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Discovery's Bright Possibilities
Irving Reti, M.B.B.S.
Psychiatrist Irving Reti knows better than most the need for variety in depression therapies. As the head of Hopkins ECT (electroconvulsive therapy) service, he sees the steady line of patients from all over the country who’ve come because antidepressants haven’t helped or because they find side effects intolerable.
“Effective as ECT can be,” he says, “we’ve known for years that we need alternatives.”
But now, psychiatry is discovering an exciting new physical approach to therapy. “Somatic treatment,” as it’s known, springs from research in which stimulating specific areas of the depressed brain—directly with electricity or through targeted electromagnetic waves—apparently raises mood and does it well.
For years, Reti, also a neuroscientist, has studied molecular changes that follow ECT and other somatic approaches. That work now informs the new therapies. Farthest along is transcranial magnetic stimulation (TMS), a use of magnetic waves to rouse areas near the brain surface, like the prefrontal cortex, that have gone metabolically sluggish.
Remarkably, trial patients show no apparent side effects in thought processes or memory. “And the early evidence says it may be especially effective in younger patients, which is good news,” says Reti, “given today’s concerns about teens and antidepressants.”