Study looking at treatment-resistant depression

A psychiatrist in Winnipeg, Canada is searching for people to take part in a research study that may include access to Magstim TMS.

Magstim is based in Whitland, Carmarthenshire. The company has always been at the cutting edge of the evolution of transcranial magnetic stimulation (TMS) from its conception as a valuable research tool to its coming of age as a revolutionary treatment for nerve and brain disorders such as major depressive disorder (MDD).

CBS News reports Dr Mandana Modirrousta, a neuropsychiatrist and researcher at St Boniface Hospital, Winnipeg is looking for sixty four people from Manitoba with “treatment-resistant depression” to take part in the study. She is seeking anyone who has tried two different treatments, such as talk therapy and a drug, but still has the symptoms of depression.

Those who take part may have one of three treatments:

  • Their current anti-depressant drug will be switched to Venlafaxine, which is sold under the brand name ​Effexor XR. It increases the concentrations of the neurotransmitters serotonin and norepinephrine in the body and the brain and is licensed for the treatment of major depressive disorder, generalised anxiety disorder, panic disorder and social phobia.
  • Their current drug will have Aripiprazole, sold under the brand name Abilify, among others, added to it. The antipsychotic drug works in concert with other antidepressants.
  • They will be treated with something repetitive transcranial magnetic stimulation (rTMS).

rTMS works through neuroplasticity, or the ability of the brain to form and reorganise synaptic connections. Theories about neuroplasticity reflect the idea that brains aren’t rigidly hardwired, as was once believed, but that they can change and be rewired.

Mandana Modirrousta, who is also an associate professor of psychiatry at the University of Manitoba, said “Basically there is a network, or different areas in our brain, that is involved in regulating our mood. When this network doesn’t work properly, people become depressed…RTMS is a non-invasive, safe method of brain stimulation in a relatively focused area. It stimulates the brain cells which are connected to other parts of the network…and we can either increase or decrease the activity of that network. After this is repeated over time…the brain takes over and they don’t need to give more TMS pulses. The brain does it itself.”

St Boniface Hospital is one of three Canadian sites involved in the study, which will take place over four years, with each participant being treated over an eight week period. The type of treatment a person receives will be chosen at random. Mandana Modirrousta, who is co-ordinating the Winnipeg part of the study, is in charge of the St Boniface Hospital RTMS clinic, which has been going since January 2012. Typically, the treatment is done daily, maybe twice daily, for a few weeks. Depending on studies that will have been done on people’s brains before starting, the pulses could be high frequency for just five minutes per session or lower frequency for thirty minutes or so.

Her research suggests the treatment is effective for about 65% of people, who say their concentration is better, they can think clearer, and they have more energy and motivation and fewer instances of depression. However, she said about half relapse six months after the rTMS treatment stops. She said “But this also means another 50 per cent still is doing well”, adding those who do relapse are given a “booster session as a maintenance treatment” every six months. She said “If it does work for someone, it’s a fantastic treatment because it does not have those systemic side-effects of medications.”

Anyone who would like to participate can call Mandana Modirrousta’s research assistant on (+1) 204-237-2677 or email

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