Shirah Vollmer MD

The Musings of Dr. Vollmer

Machines For The Mind

Posted by Dr. Vollmer on July 30, 2019


Transcranial Magnetic Stimulation….the neuromodulation device FDA approved treatment for depression. Trigeminal Nerve Stimulation..the neuromodulation device FDA approved treatment for ADHD in 7-12 year olds. Cervella, the neuromodulation device, FDA approved treatment for depression, anxiety and insomnia. All of these devices deliver electrical current to the brain/nerve endings via an external device. The mechanism of action, like antidepressants, is not known. The theory is that neural networks need a re-boot to treat psychic pain. These machines help us move away from the “chemical imbalance” theory to a “neural network malfunction” theory. Of course both mechanisms could be at play, but we do not know that yet. We know that FDA approval hinges on beating the placebo response, but we also know that all psychiatric illnesses have a high placebo response. My point is that we come from a place of humility, of not knowing how we help people, and yet, trying all of our tools, including psychodynamic tools, to help with suffering. The broader and deeper our toolbox the more likely we can help those in need and so I welcome these additions to our armamentarium.



2 Responses to “Machines For The Mind”

  1. Shelly said

    Does one need to purchase these devices or use them in physician’s offices? Are they in combination with medications or stand alone? Do you have these devices in your office? Does one need a prescription to purchase them?

    • TMS is done in a physician’s office. TNS and Cervella require prescriptions and then they need to be purchased. TMS is in combination with medications but TNS and Cervella are not. No, I do not have these devices in my office, although I do prescribe Cervella and I am open to prescribing TNS.

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