Houston Mind & Brain

04/08/2022

Treatment refractory depression is a very prevalent and debilitating problem. Our clinic offers some much needed treatment options as alternatives to standard antidepressant medications which often fail due to inefficacy or side effects. In addition to TMS which we’ve discussed in prior blogs, we are also happy to offer Spravato (esketamine), another treatment for treatment-resistant depression. FDA-approved since 2019, Spravato is an intranasal spray that is used in conjunction with an oral antidepressant for the treatment of treatment-resistant depression in adults.

What should you expect from Spravato? When first starting Spravato treatment, you will have two sessions a week for four weeks, after which Dr. Cho will review with you to decide if Spravato should be continued. At each session, you will self administer the Spravato nasal spray under the supervision of our staff, after which you will rest comfortably for 2 hours while our staff routinely monitors you for possible side effects. Common side effects include feeling sedated and/or dissociated, as well as a temporary increase in blood pressure. After you receive your treatment, you will not be able to drive or operate other heavy machinery for the rest of the day, so a ride is required when you receive Spravato treatment.

Have studies shown Spravato to be an effective treatment for treatment-resistant depression? In a 2021 academic review of 5 studies on the efficacy of Spravato with an antidepressant versus a placebo with an antidepressant, the study found that per 100 patients, the group that was administered Spravato with an antidepressant had 5-21 additional cases of remission and 14-17 additional patients who responded well to the treatment. The review was able to conclude that Spravato plus an antidepressant had a positive benefit in patients with treatment-resistant depression.

If you are struggling with depression and therapy and/or antidepressant treatments have not helped, Spravato may be an option for you. If interested, please give us a call at (832) 699-7922 or visit the link in our bio to learn more. Our friendly staff are happy to answer any questions and schedule you for a consultation!

03/25/2022

As we come up on more than 2 years living under the COVID-19 pandemic, there is an urgent need for increased access for mental health services. In a recent article published to Scientific Reports, researchers stressed that mental health concerns need to be a major focus as the US continues to struggle with the COVID-19 pandemic.

Experiences that many of us have gone through in the past two years such as social isolation, working from home, income loss, and being out of school have significantly contributed to increased levels of mental health concerns. According to a survey taken in a recent Scientific Reports article, 1 in 3 respondents reported mental health concerns, an increase from the 1 in 4 that reported mental health concerns prior to the pandemic. More specifically, anxiety increased 37% (from 16% in 2019 to 53% in 2020), depression increased 9% (from 19% to 28%), and alcohol abuse increased 8% (from 6% to 14%).

According to Patrick Bordnick, PhD/MPH, the dean of social work at Tulane University, “We are seeing issues now and will see more behavioral health issues for years to come.” In addition Tonya Hansel, PhD has stressed the need for increased availability of psychoeducation, therapy, and other treatments to address these concerning increases in mental health concerns.

Here at Houston Mind and Brain, we know that these past two years have been difficult. We are happy to provide a wide variety of services for mental health including TMS, Spravato, medication management, and psychotherapy. Don’t ignore your mental wellbeing! If you’d like to learn more, please give us a call at (832) 699-7922 or visit our website in our bio!

03/11/2022

TMS is most well known for treating depression and OCD, but did you know it can treat anxiety as well? Around 60% of those who suffer from major depressive disorder also suffer from an anxiety disorder. Symptoms of anxiety include regular feelings of nervousness, restlessness, and tension as well as having a sense of impending danger and panic. The combination of anxiety and depression is referred to as anxious depression, and it can be a challenging condition to treat.

For traditional TMS that uses a ‘figure-of-8’ coil to deliver stimulation, previously reported studies have shown that high levels of anxiety have a negative impact on treatment outcomes using traditional TMS. However, here at Houston Mind and Brain, we use deep TMS, a newer version of TMS that is able to deliver stimulation deeper into the brain structures associated with depression and anxiety. A recent 2022 study found that unlike traditional TMS, in those undergoing deep TMS treatment for depression, high baseline anxiety was found to be a positive predictor for successful treatment. In addition, when compared to placebo stimulation, deep TMS produced significantly lower anxiety and depression severity over the course of the entire 16 week study.

If you are suffering from anxiety and/or depression, deep TMS may be able to help even if other medication has not helped. Call our clinic at (832) 699-7922 to learn more. Our friendly staff are happy to answer any questions or schedule you for a consultation!

And stay tuned … Next week we’ll talk about the increased need for mental health services as the COVID-19 pandemic continues.

03/04/2022

Here at Houston Mind and Brain, in addition to normal deep TMS, we also offer two alternative forms of TMS treatment: theta burst stimulation (TBS) and accelerated TMS protocols.

TBS is a variation of deep TMS that uses low stimulation intensity and a short treatment length (~ 7 minutes compared to 20 minutes for standard TMS) to deliver deep TMS to treat depression. TBS for depression was FDA approved in 2021, and it is a rapidly growing method for treating depression and numerous studies have shown TBS’s efficacy, even when other methods such as antidepressants and psychotherapy have failed. More specifically, a 2020 review of 10 studies regarding the efficacy and tolerability of TBS showed that 40% of patients who underwent TBS responded to the treatment and 20% achieved remission entirely. All of these effects were achieved without major adverse events. In addition, a 2018 study found that TBS, although shorter in duration, was just as effective as normal deep TMS in treating depression.

TBS’s short treatment times paves the way for accelerated TMS protocols, where multiple treatments are given in a single day. These protocols can help with patients who have busy schedules and struggle to fit daily treatments into their schedules. A landmark 2020 Stanford study of accelerated TMS showed that accelerated TMS treatments were able to significantly lower depression scores over the course of just 5 days. In addition, another 2020 study of accelerated TMS using the same H1 coils that we use in our clinic also showed that accelerated TMS was effective in treating depression, with the added potential of more quickly reducing depression symptoms.

Here at Houston Mind and Brain, in addition to normal deep TMS protocols, we also offer TBS and accelerated TMS at the discretion of Dr. Cho. If you are interested in the wide range of TMS services that we offer for depression and OCD, give us a call at (832) 699-7922 or visit our website in the bio!

And stay tuned … next week we’ll be reviewing a recent study showing the effectiveness of TMS in treating anxious depression!

02/22/2022

Meet Dr. Cho! Dr. Cho is the medical director, president, and a board-certified psychiatrist here at Houston Mind and Brain. Originally from Toronto, Canada, Dr. Cho received his M.D and M.Sc in Neuroscience from the University of Toronto, completed his psychiatry residency at the University of Pittsburgh, and received additional graduate training in Psychology at Princeton University.

Over the past 20 years, Dr. Cho has led research and clinical programs in neuropsychiatric disorders and noninvasive brain stimulation. He has published over 55 peer-reviewed journal articles and has held faculty positions at the University of Pittsburgh, UT Health Science Center, and now at Baylor College of Medicine and Menninger Clinic, and served as Chief of Psychiatry at Lyndon B. Johnson Hospital. He has been the recipient of numerous awards and honors including Houston Top Doctor, NARSAD Independent Investigator Award, numerous federal NIH grants, and resident teaching awards.

With over 26 years of clinical experience in the studies of cognition, brain physiology, and brain stimulation, Dr. Cho brings the highest level of psychiatric expertise to Houston Mind and Brain. He and his excellent clinical team and staff bring the best of TMS, Spravato, psychotherapy, and medication management services to the greater Houston area, treating a wide variety of disorders including depression, anxiety, OCD, ADHD, and schizophrenia. If you struggle with any of these, Dr. Cho is eager to help, so don’t hesitate to give us a call at (832) 699-7922 or visit our website in the bio to learn more about our clinic!

And stay tuned … Next week, we’ll be talking about theta burst TMS and accelerated TMS protocol, two alternative TMS treatments that are also available at Houston Mind and Brain!

02/16/2022

Did you know that transcranial magnetic stimulation can treat OCD? Similar to depression, many who suffer from OCD have tried cognitive behavioral therapy, medication, and lifestyle changes without significant improvement or had many side effects. Luckily, TMS for OCD offers an alternative treatment that is safe, effective, and has been approved by the FDA since 2018. Using magnetic pulses, TMS stimulates the medial prefrontal cortex and anterior cingulate cortex, both of which are areas associated with decision-making. It’s extremely safe, with adverse effects usually limited to local discomfort in the scalp area (seizures are very rare, occurring in only 0.56% of patients).

Do clinical results support the use of TMS in treating OCD? They do! A 2019 study on the efficacy of TMS for OCD found that for patients who had already tried other medications for OCD, TMS was effective in treating OCD for 38% of patients, and one month following treatment, that number increased to 45%.

At Houston Mind and Brain, we are proud to partner with Brainsway, the industry leader in deep TMS, to offer the only FDA-approved TMS device to treat OCD. These treatments are administered with the guidance of Dr. Raymond Cho MD, a board certified psychiatrist with over 20 years of experience in the field. If therapy and medication have not helped with your OCD and you're interested in learning more about TMS, you can visit our website in our bio or give us a call at (832) 699-7922!

And stay tuned … next week we’ll be talking about our very own Dr. Raymond Cho MD, the director of Houston Mind and Brain!

02/14/2022

This , one Deep TMS™ patient is spreading in a heartfelt way to the team of providers and staff at TMS at Houston Mind & Brain.

Having completed treatment, she shares, “My is significantly better. I don’t have the gray cloud over my head everyday. I’m able to focus better, and as a law student that’s pretty important! If it weren’t for you, I wouldn’t have known about this treatment and feel the way I do today.”
We’re hopeful this video inspires others to use this holiday to thank a hard-working hero near and dear to their heart.
Learn how Houston Mind and Brain is elevating treatment by visiting our website in our bio today!

02/11/2022

Deep TMS™ Patient Justin sent a Valentines video to Dr. Raymond Cho that will pull at your heartstrings this Valentine’s Day. 💌

Justin says, “Since Deep TMS, I’ve been able to exhibit so much more passion, zest, interest, creativity, optimism that had stolen from me … You may wonder when you come in each day if you are making a difference and I can tell you that you’ve changed my life and made me love it again.”

Just as Justin did for our team here at Houston Mind and Brain, we encourage others to use this to spread the to their devoted providers for their commitment to bettering the of others.

Learn how Houston Mind and Brain is elevating mental health treatment by visiting our website in our bio today!

02/11/2022

Although TMS treatment is very effective in treating depression for those who have seen little to no benefit from antidepressant medication, there have been some studies showing that the therapeutic effect of TMS can wane over time. A 2019 study assessing the durability of TMS antidepressant effects showed that around half of TMS patients saw some regression in their depressive symptoms 12 months after their initial TMS course of treatment.

Here’s where maintenance TMS can help! When patients complete a course of TMS treatment that significantly lowers their depressive symptoms, maintenance TMS can often be used to “maintain” the improvements that patients feel. Maintenance TMS is when additional TMS treatments are administered, usually at a lower frequency than the initial TMS course of treatment, in order to extend the therapeutic effects of TMS. A 2022 review of 30 different studies on maintenance TMS showed clear support for both the safety and effectiveness of maintenance TMS for those who have not responded well to other antidepressant medications.

At Houston Mind and Brain, on top of normal TMS treatments, we offer maintenance TMS under special circumstances to patients who have responded well to their initial TMS course of treatment and would like the additional reassurance of maintaining their improved depressive symptoms. These decisions are discussed with Dr. Raymond Cho, who is a board-certified psychiatrist with extensive experience in brain stimulation. If you are interested in learning more about TMS for depression, visit our website in our bio or give us a call at (832) 699-7922!

And stay tuned ... next week we'll be talking about how TMS can also treat OCD!

02/04/2022

There are two primary forms of TMS: traditional TMS and deep TMS. These two TMS treatment methods differ in the type of coil used to deliver magnetic pulses to the brain. Traditional TMS, which uses a figure of 8 coil, was developed before deep TMS and is most common throughout the TMS industry. On the other hand, deep TMS, which uses a unique H coil, was developed more recently and FDA-approved for depression in 2013. Whereas it can be difficult to locate the target region using traditional TMS, the H coil used by deep TMS delivers deeper and broader stimulation to the brain regions targeted in TMS. This allows deep TMS to more effectively stimulate the activity of deeper brain regions involved in the emotional regulation network.

How do clinical results compare between deep TMS and traditional TMS? In terms of safety, both deep TMS and traditional TMS have been shown to be extremely safe, with no significant adverse effects. However, in 2019, two separate studies both showed that deep TMS consistently showed a larger reduction in depression severity when compared to traditional TMS.

At Houston Mind and Brain, we are proud to partner with Brainsway to offer state-of-the-art deep TMS for depression, OCD, and other conditions. Our TMS treatments are carried out under the supervision of Dr. Raymond Cho MD, a board certified psychiatrist with over 26 years of clinical and research practice. If you’re interested in how our TMS treatments can help you, you can visit our website in our bio or give us a call at (832) 699-7922!

And stay tuned… Next week we’ll be discussing maintenance TMS, a way to extend the longevity of TMS’s antidepressant effects.

01/28/2022

Major depressive disorder is often a difficult condition to treat, and many who have depression have tried lifestyle changes, therapy, and medication without any significant improvement or with many side effects. Here’s where transcranial magnetic stimulation (TMS) can help! TMS is a rapidly growing non-invasive and insurance-backed treatment for depression that has been FDA-approved since 2008. Using magnetic pulses, TMS stimulates the brain in a way that has been shown to reduce symptoms of depression in most patients. It’s extremely safe and most TMS patients experience no significant adverse effects!

How exactly does TMS work? TMS uses state of the art technology to deliver magnetic pulses deep into the dorsolateral prefrontal cortex (DLPFC), a brain region involved in depression and mood regulation. Research studies have shown that TMS can increase brain derived neurotrophic factor (BDNF), a chemical that supports neuronal growth. MRI studies have also shown that functional connectivity between the DLPFC and other important brain regions implicated in depression can improve with successful TMS treatment.

Here at Houston Mind and Brain, we are proud to partner with Brainsway to offer top of the line TMS services under the supervision of Dr. Raymond Cho MD, a board certified psychiatrist with over 20 years of experience in the field. If therapy and medication have not helped with your depression and you're interested in learning more about TMS, you can visit our website in our bio or give us a call at (832) 699-7922!

And stay tuned … not all TMS is created equal. Next week, we’ll be discussing the differences between deep TMS and figure of 8 coil TMS, two different ways of delivering TMS treatment.

01/20/2022

BrainsWay Deep TMS is an effective, safe, and non-invasive treatment for psychiatric and neurological disorders. This noninvasive treatment process directly stimulates brain structures associated with conditions such as . To learn more and hear directly from our patient who had great success with Deep TMS, watch the exclusive interview with Dr. Raymond Cho, Psychiatrist and Founder of Houston Mind and Brain. Call us at: 832-699-7922
Visit our website: https://houstonmindandbrain.com/
https://bit.ly/2ZTpaJO

The helmet creates a magnetic field that is pulsed through the skull. It is used to treat depression, OCD, and now to help chronic smokers quit.