Depression therapy has magnetic appeal across Minnesota

Albott said the magnetic therapy was originally limited to patients who had tried therapy and had no success, or had severe side effects, with at least four antidepressant drugs. The federal Medicare program recently expanded its coverage so that patients only had to try two drugs before being eligible for TMS, which partly explains the recent growth in Minnesota.

Coverage in Minnesota varies by insurance plan and employer. HealthPartners generally uses prior authorization in its plans to make sure patients have tried other treatments first, but Medica does not use that restriction.

Albott said she hopes it becomes more of a first-line therapy, though its time commitment will remain a barrier along with the roughly $10,000 cost shared between patients and insurers. Recent research has tried to predict which patients respond best to TMS, whether it substantially increases interest in daily life and reduces suicidal impulses, and whether it can be expanded for use by adolescents and for neurological conditions such as stroke.

The treatment already has been approved for smoking and obsessive compulsive disorder, and some researchers believe it can treat the ear-ringing condition known as tinnitus, which also reportedly increased during the COVID-19 pandemic.

Becky Steffens, 39, of Coon Rapids, didn't believe it would work, not after 15 years of dealing with depressive symptoms. Success at the University of Minnesota's clinic for treatment-resistant depression came when her doctors switched sides and directed magnetic pulses into the right side of her brain. Research has found that some patients need stimulation on that side to regulate a different portion of the brain that fuels negative thoughts.

Treatment wasn't easy because it disrupted work and was noisy and uncomfortable, she said. "It's like a little bird is pecking on the same spot on your head over and over for like 50 minutes."

It also wasn't one-and-done success, as she needed two rounds and once-a-week maintenance treatments along with other depression therapies. But TMS gave Steffens several months of complete remission and reduced symptoms the rest of the time that allowed her to discover joys in life such as painting and volunteering.

"I'm able to have a baseline where I'm not necessarily, like, happy and joyful and everything is great," she said, "but I'm not sad and stuck. I feel like it's kind of a place where I'm able to have emotions, feel them and then come back to a baseline ... and not get stuck in those negative sticky thoughts."

Poss said there will be need for other treatments, including more extreme but highly effective electroconvulsive therapy that causes patients to go into seizures and "resets" their brains without depressive symptoms. But he said he is particularly optimistic about TMS now that it is gaining interest and access is expanding.

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