Magnetic therapy works where pills fail in major depression

Mumbai: Six months ago, south Mumbaibased executive Ramesh Joshi's behaviour started worrying his family. He would take two hours to finish a meal. While walking, he would suddenly freeze at a spot. He would  stammer if he had to speak more than a couple of lines. The medical diagnosis — major depressive disorder — stunned his family.      They were even more shocked when nine anti-depressants a day failed to help him. Finally, they sought rTMS or repetitive transcranial magnetic stimulation, the newest entrant in the field of depression treatment in the city. Over three weeks and 20 sessions of magnetic stimulation later, his sluggishness and diffidence almost disappeared. His daily dosage of anti-depressants was down to two. Today, the 35-year-old is back at work and speaks clearly. "I could feel my family's shock as I took one spoonful of food every 10 minutes, but I couldn't help it,'' he said.      Joshi's psychiatrist, Dr Shamsah Sonawalla, who studied rTMS during her stint in Harvard University, says the non-invasive therapy helped transform him in the shortest possible time. Magnetic field used to stimulate brain cells  Mumbai: Magnetic therapy made its debut in the city almost two years ago, but its clinical efficacy among Indian patients in only getting established now. Dr Shamsah Sonawalla has treated 65 people with major depression using the technique at her Trans Mag Well-Being Clinic on Peddar Road. "Of these, 28 had treatment-resistant depression, 37 had moderate to severe major depression," she said. Each patient responded to the waves, but in different measures. Those who were resistant to medical treatment showed about 60% response, while those with moderate to severe depression registered 90% improvement.      A handful of clinics across Mumbai and Delhi have started offering rTMS, with each session ranging from Rs 500 to Rs 7,000. Dr Yusuf Matcheswalla has just brought his second rTMS machine for his clinic in Masina Hospital, Byculla. "The demand for this non-invasive treatment is so high that I felt the need for a second machine," said the psychiatrist, who uses it to treat varied conditions, ranging from depression to schizophrenia. Delhi's Dr Sanjay Chugh was among the first in the country to acquire this technology, having added another machine in his practice recently.      The therapy, which won the US FDA approval in 2008, involves using magnetic field externally to stimulate nerve cells in the brain. "An electromagnetic coil is placed on the scalp at a predetermined site. The rTMS device then delivers focused magnetic pulses to the brain," said Sonawalla, who also consults at Jaslok Hospital. The 20-minute sessions are held daily for 2 to 4 weeks.      Anusha Namboodiri is another case in point. The 42-year-old was in between jobs, managing a household and children as a single parent because her husband worked in Dubai. "I would start crying for the slightest reason," she said. It was when she started harbouring suicidal thoughts that she wasbrought to Trans Mag clinic. "Within a couple of her 15-session schedule, a positive change was noticeable. She is now happy at her new job and reads for hours," said Sonawalla.      The growing popularity of this treatment is also a measure of the growing incidence of depression in India. "Major depressive disorder is one of the most common and debilitating of illnesses. Around 20% of grown-up women and 10% of men experience it in their lifetime," said Sonawalla. The WorldHealth Organisation has estimated that depression will be the leading cause of disability by 2020. Depression is also going to become the second most common illness after heart disease.      It is in this backdrop that non-invasive techniques like rTMs should be viewed. "This is a treatment for the future," said Matcheswalla. Sonawalla said the treatment allowed many individuals to get back to their normal level of functioning. "It should be considered one of the most significant medical advances of the century."