Brain Stimulation For Severe Depression May Ease Suicidal Thinking - Research, Quality Of Life

According to a new study published in the Journal of Clinical Psychiatry, a specific type of non-invasive brain stimulation known as rTMS (Repeated Transcranial Magnetic Stimulation) can reduce suicidal ideation in a significant proportion of people with severe depression

40% of study participants who underwent bilateral rTMS reported that they no longer experience suicidal thoughts. Brain stimulation works by directing magnetic impulses to specific areas of the brain.

Suicidal ideation is a common symptom among people with a variety of mental disorders, such as post-traumatic stress disorder (PTSD), bipolar disorder, schizophrenia, and borderline personality disorder. It is estimated that about 90% of people who commit suicide have mental illness.

New treatment for severe depression

The new results offer hope that in the future rTMS may offer a new way to prevent suicide in people with severe depression as well as other mental illnesses.

“This is one of the first major studies showing that rTMS is effective in treating suicidal thoughts,” said Dr. Jeff Daskalakis, study author and co-director of the Center for Mental Health (CAMH) in Toronto, Canada. “One of the effective treatments for suicidal thoughts is electroconvulsive therapy, or ECT.”

“Although ECT is the most effective treatment in the psychiatric picture, it is rarely used because of the high stigma and adverse cognitive side effects associated with treatment. Less than 1% of patients with severe treatment or depression resistance receive ECT.”

Treatment for refractory depression is defined as a condition where people do not experience a noticeable improvement in their symptoms after trying at least two different antidepressants and therapies.

Research essence

The new study looked at data from two previous studies, CAMH and rTMS, given to people with refractory depression. At the beginning of these studies, 156 people said they had experienced suicidal ideation.

The new rTMS study was applied to the dorsolateral prefrontal cortex, the region of the frontal lobes, five times a week for three or six weeks.

Participants were randomized to use rTMS in one of the following ways:

• 1. Impact on both the right and left frontal lobes (bilateral rTMS).
• 2. Exposure to the left frontal lobe only (unilateral rTMS).
• 3. Fam rTMS, which is essentially a placebo.

Bilateral rTMS was the most effective of the three types listed above. A total of 40% of people who received bilateral rTMS reported that they no longer experienced suicidal thoughts by the end of the study period.

In comparison, 27% of those who received unilateral rTMS and 19% of those who received rTMS placebo said they no longer experienced suicidal thoughts.

Left unilateral rTMS is now the most common type in use. But research results indicate that targeting the right frontal lobe may be key to treating suicidal ideation, said author and Dr. Corey Weissman at the Temerti Center for Therapeutic Intervention.

Previous studies in people with depression and suicidal thoughts have shown that this region of the brain may be associated with impulsivity and difficulty regulating emotions.

Prevent suicide

Surprisingly, a reduction in suicidal ideation was not associated with a decrease in the severity of depression symptoms, and it remained at the same level.

“This suggests that suicidality is not necessarily a symptom of depression,” Weissman said

Since suicidal ideation is a consequence of many possible mental disorders, identifying a new and effective treatment method can prevent suicide and reach a wider range of people with mental illness in contrast to existing, traditional methods of exposure.

Sources:

• https://www.ncbi.nlm.nih.gov/pubmed/26981889
• https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/complementary-and-alternative-therapies
• https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/repetitive-transcranial-magnetic-stimulation
• https://www.ncbi.nlm.nih.gov/pubmed/?term=Daskalakis%20ZJ%5BAuthor%5D&cauthor=true&cauthor_uid=22975030

Based on article: psychcentral.com/news/2018/05/06/for-hard-to-treat-depression-brain-stimulation-can-ease-suicidal-thinking/135164.html

Author: Traci Pedersen