We would not be doing TMS if it hadn’t been scientifically proven to work. What does that mean in a medical practice? The first thing you need to understand is the “placebo effect”. Most people are familiar with the term, and it basically means that someone is told that they are receiving a treatment. Even if they are not actually receiving a treatment, in other words the famous sugar pill, they might get better.

That can work with blood pressure or athritis pain. There is something we call the placebo response rate. A percent of people who are given a sugar pill will say “That’s good doc. My knee feels better”.

In psychiatry, as you may imagine, the placebo effect is extra strong because we are dealing with peoples thoughts and emotions. Those are going to be more susceptible to talking yourself into that. When a drug or a medicine is approved by the FDA in the use in humans, it is shown in a type of study, called a randomized, double blind placebo control study.  The treatment or medicine needs to be two times better than placebo to be FDA approved.

In order to be given to people in a medical practice, our drug or treatment, has to be significantly better than placebo. What they do is take a large group of people and they randomize both groups. They do not tell the subjects who is getting the real treatment or the placebo treatment. In treatments like TMS, they use real TMS versus “sham” TMS. With sham TMS, this means they have a set up that looks and sounds like TMS, but is not actually delivering TMS pulses. So they don’t tell the researchers who’s getting the real one and who’s not and they don’t tell the participants who’s getting the real treatment and who is not. We really want to remove any bias.

TMS has gone through that more than twice, in order to get the FDA approval in 2008. It has been shown to be better than placebo. In fact is has been shown to be not just a little bit better than placebo, but TMS turns out to be twice as good as placebo in the studies that have been conducted.

Another way to look at it is what we consider the response rate. Then there is a percentage called the remission rate. Here we look at what percentage of people become depression free. With TMS, what we have seen is that the response rate is at 50%. You have to feel 50% better to count it as a response and the response rate there is 6:10 people. The remission rate is about 25% – 30%. Those are actually startling good numbers considering all of our TMS patients have already failed 3 or more medications. In our practice the average patient has failed 7 antidepressant medications before they have come to us to try TMS. More than half of these patients are getting better and more than a quarter are getting all better.

It has been very gratifying to see these results. Our results have complete tracked the research percentages that we see.  We have been then, therefore, quite happy with it.