Unlike the first MD, this individual is in private practice. That is, he’s not a clinical researcher. There are several individuals in the practice and they share a TMS machine.
There was almost complete agreement on the topics of overlap between the first doc and this one. There were, however, a number of other interesting bits of info to share.
The second doc believes a more accurate response rate is 70-80% with folks like me (multiple anti-depressants and combinations tried) with 40% getting full remission, i.e., no drugs needed. For folks who are bipolar or have had ECT the numbers are lower, but he doesn’t have the data to quantify how much. These stats are based on his results and others he works with across many practices.
An open research question is the need and value of ongoing maintenance treatments. His gut feel is a follow-up session may be needed as often as every three weeks for some people. He has patients who call in as the depression returns and they get a maintenance session that does the trick for awhile.
He generally follows the standard 20-30 sessions, 5 times a week, but thinks it may be better to add more sessions at the end to taper off. Along those same lines he expects there will be more breakthroughs in this area. The current procedure only treats the left side of the brain. He is fairly certain benefit will be shown eventually to treating both sides.
On the topic of folks who don’t respond, his experience is if someone is not going to get any relief you know it by 20 sessions and can stop. In fact if there’s no noticeable improvement after 3 sessions, they do a realignment just in case there was a problem.
As with the first doc, the lack of insurance coverage is a major problem getting patients. At $400 per session it just isn’t affordable for most people. His practice has had their machine since Jan and they have treated 15-20 people. (That’s, very roughly, about 1 session per day on average.) If insurance covered it, he’s convinced they would have treated at least 100 patients. Of the patients mentioned above, the doc treated 8 of them. One failed to get any benefit, 3 were partial successes and 4 experienced total remission.