Transcranial Magnetic Stimulation (TMS) Therapy

A REAL PATIENT TMS THERAPY REVIEW & CASE STUDY

By Dr. Jack Castro of Brandywine Valley TMS in Wilmington Delaware

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TMS THERAPY SUPPORTS MENTAL WELLNESS

  • Depression
  • Lack of Joy
  • Sadness and Despair
  • Low Mood
  • Lethargy
  • Insomnia
  • Oversleeping
  • Social Isolation
  • Self-Harm
  • Substance Abuse
  • Suicidal Ideation
  • Alcoholism
  • Chronic Pain

LEARN HOW DR. CASTRO TREATED MONIQUE'S BIPOLAR DEPRESSION

Background

Monique is a 61-year-old woman, came under my care in November 2021 following the retirement of her previous psychiatrist Dr C. Initially diagnosed with bipolar disorder type II, predominantly presenting depressive episodes, along with generalized anxiety disorder, Monique had a complex psychiatric history. She had experienced 3 hospitalizations in her 20s and 30s. Her treatment regimen included Abilify 5 mg, later increased to 7.5 Mg, Effexor 225 Mg, lithium ER 600 Mg, and trazodone 100 Mg. Despite these medications, Monique faced fluctuating effectiveness, leading to exacerbated symptoms of depression and anxiety, and a singular, mild manic episode which I did not witness as it had happened before we starting working together.

Presenting Issues

By April 2024, Monique reported worsening depression, which affected her daily functioning and focus. It’s unclear what triggered the relapse of her depression. Her condition impacted her ability to manage household tasks and her professional responsibilities. She expressed feeling overwhelmed, and frequently exhausted, resorting to excessive sleep. Her PHQ9 score at this time was 18, indicating moderate to severe depression.

Treatment Intervention

Given the progressive worsening of her symptoms and the limited efficacy of her extensive medication regimen, we considered alternative treatments. TMS therapy was proposed as a promising option. Starting on April 15, 2024, we initiated a high-intensity protocol tailored to her needs, considering her out-of-pocket payment constraints.

 

The treatment comprised:

  • Standard Protocol: 3000 pulses at 10 Hz targeting the left dorsolateral pre-frontal cortex, to address her depressive symptoms.
  • Additional iTBS treatments: Two sessions of iTBS (intermittent theta burst stimulation) were added to enhance the therapeutic impact.

Treatment Course and Monitoring

Over the course of 20 sessions, Monique’s response to TMS was closely monitored. The abbreviated treatment schedule was intensive, aimed at maximizing results within a limited timeframe to accommodate insurance limitations regarding bipolar depression. Her PHQ9 scores were regularly recorded, showing a steady decrease.

Outcome

By the end of the TMS treatment on June 27, 2024, Monique’s PHQ9 score had significantly improved to 6, reflecting a substantial reduction in depressive symptoms. She reported improved mood stability, enhanced focus, and better overall daily functioning.

Hear What Monique Had To Say About TMS Therapy

Conclusion & Future Considerations

Monique's case underscores the effectiveness of TMS therapy for bipolar depression, a condition often challenging to manage with medication alone. Her significant improvement demonstrates the potential of TMS to provide relief even in condensed treatment periods. Monique has decided not to pursue maintenance TMS sessions for now, satisfied with her current state of health.

 

Future Considerations

 

While Monique has chosen not to continue maintenance sessions, the option remains open should her symptoms recur. Her case will continue to inform the adaptive strategies necessary for managing complex mood disorders with TMS.

References

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TMS Therapy in Delaware: A Medication-Free Depression Treatment in New Castle & Kent Counties

By Jack Castro • February 20, 2025
Brandywine Valley TMS provides TMS therapy for depression in Delaware. Consult a specialist to see if TMS is right for you.
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Interested in more TMS case studies by Dr. Jack Castro?

TMS Treatment Could Change Your Life!

Experience the Benefits of TMS Therapy Today

TMS Therapy, an FDA-approved treatment, is non-invasive and non-sedative, offering minimal to no side effects. Unlike mental health medications, which frequently bring about undesirable side effects, TMS therapy provides an immediate sense of optimal well-being following treatment sessions. Patients often experience noticeable positive changes as early as the third week, and sometimes even sooner. On this page, we've shared one real-world patient experience.

TMS has gained a strong reputation as an outstanding alternative for individuals who do not experience positive results from traditional mental health medications.

Local to Wilmington Delaware? Contact Brandywine Valley TMS today!

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Dr. Jack Castro with a Magventure TMS Therapy chair and device.
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