There is a newer treatment called rTMS (repetitive transcranial magnetic stimulation) that has had very promising results.... Rumor has it that the end of 2010 or beginning of 2011 Medicare may begin including it in it's covered services. If this happens, other insurance companies will follow.
I was considering ECT and my therapist had a shiny new chair from the future in his office. He was a first adopter of the TMS technology, and said I was a candidate for it. Yes, entry fee is $10,000 and it's not covered by insurance. I was desperate, but fortunately I did some reading on it.
Unfortunately, TMS has *not* had promising results, as Catjudo said. The FDA specifically did NOT approve the device for treatment of depression because it said the limited trials "did not prove the efficacy" of the machine for MPD. Later (and suspiciously), however, the FDA rammed approval of the device through a fast track process of approval on the basis that the machine was similar to other devices, so it therefore didn't need "premarket approval" after all. (As someone who helps companies get their products through FDA and CE Marking approval, I can tell you that this is totally mystifying, and shocking.) Plus, the initial trials that
were done were not particularly conclusive, and there has been NO long term study to know if (a) an initial set of sessions is sufficient, or if lifelong maintenance is required (at tens of thousands of dollars more!), and (b) the long term effects to the brain from the technology itself. Furthmore, there were difficulties in the trials because developing a "placebo" machine proved problematic (users knew it was a fake, jeopardizing the study.) Finally, I noticed that my doctor, and a company rep from the machine's manufacturer, quoted a outrageously high number of "clinical trial" patients -- something like 10,000, when the number of actual people run through the trial was about 160. I told my doctor that his "10,000" number was way off, and he just scrunched his head.He was just parroting what the manufacturer reps told him. When you have reps saying "10,000 patients" and the real number is only 160, you have to question the manufacturer's integrity.
And remember, the FDA, while approving the device, specifically said the manufacturer
failed to show sufficient evidence that the device provides any relief for depression or related diagnoses.
TMS has a long way to go to prove itself as effective as ECT, and the suspicious way it sped through FDA should raise eyebrows. There is a movement to have it de-listed from FDA and to have the process restarted from scratch, properly this time. That same movement is pressuring Medicare NOT to accept it for reimbursement, until efficacy is proven through proper trials.
