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I think you missed the point of my comment and fair enough because I was ranting :) TMS is a GREAT technology. More people should use it, and it should be cons

I think you missed the point of my comment and fair enough because I was ranting :) TMS is a GREAT technology. More people should use it, and it should be considered first line treatment over meds. These machines should be in inpatient psych wards. TMS will inevitably help people. I'm not contesting any of that and this is a good thing. HOWEVER - this is a small study and I'm willing to bet they didn't include people who had failed previous rounds of TMS (or maybe even people who had failed ECT) for a reason. Because it's still the same technology. I'm pretty sure that the remission rate for this will top off around 30%, perhaps a bit more, when more studies have been done and we're looking and real world treatment resistant patients, which is about what we see with TMS (and ketamine for that matter) already. The point I'm trying to make is that treatment resistant depression is very common and debilitating. If someone is very treatment resistant, they will have tried TMS in the course of their treatment, as I did in 2012, when it was first released. I'm not sure how common this is but in my state Medicaid covers the cost of a course of TMS. We need new treatment modalities, not because TMS or existing treatments are "boring or "old news", but because treatment resistant depression is a serious issue and we have very limited tools as of yet to help people who aren't responding to these end of the line treatments. I'm also wary of how TMS is handled in clinics. It can be a bit cult like in some places (doctors overprescribing, overpromising, shrugging off side effects in populations that shouldn't be getting it like bipolar). The quote at the end of the article scares me too. I've noticed the more widespread and accepted a treatment becomes, the more stigmatized and impossible it is as a patient to get help. BUT WHAT PROZAC DIDN'T WORK FOR YOU?? BUT HUHH, CBT DIDN'T WORK FOR YOU? 15 years in, I still get doctors trying to get me back on an SSRI and try behavioralism on me. There are people who are very treatment resistant, and we need to understand this isn't a cure all. The more of a "fad" something becomes the more screwed you are in the medical system looking for help when it legitimately didn't work for you, even though we know even from this paper it's not a 100% remission rate. That's my perspective and lived experience that I'm trying to bring to this discussion. TMS is great, and it's great it's being adopted more. But I'm wary of what that means for people who really need help and have failed TMS and other treatments and need and new modalities like me. I can hold both perspectives.

TulliusCicero 5y ago
> If someone is very treatment resistant, they will have tried TMS in the course of their treatment, [citation needed] A dear relative of mine has depression that medication has only sort of worked for, and they'd never even heard of this treatment before I just linked them to it. I think you're drastically overestimating how aware people are of more recent treatments. Not everyone is hyperconnected to new medical developments. Plus, making a fairly effective treatment work in five days vs six weeks is still a huge deal. And that helps answers your question of, "Why is the media doing this with old depression treatments that have been around for ages?" Because it's not actually that old, a lot of people don't know about it, AND it's a big step forward for the practicality of that treatment.
- cupcake-unicorn 5y ago
  I'm not saying it's not a huge deal. I wouldn't consider your relative necessarily treatment resistant. I'm talking about those of us who have been left behind. In my case, that's 15+ plus of over 30 medication trials (following the STAR-D algorithm as well), failed bilateral ECT, TMS, ketamine IV, trigeminal nerve stimulation, and more. I'm on disability for the depression. I'm not trying to invalidate your relative's situation but there are also people who have been stuck in the system for years like me and we need NEW OPTIONS. As I said, both things can be true. TMS being made faster is good, but we can't stop there, and that's my perspective on the article with someone with my lived experience. Not everyone knows someone this treatment resistant so I'm offering my unique experience about it. Your relative's experience and anyone who has tried a few meds or even hasn't and wants to try TMS is valid and I'm happy this exists. What I'm saying is that for the smaller population like me who has already been left behind this isn't going to help that much.

TulliusCicero 5y ago

> If someone is very treatment resistant, they will have tried TMS in the course of their treatment, [citation needed] A dear relative of mine has depression that medication has only sort of worked for, and they'd never even heard of this treatment before I just linked them to it. I think you're drastically overestimating how aware people are of more recent treatments. Not everyone is hyperconnected to new medical developments. Plus, making a fairly effective treatment work in five days vs six weeks is still a huge deal. And that helps answers your question of, "Why is the media doing this with old depression treatments that have been around for ages?" Because it's not actually that old, a lot of people don't know about it, AND it's a big step forward for the practicality of that treatment.

cupcake-unicorn 5y ago
I'm not saying it's not a huge deal. I wouldn't consider your relative necessarily treatment resistant. I'm talking about those of us who have been left behind. In my case, that's 15+ plus of over 30 medication trials (following the STAR-D algorithm as well), failed bilateral ECT, TMS, ketamine IV, trigeminal nerve stimulation, and more. I'm on disability for the depression. I'm not trying to invalidate your relative's situation but there are also people who have been stuck in the system for years like me and we need NEW OPTIONS. As I said, both things can be true. TMS being made faster is good, but we can't stop there, and that's my perspective on the article with someone with my lived experience. Not everyone knows someone this treatment resistant so I'm offering my unique experience about it. Your relative's experience and anyone who has tried a few meds or even hasn't and wants to try TMS is valid and I'm happy this exists. What I'm saying is that for the smaller population like me who has already been left behind this isn't going to help that much.