Last month CNN ranked it number 5 out of the “top 10 health innovations of 2009.” Edward J. Bilotti, MD, Medical Director of the TMS Center of Princeton, calls it “quite possibly the most exciting advancement in the history of psychiatry.” He is talking about Transcranial Magnetic Stimulation (TMS), a new technology, approved in October, 2008, by the US Food & Drug Administration, for the treatment of major depression.

This new treatment involves an MRI-strength magnetic field that stimulates electrical currents in specific areas of the brain involved in mood regulation. It is a totally non-invasive outpatient procedure, done in the office with no anesthesia necessary. Patients can drive themselves to and from the office. Bilotti, a Tufts University Medical School graduate and board-certified by the American Board of Psychiatry and Neurology, was the first to bring this ground-breaking treatment to New Jersey, and the TMS Center of Princeton is one of a limited number of sites around the country currently offering it.

The response rate is quite remarkable, with two-thirds of patients showing significant improvement and one-third of those achieving complete remission from their depression. Unlike antidepressant medications, nothing circulates through the body, so there are no systemic side effects. Many patients who take medications experience unpleasant side effects such as weight gain, problems with sexual functioning, gastrointestinal distress, sleepiness, and agitation. None of these occur with TMS.

A patient could experience some mild, localized scalp discomfort or headache, both of which are generally short-lived and easily managed with over-the-counter acetaminophen or ibuprofen if needed. “In our experience most patients have no difficulty tolerating these treatments,” Bilotti says.

TMS is indicated for those cases of major depression that are “treatment-resistant,” meaning patients have either not gotten better with medications or have not been able to continue taking medications due to side effects.

“TMS is a superb option for the treatment-resistant depressed patient,” says Bilotti. “It offers new hope and a safe, effective alternative.” Unlike electroconvulsive therapy (ECT), sometimes called shock treatment, which has been around since the 1940s, TMS uses highly focused, pulsed magnetic fields to stimulate targeted areas of the brain. A sophisticated computerized system is used to find the precise “threshold” for each patient. As a result there are no cognitive problems like memory loss or confusion, and no anesthesia is needed.

TMS is believed to work by stimulating neurons in the prefrontal cortex and other deeper areas to produce more of the brain’s own chemicals needed for mood regulation and mood-enhancement. “I am privileged to be a part of this,” says Dey-Lynn Holden, RN of the TMS Center. “As a nurse it is very rewarding to see clients getting better when they and their loved ones had little hope left.”

Holden is a registered nurse who has undergone special training in administering TMS. She spends a great deal of time working one on one with patients as she administers the treatments and has seen the results first-hand. “The value in improving quality of life is immeasurable,” says Holden.

For more information or to schedule a consultation go to or call 609-279-1339.

TMS Center of Princeton. PC 188 Tamarack Circle, Skillman. 609-279-1339.

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