Neurostar TMS therapy (depression)?
August 19, 2011 7:59 PM   Subscribe

Neurostar TMS therapy (depression)?

I'm pretty depressed about things in general and have been for a while. The anti-depressants I'm on seem to be doing not very much, but yet I've tried a lot of them. It's a very long story, but I want help... I don't want to feel like this at night. I'm tired of my current life, I'm tired of my chronic neck pain, I'm tired of my chronic depression, I'm tired about my school situation. Everything.

My psychiatrist and I have talked frequently about different combos of anti-depressants and such, and even TMS. The problem with Neurostar TMS therapy is it's expensive as **** (I believe my psychiatrist quoted $10000 to $12000) and insurances haven't figured out what to do with it coverage wise; thus, they are reluctant to reimburse you anything until you've emptied your checking account and appealed their denial 40 times. We don't have the money, but I'm slowly losing hope for not being depressed and would almost sell my soul for it now.

I have United Healthcare (Value Options is their mental health branch), and was wondering if anyone in the Houston area has tried this treatment for depression and how was your battle with your insurance like if so?

Or if anyone knows anyone in the Houston area, I'd really really appreciate if you could ask them.

posted by isoman2kx to Health & Fitness (2 answers total) 2 users marked this as a favorite
TMS is expensive because it's an exotic treatment. Most of this equipment is developed for neuroscience research. I see a bunch of vendors every time I go to a conference.

The problem with TMS is that it's impossible to run a watertight clinical study of its effectiveness. It produces very particular immediate effects. As a result, it's very difficult to simulate it in a control group, which means that you can't have a double-blind study. Double-blind studies are needed to withstand the criticism that any effects that might be observed are due to researcher or participant bias (i.e., real TMS might be no better than placebo, but patients can tell real TMS from placebo, and hence don't get the placebo effect).

Studies that are currently available are mixed and don't seem to be showing spectacular results.
posted by Nomyte at 9:55 PM on August 19, 2011

isoman2kx, I'm so sorry that you are suffering. I don't have direct contacts in Houston in the mental health community, but worked in the field in other parts of TX in the past. I'm not sure how helpful this information is going to be, but wanted to reach out and let you know that someone is hearing you.

Like you seem to know already, TMS is still a pretty new therapy for depression so it often is not covered at least at first by insurance. Value Options can be a bit foot dragging in terms of approving services, so if you do pursue this you may be going through a lengthy appeals process.

In terms of efficacy, the data shows that it is most likely to be effective in cases of moderate depression, and that like other treatments, not everyone responds. This website from the Mayo Clinic is a pretty good resource for information about TMS with some links at the bottom of the page to additional information about treatment options for resistant depression. One therapy discussed there is electroconvulsive therapy which is another therapy for treatment resistant depression with a longer track record meaning that insurance may be more willing to cover. It might be something to discuss with your physician.

My only concern in reading your question is that you specifically mention Neurostar. This is one company that has developed TMS units for the commercial market and appear to be opening franchise-type clinics. If you do decide to pursue this, be sure to really ask good questions about the providers' practice as a whole. Is TMS all or most of what they do? It can be that when a new machine or procedure becomes available a few rush to adopt it. It can be lucrative to the providers and even for folks with the best of intentions their decisions about what is the best treatment can get clouded by the money involved. Make sure that the providers have a long track record in treating depression (i.e. it was a specialty of theirs even before the Neurostar was on the market), and that it is not the only therapy they provide (i.e., they are willing to recommend and prescribe other therapies when they are more appropriate). It can sometimes become a case of when a person only has a hammer, the whole world looks like a nail otherwise.

With all of the above caveats, it looks like the company does provide resources for helping people secure insurance coverage. . They are also clear that you may have to pay for the services out of pocket. NAMI would also be a really great resource for help in navigating the insurance process and potentially would be a link to people who have had TMS and could tell you more about their experience. Here is the link to the Houston chapter.

Finally, do you have a good support system in place? If you're ever not feeling safe, please ask for help or head for the ER. The NeuroPsychiatric Center is also available to you to help in a crisis. Contact information is Address: 1502 Taub Loop, Houston, TX 77030 Phone: 713-970-7070 (24 hours a day).

Take good care of yourself and keep fighting, there are people out here pulling for you.
posted by goggie at 10:14 PM on August 19, 2011 [3 favorites]

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