Vera French Mental Health Center staff simulate a Neurostar transcranial magnetic
stimulation (TMS) treatment. CREDIT VERA FRENCH MENTAL HEALTH CENTER
Hundreds of patients struggling with treatment-resistant Major Depressive Disorder (MDD) are finding new hope and embracing new possibilities thanks to Vera French Mental Health Center’s cutting-edge, noninvasive transcranial magnetic stimulation (TMS) treatment. In fact, Vera French CEO Dr. Richard Whitaker and psychiatrist Dr. Henry Emerle offered a glowing report on the clinic’s promising and growing […]
Already a subscriber? Log in
Want to Read More?
Get immediate, unlimited access to all subscriber content and much more. Learn more in our subscriber FAQ.
Hundreds of patients struggling with treatment-resistant Major Depressive Disorder (MDD) are finding new hope and embracing new possibilities thanks to Vera French Mental Health Center’s cutting-edge, noninvasive transcranial magnetic stimulation (TMS) treatment.In fact, Vera French CEO Dr. Richard Whitaker and psychiatrist Dr. Henry Emerle offered a glowing report on the clinic’s promising and growing NeuroStar TMS Therapy, a Mental Health Awareness Month interview in early May with the QCBJ. Dr. Whitaker said the organization began studying TMS therapy to help patients with stubborn MDD. “We felt like we needed to give them another option and started looking at transcranial magnetic stimulation about seven years ago. It was just starting to gain traction in the field,” he said. Dr. Emerle saw firsthand TMS give longtime MDD sufferers their lives, their families and even their careers back while he was a resident at the University of Michigan Hospital in Ann Arbor.Both doctors and Vera French have followed, in particular, the progress of NeuroStar. It was launched by Neuronetics, a Malvern, Pennsylvania, firm that develops non-invasive treatments for psychiatric disorders that have shown resistance or lack of improvement using traditional medicine. But the Davenport clinic did not actively pursue NeuroStar until 2020 when Iowa Medicaid agreed to pay for the treatment. “As the community mental health center, we really can’t offer something that people can't afford,” Dr. Whitaker explained.Today, the center’s doctors are among a growing number of psychiatrists across the nation who have become evangelists for TMS. Data shows it works.Before its public release, for example, Neurostar conducted nearly 40 studies on more than 150,000 patients and the positive results have been well-documented. In addition, an independent study funded by the National Institute of Mental Health (NIMH), showed that one-third of patients who complete TMS treatment achieved complete remission and were four times more likely to achieve remission than those given placebo treatments.At this writing, 231 patients had received TMS treatment at Vera French, with 230 of them completing the course of treatment and seeing positive results, the doctors told the QCBJ.Dr. Whitaker referenced a once-desperate patient who recently attended Vera French’s ribbon-cutting for its remodeled Central Park Davenport clinic – where the patient had successfully undergone TMS treatment.Dr. Whitaker said the man told him that prior to Neurostar treatment he no longer wanted to live because “I felt like there was no option for me.” But after twice receiving TMS, he was able to return to his career and told Vera French’s CEO “‘my relationships are better, and you know, my whole life is now like I had always hoped it would be.”
Other promising results
The better news for those suffering from other difficult to treat disorders is that in addition to TMS’ impressive MDD results other disorders are either under study, making their way through the FDA approval process, or have already been cleared by the FDA. Among them are: Obsessive Compulsive Disorder (OCD), migraine headaches, drug addiction, alcoholism, smoking, fibromyalgia and Alzheimer's Disease.If approved, these patients also will be able to share in the advantages of TMS therapy which lie in large part on what that treatment is not.It is not a drug, and it's not another form of shock therapy or surgery. It also has none of the common side effects associated with MDD medications or electroconvulsive therapy (ECT). Patients are awake for the in-office treatment that lasts as little as 19 minutes per daily session, and are given for five days over the course of about six weeks.The treatment itself involves placing a figure-eight-shaped coiled magnet on the scalp over the dorsolateral prefrontal area typically at the left side of the brain. Neurostar delivers about 3,000 electromagnetic pulses to wake up and activate neurons that are being suppressed by MDD. Vera French received its first $80,000 Neurostar chair, which was paid for by the Vera French Foundation, shortly before the pandemic. The early days of COVID-19 gave staff time to “play” with this new technology before they put it in operation. Doctors and technicians didn’t wait too long, however, before donning face shields and having patients mask up to begin addressing the untapped need for a mental health treatment alternative.Vera French since has added another treatment room and a second chair. This one was paid for by the Eastern Iowa Mental Health and Disability Services Region. Its leaders saw that regardless of ability to pay, Vera French was serving everybody and they were seeing the high percentage of people getting better and decided to make it more available, Dr. Whitaker said.Vera French doesn’t have the only TMS chair in the region. But it is the only Neurostar provider within a 100-mile radius. Iowa City has a chair, but the Davenport Vera French clinic offers Quad Citians the option to stay home for treatments rather than drive to Iowa City five days a week for six weeks.TMS benefits are relatively swift and impressive. ”You can take someone's severe depression and make it minimal” more than 80% of the time, Dr. Emerle said. And among that same group of patients, 40%-50% will go into full remission through TMS therapy.
Remarkable turnarounds
That’s a remarkable turnaround for those who have for years been working their way through the standard protocol that doctors generally must follow to get insurance to cover TMS. Under that protocol, Dr. Emerle said “In terms of depression, we give someone an antidepressant. If that one doesn't work, we either switch them or augment them.”Each new drug offers a diminishing rate of return and side effects, he said, pointing to the results of the STAR*D, or Sequenced Treatment Alternatives to Relieve Depression, study. It showed when multiple medications are prescribed each one offers a lower percentage chance of working.“By the time you get to four antidepressants or more that you are switched to there's only a 12.5% chance of a response and a 7.5% chance of remission,” Dr. Emlere said. It’s even more frustrating because it can take as much as two years to work through all those meds.In contrast, with TMS treatment, he said “if someone is in a severe depression, and you make it mild to minimal, they get their life back.” Importantly, too, they participate in their own therapy and recovery plan, something that can be impossible to achieve by someone with resistant MDD.“And one of the great things about this treatment is that it’s noninvasive,” he added. “The most common side effect is just a pain right at the site of treatment.” It fades quickly and is generally treated by over-the-counter headache remedies.
Spa-like treatment rooms
The NeuroStar treatment room is almost spa-like if you can ignore the coiled magnet, the QCBJ discovered during a tour. “We want it to be therapeutic so we try to pay attention to how the space is laid out and the color scheme of the space,” Dr. Emerle said. “And what we tell people is, during the treatment, during those 20 minutes, you can do whatever is relaxing to you.”Patients choose the type of music they’d like to hear or can watch their favorite television shows.Patients choose the type of music they’d like to hear or can watch their favorite television shows. “Some people like to watch the Forensic Files, which I don't get, but it's whatever they find relaxing. That's what's important, and we provide that in the space,” Dr. Emerle said.A technician also remains with the patient throughout the sessions. Guests are welcome.For those considering TMS, perhaps one of the most important questions is: “What do the treatments feel like?” Dr. Whitaker sampled it himself and Dr. Emerle received TMS treatments several times when helping train TMS aides to administer Neurostar treatment here, and earlier at Michigan. Both doctors reported experiencing what felt like repeated tapping on their skull. Serious side-effects are rare and sharing a complete medical history will help avoid them, they said.While the sky seems to be the limit for TMS, the biggest challenge Vera French faces is that there isn’t much information easily available to potential patients and prescribers about it or its efficacy.That, Dr. Emerle said, “can be kind of a barrier sometimes for people, but I want them to realize that it's really not anything to be frightened or intimidated by, and we really try to make the experience as comfortable and even calming as possible.”
Who benefits from TMS?
If you agree with two or more of these statements, Neurostar transcranial magnetic stimulation (TMS) treatment may be right for you.
Depression symptoms have interfered with my daily life.
I am not satisfied with the results I get from depression medication.
I have had or worried about side effects from depression medications.
I have switched medications for depression due to side effects.
I am interested in a proven, non-drug therapy for depression.
Neurostar At-A-Glance
NeuroStar uses focused magnetic pulses, similar to an MRI, to revitalize inactive synapses in the brain. “Waking up” these connections can have a lasting effect on neurotransmitter levels, making long-term remission from depression a reality for many.
Treatment is provided at Vera French Mental Health Center, 1441 W. Central Park Ave., Davenport.
Patients can return to normal activities right away.
They are awake during treatment. Because there are no effects on alertness or memory, patients can drive themselves to and from treatment sessions.
There are no negative effects on memory or sleep.
Treatment is covered by most health insurance plans, including Medicare, Iowa Medicaid, TRICARE, Aetna, Cigna, United Healthcare (Optum), Wellmark Blue Cross Blue Shield, but most insurers won’t do so until the standard therapy plus medication combination is exhausted.
Vera French provides TMS treatment regardless of ability to pay. For example, free treatment is available for those who qualify and there is a sliding scale based on income.
