November 28, 2024 - neurocare group
Depression and anxiety are among the leading challenges faced by adolescents and young adults today. While treatments like psychotherapy and medication are effective for many, they are not universally successful, and some young people require alternative options. Transcranial Magnetic Stimulation (TMS), a non-invasive brain stimulation therapy, has long been recognized as an effective treatment for adults with Major Depressive Disorder (MDD). However, its use in younger populations has been limited due to concerns about its effects on developing brains.
A research project presented by a team led by Dr. Paul Croarkin from the Mayo Clinic sheds new light on this question. The project examined outcomes for 1,283 young individuals with depression and anxiety who received TMS in community settings. This included adolescents aged 12–19 years and young adults aged 20–21 years, making it one of the largest datasets of its kind. The findings suggest that TMS could be a valuable and safe treatment for adolescents and young adults struggling with depression and anxiety, expanding its potential beyond the adult population.
Key Findings from the Research
The data revealed promising results for TMS as a treatment option for younger individuals. Among those who completed at least 20 sessions, nearly 60% showed a significant reduction in depressive symptoms, and over 36% achieved remission based on the Patient Health Questionnaire-9 (PHQ-9) criteria. These results are in line with what has been observed in adult populations, indicating that TMS can be just as effective for adolescents and young adults.
The study also highlighted a dose-response effect, showing that individuals who completed more sessions experienced greater improvements. While the greatest reductions in symptoms occurred during the first 10 sessions, progress continued with additional treatments. Importantly, the data also demonstrated a strong correlation between improvements in depression and reductions in anxiety, as measured by the Generalized Anxiety Disorder-7 (GAD-7) scale.
These findings offer new hope for young people who have not responded to traditional treatments or who are unable to tolerate the side effects of antidepressant medications.
Why This Matters for Adolescents
Adolescence is a critical period for mental health, with untreated depression and anxiety potentially leading to long-term consequences such as poor academic performance, social difficulties, and increased risk of self-harm. Current treatment options, while effective for some, do not work for everyone. Psychotherapy can be difficult to access due to cost or availability, and medications often carry side effects that some families and adolescents find unacceptable.
TMS presents a unique alternative. The treatment is non-invasive, involves minimal side effects, and does not require medication. It works by using magnetic fields to stimulate nerve cells in the brain involved in mood regulation. This makes it a particularly appealing option for young people and their families looking for effective, evidence-based interventions.
While professional guidelines have traditionally recommended against the use of TMS for individuals under 18 due to limited research, this study adds to a growing body of evidence that the treatment can be both safe and effective for younger populations.
Expanding Access to TMS for Teens and Young Adults
The findings of this research project could play an important role in changing how mental health professionals approach depression in adolescents. By extending the recommended age range for TMS to include individuals as young as 12, more families could gain access to this promising treatment option.
"This is an amazing step forward in showing the safety and effectiveness of TMS in adolescents and young adults," says Dr. Trevor Brown, Senior Neuroscientist and TMS trainer with the neurocare group. "With such a large sample size in this study, I think we can confidently offer and deliver TMS to this age group, especially when there is so little alternative for these patients. It has been so difficult to turn away parents of suffering adolescents who have been literally begging us to treat their suffering teenager. This is exciting news for the field."
However, challenges remain in making TMS widely available to young people. Awareness among healthcare providers and families is still limited, and insurance coverage for adolescent TMS treatments may lag behind the growing evidence of its benefits. Continued advocacy and education will be critical to ensuring that more adolescents can access this potentially life-saving treatment.
Will TMS become a recommended depression treatment for Teens and Adults?
While the project provides valuable insights into the effectiveness of TMS for younger populations, it also underscores the need for further research. Questions about the long-term effects of TMS on developing brains, the ideal number of sessions, and how outcomes vary across different subgroups remain unanswered. Addressing these questions will help refine treatment protocols and ensure the best possible outcomes for young people.
For adolescents and young adults with depression, TMS offers a new avenue of hope. As awareness and understanding of this treatment grow, it could transform the mental health landscape for younger populations, providing a safe, effective option for those in need. This project is an important step toward making TMS a more widely accepted tool in the fight against adolescent depression and anxiety.
Croarkin, P. E., Aaronson, S. T., Carpenter, L. L., Hutton, T. M., Pages, K. P., & Sackeim, H. A. (2024). A naturalistic study of transcranial magnetic stimulation treatment in adolescents and young adults with depression and anxiety. Poster presented at the Annual Meeting of the American Academy of Child & Adolescent Psychiatry. DOI: https://doi.org/10.1016/j.jaac.2024.08.477
