as magic” ... there were a number of well-controlled, randomized trials — the “strong, factual evidence” u reference.  if you believe that “some random study and peer reviews are BS” and somehow are less credible compared to the opinions of those who cite zero research, refer to anonymous professors, and seem to want to simply complain vs being proactive in evaluating possible methods of lessening w/d symptom severity....then i wonder what kind of evidence you would find compelling? people are different, so their brains are different, and no single treatment, drug or approach is likely to work for everyone.  all i’m saying here is that tms has in fact worked to varying degrees for roughly 66% of folks who have tried it, including my husband.  is it possible that some of the other 33% had negative outcomes? sure — u can read those in the thread, and jan carol references others as well. anyone w depression or anxiety seeking ANY kind of treatment should i think seek to understand the possible downsides before making a decision. but at the same time i also think it’s fair to let those same people know that some relief may be possible.

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ChessieCat
10 hours ago, wantmyhubbyback said:

anyone w depression or anxiety seeking ANY kind of treatment should i think seek to understand the possible downsides before making a decision.

 

Yes, this is very important.  Research and learn so you can make an informed decision.

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FeralUrban

________________________________________________________________________________________________

Mod Note:  Please read this full post.  It contains both positive and negative experiences with TMS. 

________________________________________________________________________________________________

 

I had a full round of TMS in 2013. I'd had a protracted period of depression for 3 years that wasn't budging. I had been on Effexor about 10 years, and before that tried numerous types of meds with no success, and or bad side effects. Initially Effexor seemed to help me. But I got undiagnosed Lyme disease which was neurological. I was extremely ill. I ended up doing a long course of antibiotics (years) which of course messed up my gut, which of course messed up my whole system. Though I eventually recovered from the symptoms of Lyme, I never got out of the depression or fatigue / malaise that came after it. 

 

The TMS worked beautifully on the depression -- it was like my world went from black and white to color. I felt again what it was to be alive. I was amazed. But… prior to the TMS I had been getting a weird pain in my ribs and then in my neck. It was neuralgia, but that too went undiagnosed. When I had the TMS the nerve pain spread to my right half of my face. I had an additional issue of two infected upper molars, failed root canals and eventual extractions. So I with so much going on I did not associate the spread of the nerve pain with the TMS. 

Then I went 2 1/2 years and did OK with depression, but the nerve pain thing was chronic, painful, and I couldn't get a neurologist who could actually diagnose it. They were basically saying thing to me like, "Well, you have trigemnial neuralgia."

I'd say, "What about my arm and my ribs? 

They'd say, "That's something separate." 

Since both would occur simultaneously I knew they hadn't a clue. It got worse, eventually affecting all branches of the trigeminal nerve, several arm nerves, the ribs, plus allodynia (pain from light touch of wind). I went from one neurologist to the next to no good effect.

 

Then in 2015 my sister died suddenly. We were both traumatized as children. I fared better than she did. I was blown away emotionally.

 

Concerned I was slipping into a depression, went into TMS treatments proactively. They had previously told me it works better, with fewer treatments if you hit a relapse sooner. I had about 17 treatments. They did take me out of depression. But they had another bizarre effect. I was using medical marijuana legally, on the advice of a neurologist, and it was helping with the nerve pain. But about 10-20 minutes into a TMS treatment I would get stratospherically high, regardless of how much I had considered prior. I was told the TMS increases the potency of antidepressants, and apparently it also increased the potency of marijuana. One theory on  how it does this it that it weakens the blood brain barrier. Another is that it forces the neurons to turn on and off repeatedly with each pulse and it is sort of like doing pushups, it make them function more robustly. 

 

I also noticed that it would make the nerve pain in my face worse, but I was at that time of a mindset, that I was in danger of falling into a deep well of depression and I wanted to do whatever it took to not go there. 

TMS has what is called a post treatment effect. For about 6-12 weeks after the treatment, it continues to affect the brain, the depression, or however you wish to conceive of it's effect.  What happened starting with about the last 2 or 3 treatments, is the the nerve pain spread to the entire right side of my body. During the 3 months following the pain accelerated to levels I did not know where possible. I was in the ER 3 times. The standard neurological meds had previous proved useless. I was given sumatriptan, which BTW should never be prescribed with an antidepressant. Basically what happened was I went in to a long term serotonin toxicity (just below the threshold of serotonin syndrome) but with all the symptoms, just at a lesser degree, plus this horrible nerve pain -- half my body on fire.

 

Eventually my psychiatrist figured it out and we started the taper of Effexor, did it in 3 months, ended up in trouble, found this site and have spent the last 17 months tapering from 37.5 to 5 mg. 

Eventually I found a great neurologist at MGH in Boston, who diagnosed the consequences of serotonin toxicity as Central Pain Syndrome -- basically hyper reactive autonomic nervous system triggering the sensory motor cortex to perceive phantom pain in the body and movement disorder stuff. Almost each drop in dose made the CPS worse.  I've had to take new additional medications  to try to get the CPS under control. Thankfully she had done this in collaboration with me, cautiously and I've been in a trend of reduced CPS symptoms for a few months. It's a big deal. I was house bound. 

Long story short: TMS increases potency of medications in the brain, especially SSRI SNRI drugs. So if it works to ease withdrawals, it's just a way of increasing the level of meds. 

Although I would have heartily endorsed this after my first round, now I'm very clearly letting you know, if you want to end up with brain stem and sensory motor cortex damage, have at it. CPS is so bad, that those who don't find a way to manage it, or reduce it generally don't get past 10 years. Usually because of suicide. 

So while I"m slowly continuing my withdrawal, I've also slowly figuring out how to work with a complicated neurological condition which may or may not improve after I get off the Effexor. 

 

Edited by ChessieCat
Added Mod Note

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JanCarol
On 29/10/2017 at 11:32 PM, wantmyhubbyback said:

well —  i read all of the available independent research and did not think of it as “science as magic” ... there were a number of well-controlled, randomized trials — the “strong, factual evidence” u reference

 

After Ben Goldacre's "Bad Medicine,"

Robert Whitaker and Lisa Cosgrove "Psychiatry Under the Influence"

Peter Gotzsche's "Deadly Medicine and Organized Crime"

and scads of other texts which belie the problems with entangling profit, share value, and medicine - 

 

I do not trust many "well controlled randomized trials." 

 

A number of questions come up:  who ran the trials?  Were they trials run only by people selling the stuff they are trialling?  (this is the case with the "mold detox protocols" for example)

How did they choose their samples?  What disqualified someone from the trial?  What included them in the trial?  How large were the samples?  What were the variables in protocol?  How was improvement measured?  (for example, in drug trials, "suicidality" was listed as "anxious thoughts" - big difference!)

There are a million ways to twist a "randomized controlled trial."  Ben Goldacre seems to think this can be fixed by transparency, but the bottom line is - most people (including psychiatrists) are incapable of untangling the statistics and warps of a study, even if it were spelled out.  

This requires specialists such as the Cochrane Collaboration to review the studies and see if they are valid.

SO I checked with Cochrane, and came up with this:  http://www.cochrane.org/CD003493/DEPRESSN_transcranial-magnetic-stimulation-tms-for-depression 

Quote

The information in this review suggests that there is no strong evidence for benefit from using transcranial magnetic stimulation to treat depression, although the small sample sizes do not exclude the possibility of benefit.

 

and:  

http://www.cochrane.org/CD003387/DEPRESSN_transcranial-magnetic-stimulation-tms-for-the-treatment-of-obsessive-compulsive-disorder-ocd

 

Quote

There are currently insufficient data from randomised controlled trials to draw any conclusions about the efficacy of transcranial magnetic stimulation in the treatment of obsessive-compulsive disorder.

 

 

http://www.cochrane.org/CD006081/SCHIZ_transcranial-magnetic-stimulation-tms-treatment-schizophrenia

 

Quote
Authors' conclusions: 

Based on this review, there is insufficient evidence to support or refute the use of TMS to treat symptoms of schizophrenia. Although some evidence suggests that TMS, and in particular temporoparietal TMS, may improve certain symptoms (such as auditory hallucinations and positive symptoms of schizophrenia) compared to sham TMS, the results were not robust enough to be unequivocal across the assessment measures used. There was insufficient evidence to suggest any added benefit with TMS used as an adjunctive therapyto antipsychotic medication.

 

The overall quality of evidence was graded as very low due to risk of bias, and this was accompanied by an imprecision in estimates due to the relatively small number of participants in the studies. Thus, consideration is required in improving the quality of trial processes, as well as the quality of reporting of ongoing and future TMS trials, so as to facilitate accurate future judgements in assessing risk of bias. Differences in TMS techniques in relation to stimulation intensity, stimulation length, brain areas stimulated and variations in the design of sham TMS all contributed to the heterogeneity of study findings and limited the interpretation and applicability of the results. In addition, the trials assessed their outcomes with a variety of scales, and usable data were limited. Therefore, to better evaluate the treatment effects of TMS in people with schizophrenia, we favour the use of standardised treatment protocols

and outcome measures.

 

and http://www.cochrane.org/CD009083/DEPRESSN_repetitive-transcranial-magnetic-stimulation-rtms-for-panic-disorder

 

Quote
Authors' conclusions: 

Only two RCTs of rTMS were available and their sample sizes were small. The available data were insufficient for us to draw any conclusions about the efficacy of rTMS for PD. Further trials with large sample sizes and adequate methodology are needed to confirm the effectiveness of rTMS for PD.

 

 

Basically, the trials are biased, small, and inadequate to prove anything.  

Pay attention to what Oskcaja says - if the changes become "personality changes," it's time to quit.  Here's the conundrum though - how do you quit BEFORE a thing goes bad?  My crystal ball isn't quite working today...

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JanCarol

I would also like to point out that I cook with magnetic induction.

 

This is why metal would be a problem - it would heat up!

 

I'm not sure I want the same technology I use to make popcorn to be used on my brain.  That's a purely emotional response - but food for thought (pun intended).

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JanCarol

But to present a balanced perspective, here is the material my brother-in-law sent from his clinic in Melbourne:

 

http://www.neurocareclinics.com.au/therapies/rtms/

 

Looks good, eh? 

 

Of course, it's meant to!  These technicians and their toys are very expensive, and they are often in posh offices.

I did this in the wrong order - I wanted to finish on magnetic induction cooking - but - there ya go.  My research topic for the day.

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wantmyhubbyback
On 10/29/2017 at 9:32 AM, wantmyhubbyback said:

anyone w depression or anxiety seeking ANY kind of treatment should i think seek to understand the possible downsides before making a decision. but at the same time i also think it’s fair to let those same people know that some relief may be possible.

 

just saying this again.  i also think it's unfair to tag this thread with a moderator's note that references a poor experience without also indicating those who have had positive outcomes. 

 

jancarol, appreciate your comment re "balance." there are no givens in the recovery from depression & anxiety, and it should also be noted that TMS generally should not be the first line of response -- in fact, our insurance co standards call for patients to have shown resistance to at least 2 different ADs or treatments.  hubby was hospitalized 4x for depression/anxiety in a 24-month time period, during which they jacked up his meds to unconscionable levels. TMS has helped him to reduce/eliminate some of them, tho he's still anxious and depressed in the mornings ... so even while i'm a fan of TMS, i'm the first to say it's not a "cure."  but it's clear it did have a positive effect on him,

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ChessieCat
7 hours ago, wantmyhubbyback said:

just saying this again.  i also think it's unfair to tag this thread with a moderator's note that references a poor experience without also indicating those who have had positive outcomes. 

 

It was me who put the Mod Note in the first post.  I will explain why I did this.

 

When people get desperate they look for something which might work so they are generally looking for the positives, not the negatives.  The reason I say this is that their desperation can make them willing to try anything.  They want some glimmer of hope and this generally has them looking for the ones for whom it worked.  Their desperation can make them unconsciously blind to the negative responses.

 

I considered whether I should add the Mod Note.  When a member posts about something working or not working information is sometimes not fully provided so it can be difficult to glean whether the information has value.  In this case I decided that the information that FeralUrban wrote about his experience is valuable to people needing to make a decision about TMS and because the post is down the page I was concerned that people reading this topic may miss his post or not read all of it.  His second paragraph starts with "The TMS worked beautifully on the depression -- it was like my world went from black and white to color. I felt again what it was to be alive. I was amazed."  Some people may not read any further than that.

 

The Mod Note also said suggest.  So that people can make an informed decision they should get as much information about something as they can, both positive and negative.

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ChessieCat
On 30/03/2017 at 12:42 PM, wantmyhubbyback said:

hi, new.  hubby has tried tms twice -- the results the first time were better  than the 2nd time ... but the first time he was both coming off a really high dose of zyprexa and hospitalization so maybe that's why?

 

I have just gone back and read your post.  It may be that the improvement was from reducing the Zyprexa and not the TMS.  When two or more things are changed at the same time or within a short period of time, it is impossible to know for sure what caused the result.

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Downbutnotout

My tms did not work! I am devastated. They could not find a connection between my brain and the machine. It happens very rarely.

 

 

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JanCarol

Here are some reports from Mad In America:

 

https://www.madinamerica.com/2014/02/transcranial-magnetic-stimulation/

 

(remember to read the comments - people have had negative experiences with this)


One of the comments in the article suggests going to an osteopath instead, for a less invasive 'adjustment.'

and

 

https://www.madinamerica.com/2017/05/brain-stimulation-research-lacking-reproducibility-scientific-integrity/

 

 

Edited by JanCarol

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wildchild93

Anyone experience any benefits from TMS therapy to relieve symptoms of depression/anxiety in protracted withdrawl?

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Downbutnotout

There is a post confirming this if you put in tms. There are others saying it’s a bad idea. I was going to do it but unfortunately, it didn’t work for me. The machine couldn’t connect to my brain. No motor threshold. It never ever happens. I did research it. You’ll find just as many against as for. 

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wildchild93

Tms helped me to sleep every night for a month during a period of time when I wasn’t sleeping at all. When I had finished the treatment, I stopped sleeping again. I’m trying to qualify for a second round now. The treatment was free for me; insurance covered it 100%

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