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Electromagnetic pulses treat depression

Dr. Michael Genovese is pictured with the NeuroStar

Dr. Michael Genovese is pictured with the NeuroStar TMS Therapy system which is used for magnetic pulse energy treatment at his office in Garden City Thursday. (March 1, 2012) Credit: Barry Sloan

Several Long Island psychiatrists have turned to a drug-free method of treating patients with severe depression by directing pulses of electromagnetic energy into the mood center of the brain.

Using a magnet therapeutically, doctors say, helps overcome challenges posed by anti-depressants -- sometimes they work, but often they don't, when depression is severe.

"Most of our patients have not had their depression come back," said Dr. Michael Genovese, a Garden City psychiatrist who has treated 62 patients with electromagnetic therapy.

Genovese in 2009 became part of the first wave of private practitioners to embrace the therapy following its extensive clinical testing and use in academic treatment centers. Federal medical-device regulators approved the treatment system, developed by Neuronetics Inc., in 2008.

Genovese's practice is one of eight psychiatric centers on Long Island with the device, known as NeuroStar. It's designed to boost specific chemicals in the brain by stimulating their production via pulses of electromagnetic energy.

"It sounds kind of geeky but it's really kind of cool," Genovese said.

Formally called transcranial magnetic stimulation -- TMS -- the system utilizes an MRI-strength magnet encased in a coil placed on the scalp. Patients recline in a chair similar to one in a dental office as the machine delivers pulses to a specific region in the brain's left prefrontal cortex.

A computer turns the magnet on and off 10 times per second, Genovese said, and sounds like a typewriter as it induces an electromagnetic current.

Patients undergo daily therapy for 37 minutes over a six-week period. The electromagnetic energy stimulates neurons -- impulse-triggering cells in the brain -- to balance the production of three neurotransmitters: serotonin, dopamine and norepinephrine.

"Basically this retrains the neurons to release these neurotransmitters appropriately," Genovese said.

Depression affects nearly 20 percent of the U.S. population with varying severity, according the National Institute of Mental Health.

"Major depressive disorder consists of extended periods in which a patient suffers from persistent sadness," said Dr. Marie Surpris, a Riverhead psychiatrist who has offered the treatment for about six months. "There's a lack of motivation. They're unable to work or go to school, and lack interest in activities they used to enjoy."

Many patients develop resistance to medications used to treat major depressive disorder, Surpris said, noting the drugs also can cause side effects, such as weight gain, decreased libido and nausea.

Debbie Hurley, 42, a book author in St. James, had suffered major depression for nearly 20 years. Her condition resisted medication. Having finished TMS therapy two weeks ago, Hurley marvels at her progress.

"I probably started to feel a positive change within two weeks of TMS," Hurley said. "By the third or fourth week I had no anxiety, no depression. I felt like the old me was back -- and I was thinking about the future and things I wanted to do in the future," Hurley said. "I usually just thought about surviving."

The American Psychiatric Association recommends TMS for patients who've not fared well on antidepressant therapy. But some insurers won't pay for the treatment, which costs $200 to $300 per session.

Studies suggest an infinitesimal chance of seizure with the therapy, a risk shared with some antidepressant drugs.

"The risk of seizure is quite rare," said Dr. Mike Brock, Neuronetics' medical director, who estimated it based on years of research at 0.1 percent.