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Sandeep Vaishnavi, MD, PhD, director of The Neuropsychiatric Clinic at Carolina Partner, is board-certified in Behavioral Neurology & Neuropsychiatry by the United Council for Neurologic Subspecialties as well as board-certified in General Psychiatry by the American Board of Psychiatry and Neurology.

TMS: Addressing the Ongoing Search for
Non-Invasive Mental Health Care Solutions

Talk to any of the psychiatrists at Carolina Partners in Mental Health Care, and they will tell you just how far mental health treatment has come in the last 50 years. It’s astonishing: antidepressants did not even exist until 1952, and like many medical advancements, they were discovered by accident. Iproniazid, for example, was initially designed to treat tuberculosis; then doctors prescribing it began to notice their patients’ moods improving—becoming giddy, energetic, and increasingly optimistic.

Sandeep Vaishnavi, MD, PhD

This was a watershed moment in the history of depression treatment—the moment when medical professionals made a tangible connection between feelings and the neurotransmitters of the brain. ‘Was it possible,’ they asked, ‘to alter the way we feel simply by taking a pill?’ Up until that point, depression treatment had been a primitive affair, built on a shaky foundation of misapprehensions and stigmas. Rather infamously in the days of early “insane asylums,” patients were locked away in squalid conditions, physically abused, and even lobotomized. Antidepressants helped changed the whole landscape.

But antidepressants are not the end of the story. As far as treatments go, they remain problematic. Iproniazid could, among other things, cause long-term liver damage, and although antidepressants have been significantly refined in the last half-century, they are still unpredictable at best. Dosages must be constantly adjusted, side-effects managed, formulas refined. Really, the whole history of depression treatment since 1952 can be compressed into the question: Can we learn enough about the human brain that we can eliminate the guesswork and harmful side-effects of pills, and decrease the rates at which depression reoccurs in treated patients?

Introducing TMS

That’s the question that Dr. Sandeep Vaishnavi of Carolina Partners intended to answer when he became interested in TMS— Transcranial Magnetic Stimulation. TMS, he explains “is an FDA-approved alternative to antidepressants for patients who are not responding well to traditional modes of treatment.

“The process is simple and non-invasive,” he says. “A metal coil is placed around your head, which generates magnetic fields targeting specific areas in your brain. Over a few sessions of just sitting in a comfortable chair, this gentle magnetic stimulation helps increase vital neurotransmitters like dopamine and serotonin—exactly what antidepressants hope to do, but with much more predictable, measurable results.”

Dr. Vaishnavi notes that “clinical trials have shown TMS to have high rates of success compared to traditional antidepressant regimens, with very few side effects—usually nothing worse than a short-lived headache. Moreover, these trials have also shown the positive effects of TMS to be enduring over time.”

Carolina Partners Neuropsychiatry Clinic

A few years ago, Dr. Vaishnavi founded the Carolina Partners Neuropsychiatry Clinic, hoping to use neuroscience and cutting-edge technological advancements to increase the efficacy of psychiatric treatment. “At the Clinic,” explains, “we use digital technology to help us take a more holistic approach to healing—combining what we know about neuroscience and psychiatry to better evaluate, test, and treat neuropsychiatric illnesses.

“TMS,” he says, “is a wonderful example of this approach of translating new neuroscience findings to clinical practice.  Now that we know from neuroscience what neural circuits are involved in many neuropsychiatric conditions, we can use this information to improve care. We can directly affect neural circuits in the brain and make a real difference in the lives of patients.”

To Dr. Vaishnavi and others in his field, TMS (and other similar neuromodulation innovations) represent the next chapter of psychiatric care. “We’ve come a long way since those early, brutal days of institutionalizing people for their feelings,” he notes, “but as our technology continues to advance, along with our neuroscientific understanding, our treatment of psychiatric disorders is only going to get better.”