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Would you have tried rTMS if it was free? [Poll]

827 Views 9 Replies 3 Participants Last post by  teal
Would you have tried rTMS if it was free?
Yes, for sure!787.50%
No, I wouldn't!112.50%
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I would not. rTMS is a treatment option here in Denmark for refractory depression and it is free in those hospitals who use it. rTMS is only approved for depression at the left and right DLPFC in Europe and the US. Many american patients are covered by their insurance company to get rTMS but only for depression at these locations. These locations are also very easy to find without neuronavigation. So, it is a cheaper setup. But, the left and right DLPFC are not locations that have any effect on depersonalisation. Most have no effect from it and some even see that their depersonalisation symptoms get worse at these locations. So, no i will not try these areas for free. Because the locations for depersonalisation are difficult to locate without additional equipment for location and the often the cost a a MRI scan this makes it very limited who can offer it. The rTMS equipment used for free in Denmark for refractory depression do not have neuronavigation so they can find locations that works for depersonalisation like the right VLPFC, TPJ or angular gyrus. The trials done at these locations are also very small and not replicated in large sizes so there is no approval as a treatment. I know about a canadian women with depersonalisation that has been a patient in one of the largest rTMS research facially in the world. They have neuronavigation. They have tried the right and left DLPFC. Then she tried the medial prefrontal cortex that is the area that the research unit is doing research into. No, effect. I said to her she should ask for the right VLPFC. This was rejected because it is a location that the research facility have no approval to work with. They have set of a experimental trial that is approved to work at that location.

So, free treatment or treatment that is covered by insurance companies at these locations will not be an option for the next 10-15.years unless it is a trail. Either you find a private rTMS clinic that have this equipment, have read into depersonalisation and you pay the cost yourself. That is no free treatment.
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Well, you can compere it with lamotrigin combination trails. There are publications on the subject that are very small but there are indications that 50% might have some benefit from it. 50% ought to have some reduction in symptoms on that combination. Yet, very few have given it a try and with a try i mean doses of lamotrigine that is known to be productive in DP like or as high as with a antidepressant or two that works. To give that trial alone a "fair" chance might take 6-8.months to try. Most have not tried it. with rTMS it could be the same.
It is my impression that there is very little interest on the subject. One have two months ago posted some videos on youtube about his rTMS trial on the right VLPFC and its effects on his emotional numbing.It worked on that aspect of the disorder on him. I have reposted his videos here. Very few have seen them. Prior to my posting his video had been shown 200.times and it is still very low. It might be to complicated and techical for most to relate to.
No, the factor is that people here don't try whatever it is because it is not offered to them. The combination of lamotrigin with a antideressent has been known for 15.years. Very few have tried it despite it might benefit 50% to a degree.A central aspect is that depersonalisation is still highly unknown and under diagnosed. So, all treatment initiatives is on the side of the patients in many cases. Very few will ever see a psychtrist who says that;" now we will try the lamotrigin combo with two different antidepressant and see if it might benefit you" because they don't know about the disorder or its treatment. The same with rTMS: I have come across many with depersonalisation from US and Canada who have tried rTMS without any effect. So, they thinking they have tried rTMS but when asked about locations tried it shows that they have never tried rTMS for depersonalisation with the locations tried. Because the disorder and treatment is highly unknown you really have to be very aware, active and systematic to work with this disorder: We are offered nothing by the mental health system.
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