Scientists at Stanford University School of Medicine believe they have found a noninvasive way for people to experience rapid remission from severe depression in five days or less.
The Stanford accelerated intelligent neuromodulation therapy (SAINT) has shown promise and appears to be helping people, such as 60-year-old Tommy Van Brocklin, who has been battling depression since he was 15.
Over the years, Van Brocklin said he underwent different types of treatment for depression, including talk therapy which worked for about "half a day after an appointment." In the 1990s, he started taking Paxil, which "worked liked a miracle drug." But Paxil began to lose its effect after 10 or 15 years, and after 25 years, it lost its effect altogether. Van Brocklin took other medications, one of which made him suicidal.
One day, Van Brocklin's sister, who lives in California, told him about SAINT and connected him with the Stanford researchers. So in September 2021, Van Brocklin flew from his home in Memphis, Tennessee, and out to California to participate in the study. Van Brocklin said he felt nothing on the first day, but he felt emotional on the second day.
"I felt the struggle of what I'd been through all these years," he said. "The next day, all of a sudden, it broke through. I felt so much better, and it's stuck with me."
SAINT could be a game-changer, said Dr. Nolan Williams, the study's senior author, published in October in the American Journal of Psychiatry.
"It works well, it works quickly and it's noninvasive," said Dr. Williams, an assistant professor of psychiatry and behavioral sciences at Stanford Medicine.
Depression is a leading cause of disability worldwide and is a significant contributor to the global burden of disease. According to the National Institute of Mental Health, an estimated 19.4 million adults in the United States aged 18 or older had at least one major depressive episode in 2019. This number represented 7.8 percent of all U.S. adults. What's more, depression appears to affect more adult females than males.
The SAINT Study
SAINT is a new type of repetitive transcranial magnetic stimulation (rTMS). rTMS is an intense, noninvasive procedure that uses electrical impulses to balance out erratic neuronal activity in the brain.
The Stanford study involved 29 trial participants with treatment-resistant depression. About half of the participants received SAINT, while the rest received a placebo treatment. For those receiving SAINT, researchers took an MRI scan to find the best possible location to send electrical pulses to the prefrontal cortex, the part of the brain that regulates problem-solving and controlling emotions. Dr. Williams said this area of the brain is thought to be underactive in depression.
Scientists disguised their treatment with a magnetic coil that mimicked the magnetic pulse of participants receiving the placebo. In addition, both groups wore noise-canceling earphones and received topical ointment to dull the sensation.
The scientists were rapid and astounded by the results: Almost 80 percent of SAINT participants were symptom-free in five days or less, compared to 13 percent of participants who received the placebo treatment. The treatment's most common side effects participants reported were headaches and temporary fatigue.
Unlike SAINT, the rTMS treatment currently approved by the U.S. Food and Drug Administration (FDA) requires six weeks of daily sessions. Unfortunately, statistics show that only half of the people who undergo rTMS improve and only about a third go into remission from depression.
Stanford researchers hope that SAINT will receive clearance from the FDA by this year. Dr. Williams said he is optimistic that insurance companies and Medicare, which already covers conventional rTMS regimens, will cover SAINT.
Study Participants Still See Results From Treatment
Stanford science conducted a previous study of the SAINT treatment. Emma, a 59-year-old California resident who did not want to use her last name, said the treatment she had three years ago is still holding.
Emma had been fighting debilitating depression for 40 years. She had taken medication for years and said she was suicidal and felt she would die. So, Emma's psychiatrist recommended that she enroll in the study.
The researchers first took an MRI scan to find the best location to deliver electrical pulses to her brain. Then, she sat in a chair for 10 hours a day for five days while a magnetic field stimulated her brain.
At the end of the first day, Emma felt an "unfamiliar calm." Surprisingly, as she rode home the first night, she said she looked out of the window and "enjoyed the ride." Although she still has her ups and downs, Emma says, "it's an entirely different me dealing with it."
Because of the rapid remission participants experienced, Stanford researchers hope that the SAINT treatment can be used with members of the general public suffering from depression and at a "crisis point."
"We want to get this into emergency departments and psychiatric wards where we can treat people who are in a psychiatric emergency," Dr. Williams said. "The period right after hospitalization is when there's the highest risk of suicide."
Van Brocklin said he had made several changes since he returned from treatment and has a "really strong desire" to get his life together.
"I don't procrastinate anymore," he added. "I'm sleeping better. I completely quit alcohol. I'm walking my dog and playing the guitar again for nothing more than the sheer joy of it."
Most importantly, he said, "I'm remaining positive and being respectful of others. These are big changes in my life."
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