"Not all patients tolerate antidepressants": an innovative alternative to depression medication in Toulon

The psychiatry department at Sainte Musse Hospital in Toulon is innovating in the field of non-invasive neurostimulation , with a new, more efficient repetitive transcranial magnetic stimulation (rTMS) tool. Explanations from Drs. Jean-Luc Bartoli and Manuel Dias Alves , psychiatrists.

What is the point of rTMS?

Repetitive transcranial magnetic stimulation (rTMS) generates a magnetic field to stimulate or inhibit specific areas of the brain, depending on the condition being treated. In the treatment of depression, rTMS can be used in addition to, or in some cases, as a replacement for, drug treatments.

" It's one treatment among others that allows depression to be treated early, effectively, and not partially to avoid relapses," summarizes Dr. Bartoli. "Conventional treatments for depression are quite limited, hence the interest in making patients aware of this more interventional method."

The sessions in detail

The first session is a session of approximately 45 minutes to identify the area to be stimulated: the patient wears a cap on which targets corresponding to these areas are marked. This is followed by daily sessions of approximately 15 minutes, the number of which varies depending on the pathology.

"Thirty of these are needed to treat depression," says Dr. Bartoli. "It's quite restrictive for the patient, who has to travel to the hospital every day, but transportation can be covered."

There are few contraindications . They concern patients who have undergone surgery on the skull or suffered from recent brain problems. In cases of unstabilized epilepsy, special precautions for use are implemented.

Unlike electroconvulsive therapy (better known to the general public as electroshock), rTMS does not require anesthesia and the side effects – dizziness, nausea, headaches – are generally mild.

The advantages noted

"It is rare for patients not to tolerate rTMS, while a third of them do not tolerate antidepressant treatments well, which are not always effective," the two psychiatrists emphasize.

" The problem," says Dr. Bartoli, "is that not all patients who cannot tolerate antidepressants and for whom rTMS represents an alternative or complementary treatment are referred to us. It is important that they have access to this unique technical platform in the Var department.