Is TMS needed ?????

The National Comorbidity Survey, which is the most up to date estimates of the prevalence and consequences of major psychiatric disorders in the US population, has estimated that in any one year period of time, there are an estimated 14 million US adults who meet formal diagnostic criteria for Major Depressive Disorder.  Of these 14 million adults, only half (about 7.2 million individuals) seek treatment within the health care system. Of these 7.2 million treated patients, the National Comorbidity Survey estimated that about 4 million people remain poorly served by existing treatments.

The current treatment reality of major depression underscores the unmet needs that still exist, even 20 years after the availability of the first modern SSRI antidepressant:

Partial or non-response to first treatment intervention is a common outcome.

As treatment resistance emerges, the likelihood of future benefit diminishes – this underscores the need to provide safe

and effective treatment that works, as early as possible in treatment.

Despite all available treatments, it is estimated that about 25% of patients will remain refractory to any treatment, 

One of the key issues in the treatment of depression is that adverse events and poor tolerability of current treatment options is a major impediment to therapeutic success

There are many reasons why patients may not continue the prescribed treatment, among the most important:

•Adverse effects

•Patients may begin to feel better and decide they no longer need treatment

•Regimen may be too complex

•Patient’s memory may be affected by MDD

Treatment resistance translates into:

• Patients experience significantly more inpatient hospitalizations, outpatient office visits and use more and costlier psychotropic medications,

• The health care costs, on average, range from 2 to 6 times the costs for a non-treatment resistant patient,

• For example, one report estimated that the mean total medical costs in a population of hospitalized treatment resistant patients were in excess of $42,000 compared to only $6,500 for a comparison group of non-treatment resistant patients,

• The economic costs are also seen in the workplace (ie. increased disability and absenteeism), and in an increased utilization of health care services for non-psychiatric conditions.