A specific kind of brain stimulation is effective in reducing suicidal thinking in a significant portion of people with hard-to-treat depression, according to a new CAMH study published in The Journal of Clinical Psychiatry. Forty per cent of people in the study reported that they no longer experienced suicidal thoughts after receiving bilateral repetitive transcranial magnetic stimulation (rTMS).
“This is one of the first large studies showing rTMS is effective in treating suicidal ideation,” says Dr. Jeff Daskalakis, senior author of the study and Co-Director of the Temerty Centre for Therapeutic Brain Intervention in CAMH’s Campbell Family Mental Health Research Institute. “The effects on suicidal ideation were independent of effects on depressive symptoms.”
The promising findings give hope that, with further evidence, rTMS may offer a new way to prevent suicide in people with hard-to-treat depression, as well as other mental illnesses. Suicidal thinking can occur in several mental illnesses, including post-traumatic stress disorder, bipolar disorder, schizophrenia and borderline personality disorder. It’s estimated that about 90 per cent of people who die by suicide have a mental illness.
While medications and psychotherapy are effective treatments for many people with mental illnesses, there’s an urgent need for new treatments that quickly and specifically reverse suicidal thinking. “One of the only effective treatments for suicidal ideation is electroconvulsive therapy or ECT,” says Dr. Daskalakis. “While ECT is the most effective treatment in psychiatric care, it’s rarely used, because of high stigma and adverse cognitive side effects associated with the treatment. Less than one per cent of patients with hard-to-treat, or treatment-resistant, depression get ECT.”
Treatment-resistant depression is defined as the condition when people do not experience a noticeable improvement in their symptoms after trying at least two different antidepressant medications. Up to 40 per cent of people with depression are treatment resistant, representing about 600,000 Canadians a year. Earlier CAMH studies have shown rTMS is an effective therapy for treatment-resistant depression.
