In a recent interview with Fox 5 New York. Dr. Alan Manevitz explains the science of why showers makes us feel good and relax. "Our minds tend to relax", he says, and that allows ideas to flow.
New York News
Study: Electromagnetic Therapy Offers Relief To Fibromyalgia Sufferers
NEW YORK (CBSNewYork) – There is new hope for people with fibromyalgia – and it comes from magnets.
A new study found a device that pulses magnetic waves into the brain may offer relief.
As CBS 2′s Dr. Max Gomez reported, the process is non-invasive and has almost no side effects.
Fibromyalgia is the most common cause of chronic, widespread pain in the U.S., affecting between six and 12 million people nationwide.
Treatments aren’t that effective because traditional narcotic painkillers don’t work with fibromyalgia. But, as Gomez reported, electromagnets just might work.
“There’s a sensitization in the brain actual that makes you feel pain more strongly and lowers the pain threshold,” Dr. Alan Manevitz of Lenox Hill Hospital said.
A device called transcranial magnetic stimulation – or TMS – has brought relief to some fibromyalgia sufferers.
It works by pulsing electromagnetic waves into specific regions of the sufferer’s brain.
A new study in the Journal Neurology finds that magnetic stimulation can actually improve the non-pain symptoms of fibromyalgia, like depression, mood and overall quality of life.
Other studies have found that TMS also alleviates the pain symptoms. The difference is where and how the magnetic pulses are used.
“As you use the magnet in different areas of the brain, sometimes simultaneously in two areas, we’re able to both reduce pain as well as improve quality of life symptoms,” Dr. Manevitz said.
TMS seems to work by altering some of the pain circuits in the brain. “The brain is an electrical device and we know that when we add an electrical impulse to that device, the device will change,” Dr. James Halper of Lenox Hill added.
The TMS device has been FDA approved to treat depression, so its use for fibromyalgia is still off-label and experimental, Gomez noted.
Those who have undergone the treatment said there’s no real side effects other than a light tapping sensation in their head.
Treating Insomnia With Special Talk Therapy Can Make a Difference in Depression
A new study funded by the National Institute of Mental Health found that treating insomnia in people with depression could double their chances for full recovery.
Insomnia is an extremely common problem associated with depressions affecting more than half of the 18 million depressed patients in the country. CBS 2’s Dr. Max Gomez reports on the findings of the study which could make a significant difference for people fighting depression. The development was also reported by the New York Times.
I have been suffering from depression for quite some time and it’s almost impossible to sleep,” Michelle said. Michelle said that she would go for days or weeks without sleeping if she didn’t take her sleep medication and it made her depression worse. “It can make you not focused and irritable. It can make you feel not part of the community of the world. It can make you feel like an alien,” she said.
It is unclear whether insomnia is a symptom or a cause of depression but a number of studies are looking at whether treating insomnia with special talk therapy can make a difference in depression.
Continue reading “Treating Insomnia With Special Talk Therapy Can Make a Difference in Depression”
TMS Treatment May Help People Quit Smoking
TUESDAY, Nov. 12 (HealthDay News) – By Steven Reinberg, HealthDay Reporter – When willpower doesn't work, smokers who want to quit may have a new tool someday: magnetic brain stimulation.
A study of 115 smokers found that 13 sessions of the treatment over three weeks helped some heavy smokers quit for as long as six months.
This noninvasive technique, called repeated high-frequency transcranial magnetic stimulation, sends electric impulses to the brain. It is sometimes used to treat depression.
"Using noninvasive stimulation can reduce nicotine craving and smoking," said lead researcher Abraham Zangen, an associate professor at Ben-Gurion University of the Negev in Beer-Sheva.
"If you stimulate regions in the brain that are associated with craving for drugs, you can change the circuitry in the brain that mediates this dependence and eventually reduce smoking," he said. "And many of those treated stop smoking."
The study participants smoked at least a pack a day and had failed at least two previous attempts to quit, said Zangen, who has a financial interest in the equipment used in the study.
The researchers divided the participants into three groups. One group received high-frequency brain stimulation, another low-frequency stimulation, and the third received a phony treatment. The groups were further divided into those who saw a visual cue — a picture of a lit cigarette — just before stimulation and those who didn't.
The idea of the cue is to make sure attention is directed at smoking and not some other craving, Zangen said.
After 13 treatments, those who received the highest level of stimulation plus the visual cue had the best results — 44 percent of them had quit. After six months, one-third of this group were still not smoking compared to 28 percent of those who weren't shown the visual cue before treatment.
The results of the study were scheduled for presentation Tuesday at the annual meeting of the Society for Neuroscience in San Diego.
Although magnetic brain stimulation is approved by the U.S. Food and Drug Administration for treating depression, it is not yet approved for helping people quit smoking, Zangen said.
Dr. Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York City, said, "It's a very effective treatment for depression and anxiety."
Manevitz thinks using it to help people stop smoking makes sense. Other studies, he noted, have found that stimulating an area of the brain called the insula can reduce the desire to smoke.
"Adding brain stimulation to other smoking cessation methods like nicotine substitution might make it even more effective," he said.
When used for depression, magnetic brain stimulation costs from $300 to $350 a session, and the treatment may not be covered by insurance, Manevitz said.
For the treatments, participants wear a helmet fitted with coils that deliver magnetic stimulation to the areas of the brain — the prefrontal cortex and the insula — associated with nicotine addiction.
Dan Jacobsen, from the Center for Tobacco Control at North Shore-LIJ Health System in Great Neck, N.Y., thinks the idea is interesting but he doesn't see this becoming a viable treatment option anytime soon.
"This treatment is not a simple procedure," he noted. And the six-month results weren't as good as the success rates for other treatments, including medication and nicotine replacement, combined with behavioral components, he said.
Side effects from the treatment were mild and included headaches or muscle twitching. These symptoms went away with continued treatment, Zangen said. One potentially serious but rare side effect is that brain stimulation can induce a seizure, especially in those prone to epilepsy, he noted.
Data and conclusions presented at meetings are typically considered preliminary until published in a peer-reviewed medical journal.
Depression Treatments: Epoch Times Interview with Dr Alan Manevitz
Epoch Times, Depression Treatments: Looking Back, Looking Forward
by Christine Lin
NEW YORK—Though treatments exist, fewer than half of those suffering from depression receive help, according to the World Health Organization.
In the last decade, treatment for depression has come a long way. Short of electroconvulsive therapy, which could lead to memory loss, the only viable options were antidepressants, which come with complicated, systemic side effects. But today, non-drug technologies for treating depression have been improving patient outcomes. A technology that has been making rapid progress is Transcranial Magnetic Stimulation (TMS).
TMS has been in use since the 1980s but not adopted medically for the treatment of depression until 2003 when TMS machines were made available to Canadian doctors. In the United States, TMS didn’t win approval from the FDA until 2008.
That year, Drs. Alan Manevitz and James Halper were maintaining their practice on Sutton Place South, just off the East River. The two doctors had been in practice together for over a decade, combining psychopharmacology with psychotherapy.
They came across TMS through published research and decided to take a deeper look.
“It sounded very exciting,” Dr. Halper said. “It’s not just chemicals in the body that go all over the place. Here was a way to target the parts of the brain we wanted to change while avoiding systemic side effects. Antidepressants had turned out to be less effective than we hoped.”
Depression manifests biochemically as a deficiency in the production of the neurotransmitters dopamine, norepinephrine, and serotonin. Traditional antidepressants work by making the patient’s existing neurotransmitters stay in action longer.
No matter how far the pills can stretch a limited number of neurotransmitters, they don’t address the fundamental shortage in neurotransmitter production, Dr. Manevitz said.
So, in 2008, he and Dr. Halper bought their first TMS machine, which turned out to be the first in New York City and the third in the world.
People experiencing depression exhibit too much activity in the brain’s right hemisphere and too little in the left hemisphere, according to researched published by the National Institutes of Health. TMS delivers powerful magnetic pulses to the brain’s left hemisphere, increasing the amount of neurotransmitters the brain produces.
TMS is a magnet and not radiation, and the most common side effect is fleeting pain or discomfort at the treatment site. Fewer than 1 percent of patients experience a seizure.
Patients are expected to commit to a six-week course of 40-minute sessions over five consecutive days a week. The patient sits in the TMS chair with the magnet placed over the left side of the head. Patients can read or watch television, but cannot fall asleep.
The treatment feels like a woodpecker tapping, said practice coordinator Joanna Robben, but patients typically become desensitized to the sensation after four sessions.
On the first day the doctors offered TMS, patients flocked in from all over the world, particularly from Japan.
Now, almost 500 providers across the country offer TMS for depression, according to Neuronetics, the leading manufacturers of TMS machines.
TMS used to be a last intervention, recommended only after a patient fails to see improvement after trying three or four classes of antidepressants.
“Now people are thinking, why not try it first?” Dr. Manevitz said.
TMS as a Tool
This fall marks Manevitz and Halper’s fifth year treating patients with a NeuroStar TMS machine.
Neuronetics, its manufacturer, says that 1 in 2 patients improved significantly, and 1 in 3 patients were completely free of depression symptoms after six weeks of treatment using NeuroStar.
“All the research shows that therapy and medicine together work better than therapy or medicine alone,” Manevitz said. “So now here was TMS, and we said what if we gave medicine, therapy, and TMS?”
The doctors’ hunch turned out to be correct. In a retrospective study of their first 100 TMS patients, 70 percent entered remission and 90 responded.
A New York-based psychologist (name omitted for privacy) who struggled with depression for over 40 years began TMS with Manevitz this spring.
“As I get older, medications become more toxic to elderly patients,” she said. “The amount changes, side effects become greater. As you get over 65, you might develop tremors and cognitive impairments.”
TMS made her realize for the first time that she hadn’t been feeling well because she didn’t know what feeling well was like, she said.
“I responded to it immediately. I felt well…I slept better, my thinking patterns changed, I felt a sense of joy—I was really happy. It wasn’t a high. It was a very good feeling of well being.”
Another patient, a lawyer based in New York, didn’t feel the results immediately.
“I ended up doing two courses of 40 sessions,” he said.
“It took close to 10 sessions before I started to see subtle benefits. But I kept with it.” This was close to four years ago. Several months ago he experienced a new bout of depression and got a “refresher session” for the first time. “I instantly felt better,” he said.
Of the treatment, he said, “I felt like I was getting flow to a part of my brain that wasn’t getting enough flow.”
TMS is not a silver bullet, this patient said, but one of several tools to be used in treating depression.
The doctors coached him on how to maintain healthy relationships and to change negative thinking patterns as part of a bio-psycho-social approach.
“One thing we noticed was that therapy seemed to flow better after the [TMS] treatment,” Manevitz said. “Somehow the patient was more open.”
Always ready to add cutting-edge technologies into their patients’ treatment options, Manevitz and Halper bought a Brainway TMS just over a month ago. Brainway was approved by the FDA earlier this year. It works on a slightly different mechanism and targets a deeper part of the brain.
“We see psychiatry as a work in progress,” Halper said. “It’s a very exciting field. It’s always evolving. I’m hoping to combine TMS with more neuroimaging to target it more, and see if we can predict patient response with neuroimaging.”