Therapy begins with Avery using an electromyograph machine to detect muscle response, enabling him to find the optimal location and intensity for magnetic stimulation. Then a butterfly-shaped electromagnetic coil is placed against the patient's head. The machine generates a current strong enough to produce an alternating magnetic field, which in turn produces electricity. The current creates a clicking noise and the sensation of a tiny shock, like the feeling of static electricity on a cold day.
Multiple stimuli are triggered-10 pulses per second-creating a rat-a-tat-tat clicking, with the patient receiving 32 series of pulses during the half-hour session. Patients are able to walk out the door and drive home after their therapy. Those who receive ECT, by comparison, may be confused for a few hours after each treatment.
Early results show that, after magnetic-stimulation treatments, some patients score lower on a standard measure of clinical depression. Avery's current study compares the response of subjects who receive magnetic stimulation to those who receive a fake stimulation. There is no cost to participants in the study, but because the procedure is still experimental, it cannot be offered to the general public and is not covered by health insurance.
Avery seeks funding from the National Institutes of Health to expand his research and answer key questions: How long does the positive effect of magnetic stimulation last? What's the optimal length of each treatment session? What patients will benefit from the therapy?
Comparisons between ECT, psychotherapy, and medications show why magnetic stimulation, a relatively benign version of ECT, is of such interest to Avery and fellow psychiatrists. Studies have shown that patients treated with ECT have significantly lower death rates than those who receive psychotherapy, and drugs have a lower response rate and take longer to act than ECT, prolonging the agony of depression.
Early results are encouraging, but so far there is too small a sample to provide definitive answers. Avery is optimistic that magnetic stimulation may prove to be an effective alternative to ECT for people with medication-resistant depression.
Author Martha Manning wrote about her recovery from depression after ECT treatments and hospitalization. Though unwilling to be "the ECT poster girl," she is realistic about what it did for her.
"I am the first to admit the downside - confusion and memory loss. But damn it, it worked. I didn't want to have it. Who would: I didn't want to have a Cesarean section either. But I got (my daughter) Keara. A beautiful healthy new life. It was no picnic. But I'd do it again in a heartbeat."
Larry Zalin is media relations coordinator at Harborview Medical Center. He has a master's degree in English from the State University of New York at Binghamton.
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