TMS Seen As Alternative To ECT For Treatment of Depression.

The St. Petersburg Times (3/3, Stein, http://tinyurl.com/TMS-depression) reports that for patients who don’t respond to drugs and counseling, TMS (transcranial magnetic stimulation) offers an alternative to electric shock therapy, still used to treat depression despite its reputation in popular culture as a barbaric treatment.  Many physicians consider ECT the gold standard treatment for severe depression that doesn’t respond to other remedies.  It is considered safe, but side effects can include short-term memory loss.  TMS involves using an electromagnetic coil to beam pulsations through the skull to stimulate a part of the brain thought to be involved in depression.  By contrast, the primary discomfort associated with TMS is a staccato tapping noise.  Another consideration is cost, which can reach $10,000 and isn’t routinely covered by insurance since it is relatively new and its availability limited. At USF, the treatment costs about $350 per session, and patients need about 10 to 20 procedures.  Clinical trials on TMS have yielded mixed results, and the U.S. Food and Drug Administration received some criticism when it approved the therapy for use in treatment-resistant depression over a year ago.  At least some questions may be settled in May, when the results of a five-year study sponsored by the NIH will be published in the Archives of General Psychiatry.

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FDA expands approval of fluoxetine/olanzapine combination to treat resistant depression.

The AP (3/23) reported that on Mar. 23, pharmaceutical developer Eli Lilly & Co. announced that the Food and Drug Administration (FDA) “approved the bipolar depression” medication Symbyax [fluoxetine/olanzapine] “as a therapy for treatment-resistant depression.”
        Forbes (3/24, Ackerman) points out that the medication, “which combines the active ingredients of its Zyprexa [olanzapine] antipsychotic and Prozac [fluoxetine] antidepressant, is approved for patients with major depressive disorder who have not responded to two separate trials of different antidepressants.” Eli Lilly said that “Symbyax was the first” medication “approved by the FDA for treatment of bipolar depression in adults in 2003.”
        “Lilly waited two years for the FDA’s approval, because” the FDA “wanted stronger language in the” medicine’s “label about the risk of weight gain and diabetes,” the Indianapolis Business Journal (3/23) added. The pharmaceutical company “said it now has updated Symbyax’s label” accordingly. Meanwhile, “in a related action,” the agency “said doctors could prescribe” olanzapine and fluoxetine “in separate pills, to treat bipolar depression and treatment-resistant depression.” The Wall Street Journal (3/23, Johnson) Health Blog also covered the story.

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