TMS/Ketamine/ECT: What Residents and Trainees Need to Know-View Presentation

Video Transcription

Video Summary

In this comprehensive final session, Dr. Simon Kung and his colleagues at the Mayo Clinic discussed various treatments for depression, focusing on Transcranial Magnetic Stimulation (TMS), ketamine, and Electroconvulsive Therapy (ECT). Dr. Kung covered TMS, detailing its use for major depressive disorder and its relatively rare side effects like temporary pain. TMS induces brain stimulation via magnetic fields, targeting regions like the dorsolateral prefrontal cortex. He also mentioned the newer accelerated TMS protocols which have shown promising results for major depressive disorder. Dr. Balinder Singh discussed ketamine, emphasizing its rapid onset in reducing depressive symptoms. However, its effects tend to be short-lived unless continued over several sessions. The discussion included the challenges and potential interactions related to ketamine use, as well as its transition from IV to intranasal forms. Dr. George Petrides addressed ECT, highlighting its historical context and modern usage. He detailed ECT's efficacy, particularly for severe cases like catatonia and treatment-resistant depression, and reassured safety with low mortality rates compared to procedures like colonoscopies. Each treatment option was evaluated for its viability based on patient condition, insurance coverage, and logistical considerations. The session concluded with a Q&A, allowing for clarification on treatment protocols and patient management. Overall, the presentations provided a thorough guide to contemporary interventional psychiatry approaches for treating severe depression.

Keywords

Transcranial Magnetic Stimulation

TMS

ketamine

Electroconvulsive Therapy

ECT

major depressive disorder

brain stimulation

dorsolateral prefrontal cortex

accelerated TMS protocols

treatment-resistant depression

interventional psychiatry

severe depression