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David Mrazek, M.D.
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David Mrazek, M.D.
David Mrazek, M.D.
Dr. David A. Mrazek is chair of the Department of Psychiatry and Psychology at Mayo Clinic, Rochester, Minn., and a professor of psychiatry at College of Medicine, Mayo Clinic. Dr. Mrazek has developed a federally funded psychiatric pharmacogenomics research program and implemented clinical psychiatric pharmacogenomics services at Mayo Clinic.
He has received numerous awards including the Award for Creativity in Psychiatric Education from the American College of Psychiatrists and the Agnes Purcell McGavin Award for Distinguished Career Achievement in Child and Adolescent Psychiatry from the American Psychiatric Association. He currently serves as chairman of the board of the American Board of Psychiatry and Neurology.
Dr. Mrazek has focused his current efforts on using pharmacogenomics testing to improve clinical care. One of his specific goals is to decrease the risks of taking psychiatric medications.
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Depression blog
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Dec. 3, 2010
Transcranial magnetic stimulation: Make decision carefully
By David Mrazek, M.D.
Who should receive transcranial magnetic stimulation (TMS)?
Experience with TMS makes it clear that not all patients respond to this treatment, but it also demonstrates that some do. The success rate varies as a consequence of a number of factors, but the type and severity of the depression makes a difference.
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TMS works best for patients with moderate depression who don't tolerate antidepressant medications. TMS is unlikely to work if you've received electro-convulsant therapy (ECT) and weren't helped by it.
TMS is still a quite new treatment. Psychiatrists vary in their experience using it and their confidence in its effectiveness. The most attractive features of TMS are that it's quite safe and effective for some patients. The biggest drawbacks are that it doesn't help some patients, it can take several weeks to begin to work, and is quite expensive.
If you're struggling with depression, you must ultimately decide whether TMS is the right treatment. A decision should be made on the basis of a frank discussion between a knowledgeable psychiatrist and an informed patient. Once you understand the potential benefits and risks as well as the cost, the decision should be made as to whether the potential gain is worth the cost. Beginning a new treatment is not usually an easy decision, but it should be a joint decision based on the available evidence.
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