Using MRI to treat depression

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SARASOTA - A partly sunny day describes more than the weather for Christine Uttaro. The Venice resident has battled major depression for two decades, and has tried, she says, most of the available anti-depressant drugs, as many as ten at a time.

“They're effective for a while,” Uttaro says, “then they don't work.”

In 2004, she fell into a depression that lasted for more than five years, one she describes as being enveloped in darkness. “The despair is more than I can express,” she says. “In 2009 I went to my psychiatrist and said, 'I'm

desperate. I'm losing hope.'”

People with depression, like Uttaro, who feel like they've reached the end of the line might have a new place to turn, thanks to treatment that essentially uses an MRI to stimulate the brain. “It's a pulsed MRI machine,” says Rebecca Cohen, a psychiatrist who uses it at Comprehensive MedPsych Systems in Sarasota. The magnetic energy goes about 2-3 centimeters into the brain. “And it boosts, or activates the mood centers of the brain,” Cohen says.

It's called Transcranial Magnetic Stimulation (TMS). The FDA approved it in 2008 to treat people who have failed to respond to anti-depressants. “In the FDA trials, over half the patients responded to TMS and about a third of the patients had complete remission,” Cohen says, noting that TMS has been used only on so-called treatment-resistant patients.

Like Uttaro.

“And in, like, eight weeks,” she says, “I was in remission.”

Cohen warns that depression has no cure, and Christine comes in for "booster treatments" when her symptoms return. But her world has vastly changed since the days when even driving a car or reading a recipe proved an exhausting task, and even the sunniest days showed her only clouds. “That I can sit here and have this conversation with you is a wonderful thing.”

Because the treatment is fairly new, many health insurers don't cover it yet. Cohen expects that to change as TMS proves itself and, someday, believes that it will become a routine part of treating major depression. “It's benign, well-tolerated, and patients seem to get so much better,” she says.