This new research, published in the journal Biological Psychiatry, finds that as people's depression improves, their sleep improves, and treatment does not need to cause insomnia or other sleeping problems.
A research team performed a secondary analysis of a study of 301 patients at 23 sites looking at the differences between the Neuronetics Transcranial Magnetic Stimulation Therapy System and placebo treatment in patients who do not respond properly to antidepressant medications.
TMS sessions were given to participants for 40 minutes, five days a week, for six weeks. The original findings, published in Biological Psychiatry in 2007, supported the Food and Drug Administration's approval of TMS for the treatment of depression.
This secondary review verified TMS' successfulness, but uncovered no significant difference of rates for insomnia or sleepiness among those who received placebo or actual treatments. Patients in the treatment group were also not more likely to ask for medication to help with anxiety or insomnia.
The authors report that the new findings will alleviate worries of sleep-related side effects and help physicians remember to remain attentive to residual insomnia in depressed people that are being treated with TMS.
Sleep issues are a major side effect associated with antidepressants. Some drugs sedate patients, while others speed up their systems and make sleeping more difficult. The majority of patients with major depressive disorder suffer from insomnia. Many find they have insomnia for a while, and then go through bouts of sleeping too much. Fortunately, TMS does not have any negative effect on sleeping patterns.
"One of the many bad things about depression is that often patients cannot sleep. We think it's a significant symptom. If patients can't sleep, it really adds to their distress, and even increases the likelihood of suicide. We need antidepressant treatments that patients can tolerate so that they will stay with the treatment, which takes weeks to fully achieve. Our study adds to the evidence showing that TMS has remarkably few side effects."
TMS is a popular request by patients with depression either in combination with medications or to avoid them.
Rosenquist said: "Mood disorders are associated with widespread structural and functional changes in the human brain, which can be reversed with successful treatment. Clinical researchers are working to find the optimal way to restore normal brain function."
TMS works on the prefrontal cortex, a region in the brain involved in mood regulation, and some other higher-order functions, such as decision-making, evaluating, and planning.
During a TMS session, the patient sits in a reclining chair and brief pulses of an MRI strength magnet are applied, the device is held against the front of the head. The magnet energy applied increases the activity of the brain cells close to the surface of the brain, which then makes the rest of the brain become more active.
Approximately 14.8 million American adults (6.7%) live with major depressive disorder each year, says the NIMH (National Institute of Mental Health). It is the main cause of disability among Americans aged from 15 to 44. Rosenquist explained that nobody knows what exactly causes depression or why antidepressants and other therapies, such as TMS, work.
Rosenquist said "It's an important puzzle and the work continues. We are excited to be a part of this effort at Georgia Health Sciences University."
Written by Kelly Fitzgerald