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Combining TMS with Psychotherapy
Sept 19, 2019
Transcranial Magnetic Stimulation (TMS), a safe, non-invasive type of brain stimulation, was approved by the FDA for the treatment of depression in 2008, and is now clinically available for the treatment of adults who have not been helped by antidepressant medications. Recently, FDA cleared TMS for use in patients with obsessive-compulsive disorder, if given immediately after cognitive behavioral therapy, a type of psychotherapy.   The process will address the potential of combining psychotherapy with TMS for the treatment of depression, taking advantage of potential synergies between the two non-pharmacological approaches.

Pace NeuroHealth has adopted the same belief and process, that stimulating the brain during rTMS or dTMD treatment through talk therapy will engage the neural pathways and encourage positive responses. 

TMS for Clozapine-Refractory Schizophrenia
Sept 18, 2019
Over half of patients with treatment refractory schizophrenia will not respond to clozapine. A potential non-pharmacological strategy for clozapine augmentation is repetitive transcranial magnetic stimulation (rTMS).

There is meta-analytic evidence that rTMS can reduce auditory hallucinations and negative symptoms in patients with schizophrenia on any antipsychotic.
A recent study found rTMS was associated with reductions in total and positive psychotic symptoms in clozapine-treated patients with schizophrenia and predominant negative symptoms.

Heterogeneity was assessed using the I statistic. The authors also performed sensitivity analysis based on location of electrode placement and study duration.

Siskind and colleagues4 conducted a systematic review and pairwise meta-analysis of rTMS studies in clozapine refractory schizophrenia. They searched multiple databases to identify all randomized-controlled trials of rTMS versus sham treatment in patients with clozapine-refractory schizophrenia. They performed pairwise meta-analysis on endpoint data: the primary outcome was total psychotic symptoms, and secondary outcomes were positive and negative symptoms.

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