Transcranial magnetic stimulation (TMS) is a technology that uses magnetic fields to stimulate or suppress electrical activity in brain circuits. It's part of a transformation in how psychiatrists are thinking about mental health disorders that today's guest calls psychiatry 3.0.

Nolan Williams has recently pioneered a new form of TMS therapy that has just been approved by the FDA to treat patients with treatment-resistant depression. That actually describes a lot of people with serious depression — somewhere between a third to a half. At some point talk therapy doesn't work, drugs don't work, and for most people, there's not much else to try.

TMS has been used for depression before, but Williams' team has taken a new, more targeted approach. It's called SAINT, which stands for Stanford Accelerated Intelligent Neuromodulation Therapy. Basically, it uses MRI brain imaging to precisely target intensive TMS stimulation to tweak the function of specific circuits in each patient's brain.

Remarkably, after just one week in Williams' SAINT trial, 80% of patients went into full remission. The stories these patients tell about the impact this has had on their lives are incredible.

We talked to Williams, who is a faculty director of the Koret Human Neurosciences Community Laboratory at Wu Tsai Neuro, about what makes this approach unique and what it means for the future of psychiatry.

Additional Reading

• Researchers treat depression by reversing brain signals traveling the wrong way (Stanford Medicine)
• FDA Clears Accelerated TMS Protocol for Depression (Psychiatric News)
• Experimental depression treatment is nearly 80% effective in controlled study (Stanford Medicine)
• An experimental depression treatment uses electric currents to bring relief (NPR) 
• Jolting the brain's circuits with electricity is moving from radical to almost mainstream therapy. Some crucial hurdles remain (STAT News)

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