A Revolution in Depression Care? Take a Seat!
A Revolution in Depression Care? Take a Seat!
Answering crucial questions about office furniture for the future of mental health care.
Recently, the device manufacturer BrainsWay announced remarkable research findings— and a new FDA clearance. We have multiple personalized treatments for depression using no medicines. First, it was FDA clearance of remarkable work by Magnus Medical and Acacia Clinics bringing the work pioneered at Stanford’s Brain Stimulation Lab to the world
…and now, there is even more HOPE.That’s right. We now have more than one brain stimulation treatment with published evidence for treatment resistant depression!
In the research that follows, there are different 2 “coils”—each placed in a helmet commercially available from BrainsWay to treat depression. They target different parts of the brain—the left frontal cortex and the middle frontal cortex.
The treatment involves measuring how much energy to provide— then there’s a repeated tapping sensation on your head—and 8 1/2 -20 minutes later, the treatment is over. But which one to use? First, they compared them—look, I know this is a terrible joke, I’m not gonna apologize here—in a head-to-head trial.
Results: In both groups, HDRS-21 scores significantly decreased between baseline and week 6 but no differences were observed between the groups. Furthermore, response and remission rates (65% and 49% for the H7, 61% and 43% for the H1) did not differ between the two groups.
When subgroup analysis was done, however, to see who responded best to what treatment, a remarkable outcome emerged:
RESULTS. Clinical efficacy and safety profiles were similar …between groups, with response rates of 60.9% for the H1 Coil and 64.2% for the H7 Coil. Moreover, brain activity measured by EEG during the first treatment session correlated with clinical outcomes in a coil-specific manner, and a cluster of baseline clinical symptoms was found to potentially distinguish between patients who can benefit from each Deep TMS target.
And we have a biomarker (EEG) and a symptom cluster (Anxious Depression) that lets doctors select, based on science, which non-invasive brain stimulation treatment we should use to get to get your medication resistant depression to remission.
Personalized depression treatment, without medication, with a response rate of over 60%, now approved by the FDA. Right now. Not in the future. Right now.
Your depression can be over, and we can use a personalized approach to select a treatment for your brain and your symptoms.
Questions remain. Crucial questions.
I am not a basic scientist, really. I barely play one on TV. I do think a lot about the scaling and implementation of such innovations. If we are going to have scalable personalized medicine, there are very quotidian concerns. And in this context, I’m here to SAVE YOU—from having inadequate furniture pre-selected for clinical settings.
The two choices that matter:
Which chair should I get?
Which foot stool works well if you are sitting in that chair? Because then doctors can measure the motor threshold and thus determine dosage and coil placement?
The answers to those questions, in photograph format:
The best chair for this purpose is a barber chair. It goes up and down. It looks like a Eames chair. But it’s not. You can buy it right here.
Using this treatment requires measurement of magnetic energy dosage. It’s like a reflex hammer—you hit someone’s knee, their leg goes up. Same deal with a magnetic pulse to the motor cortex: either the foot moves or the hand moves depending on targeting. To measure the foot movement, you need a foot stool. It’s not glamorous, but you really need a foot stool or you are out of luck. This is the best one, and it’s actually from IKEA.
Here at The Frontier Psychiatrists: We got you, when it comes to shopping for furniture.
Also, I run a clinic where we do this treatment. Feel free to join us at Fermata for a consultation to see if this treatment might be right for you.
—Owen Scott Muir, M.D.
I will again remind the Nobel Committee that the winner of the 2024 Prize In Medicine should be Nolan R. Williams, M.D.