Recent News – Welcomes Patient Care Coorindators – Lenox Hill TMS Highlights: 2012 – Insurance Updates
Latest TMS-Related Research – Helpful Links
Since 2009, TMS has helped treat more than 11,000 patients with symptoms of severe depression. Lenox Hill TMS has performed over 2,500 treatments since its inception in New York in 2010, and San Francisco in 2011.
NeuroStar TMS® System received the prestigious Phoenix 2012 Most Promising New Product Award at the 19th annual Phoenix Conference. Phoenix, the Medical Device and Diagnostic Conference, presents awards each year to exceptional individuals and companies representing the medical device and diagnostic industry.
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WELCOMES SAN FRANCISCO AND NEW YORK PATIENT CARE COORDINATORS
Chavi Bhardwaj received her B.S. in Physiology from San Francisco State University. Upon graduation, she worked at a private family medical practice in San Jose, California, and at the California Pacific Medical Center’s Cardiothoracic Surgery/Lung Therapies Facility. She also served as a Biomechanics Laboratory Manager at the Taylor Collaboration.
Chavi has been an integral part of the TMS community in the Bay area. Her previous experience working at a TMS office in San Ramon encouraged her to join Lenox Hill TMS, San Francisco’s premier TMS center, as the Patient Care Coordinator in 2012. Chavi’s combined knowledge and experience with TMS has further kindled her interest in the clinical world, as well as in healthcare administration.
Elizabeth Yoo, M.D., a native of New York City, attended SUNY Binghamton University where she received her B.A. in English. She graduated from Ross University School of Medicine, and trained in hospitals throughout New York. Her volunteer work as a client advocate has directed her towards a career in mental health. Psychiatry intrigues her because of how it personalizes medicine and integrates her background in the humanities with her medical knowledge. She wants to utilize the powerful link between the mind and body to deliver optimal patient care. Elizabeth appreciates applying concrete medical knowledge to treat depression by administering TMS. “It is exciting to be part of the TMS movement, and to see firsthand how effective this non-invasive technique to deliver focused treatment can be. I hope that more patients will take advantage of this valuable service, as we collaborate with them to combat their depression.
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LENOX HILL TMS HIGHLIGHTS: 2012
January – Dr. Estrada, who in addition to treating patients with TMS, is also the Chief of ECT at Lenox Hill Hospital in New York, was featured on the “Dr. Oz” show focusing on ECT (Electroconvulsive Therapy).
March 8 – Dr. Estrada presented Grand Rounds on “Brain Stimulation Therapies in Psychiatry” at California Pacific Medical Center, St. Luke’s Campus in San Francisco.
March 14 – The “Dr. Oz” show investigates TMS as a form of treatment for depression on the March 14, 2012 episode. See the video on our website, www.lenoxhilltms.com
May – Doctors Bruno and Estrada attended the ISEN (International Society for ECT and Neurostimulation) Conference and APA (American Psychiatric Association) Annual Conference in Philadelphia.
May – Dr. Estrada and Dr. Bruno are instrumental in establishing Northern California TMS Society in May 2012; they participate in the quarterly meetings; areas of focus include professional standards, insurance updates, reviewing research studies.
December – A National Clinical TMS Society is established in December 2012. Drs. Estrada, Bruno, and Lorente are members. The purpose of this society is to:
Discuss and share ideas about clinical aspects of TMS (protocols, outcome data, measures, etc), as well as logistical aspects (insurance, marketing, etc)
Create a centralized web-based forum
Host a series of conferences
Formulate a foundation to help those who cannot afford the treatment
Establish CME-based teaching and research
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INSURANCE COVERAGE UPDATES
Magellan, MHN, Anthem, Emblem, and BC/BS of California have established a medical policy for coverage of TMS for their members.
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LATEST TMS-RELATED RESEARCH
“Transcranial Magnetic Stimulation (TMS) For Major Depression: A Multisite, Naturalistic, Observational Study Of Acute Treatment Outcomes In Clinical Practice”,Linda L. Carpenter M.D., David G. Brock M.D., Ian A. Cook M.D., Mark A. Demitrack M.D.
“Depression and Anxiety”, Volume 29, Issue 7, pages 587–596, July 2012
Three hundred thirty-nine patients consented to serial assessments during clinical treatment with TMS. A recurrent course of illness was reported in over 90% of patients.
Forty-two clinical practices were included in this study. Thirty-two (76%) were in private clinical practices, seven (17%) were in academic medical centers, and three (7%) were in nonacademic institutional settings.
Among these, patients who were younger and had a lower baseline symptom severity had a modestly better outcome; features that have been reported as positive moderators of antidepressant treatment in general.
It is also worth noting that nearly all of the patients in this observational study continued on their previously ineffective antidepressant regimens during the acute course of TMS. The high adherence rate (83%) and paucity of medically serious adverse events reported during this naturalistic study underscore the benign safety profile associated with the treatment.
In conclusion, this naturalistic study observed clinical response and adherence rates similar to those reported in open-label clinical trials in research study populations. These data validate the TMS efficacy reported in published controlled trials, and further support TMS as an effective and well-tolerated therapy for those who have failed to benefit from antidepressant medication.
“Long-Term Efficacy Of Repeated Daily Prefrontal Transcranial Magnetic Stimulation (TMS) In Treatment-Resistant Depression”Antonio Mantovani M.D., Ph.D., Mark S. George M.D., Harold A. Sackeim Ph.D., Sarah H. Lisanby M.D.
“Depression and Anxiety”Volume 29, Issue 10, pages 883–890, October 2012
This study examined the long-term durability of clinical benefit from TMS using a protocol-specified TMS taper and either continuation pharmacotherapy or naturalistic follow-up. While one third of the sample was lost to follow-up, our results demonstrate that most patients contributing to observations experienced persistence of benefit from TMS followed by pharmacotherapy or no medication. In the current study, we examined persistence of benefit during a 3-month follow-up following acute treatment with TMS.
Our results demonstrate that most patients contributing observations experienced persistence of benefit from TMS followed by pharmacotherapy or no medication, with a low overall relapse rate of 13.5% (5/37). For those who did relapse, the average time to relapse after acute TMS +/- 3.3 weeks, so relapse appeared to be skewed to early in the follow-up phase.
“Effectiveness Of Transcranial Magnetic Stimulation In Clinical Practice Post-FDA Approval In The United States: Results Observed With The First 100 Consecutive Cases Of Depression At An Academic Medical Center”Connolly KR, Helmer A, Cristancho MA, Cristancho P, O’Reardon JP. Psychiatry.com, April 2012
We examined the effectiveness and safety of TMS in the first 100 consecutive patients treated for depression (full DSM-IV criteria for major depressive episode in either major depressive disorder or bipolar disorder) at an academic medical center (University of Pennsylvania) between July 21, 2008, and March 25, 2011. Sixty-five patients were diagnosed with MDD, 20 with bipolar depression, and 3 with depression Not Otherwise Specified.
The clinical cohort was treatment resistant, with a mean of 3.4 failed adequate trials in the current episode. Thirty-one individuals had received prior lifetime ECT, and 60% had a history of psychiatric hospitalization. The response rate was 50.6% and the remission rate was 24.7% at 6 weeks. TMS treatment was well tolerated, with a discontinuation rate of 3% in the acute treatment phase. No serious adverse events related to TMS were observed during acute or maintenance treatment.
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American Psychiatric Association: www.psych.org
Depression and Bipolar Support Alliance: www.ndmda.org
National Alliance for the Mentally Ill (NAMI): www.nami.org
National Institute of Mental Health (NIMH): www.nimh.nih.gov
National Mental Health Association: www.nmha.org
National Mental Health Information Center: www.mentalhealth.org
Postpartum Support International: http://postpartum.net
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