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SJM_PROFILE_Depression Docs_0124_profile 1 / 24 / 24 2 : 56 PM Page 1 PROMOTION B U S I N E S S S P O T L I G H T Both , as Dr . Dal points out , are FDA - approved therapies covered by Medicare and most commercial insurance , and have demonstrated their significant capacity for helping patients who thought they’d exhausted all their current options in bat - Emerging Treatments , tling “ treatment - resistant depression , major depressive disorder , which has not responded to two to four antidepressants and therapy trials . ” Renewed Hope While only a medical professional can determine if TMS or Spravato is right for At Depression Doctors , patients benefit from working treating an individual’s depression — timing , dosage or administration , frequency of ses - with a proficient , experienced and compassionate sions and individual medical histories are team that knows how to develop and implement just some of the elements that need to be monitored , adjusted or considered painstakingly individualized treatment plans for a according to a doctor’s assessment — it is broad spectrum of diagnoses , which may include important to understand the differences between the two . two especially promising therapies . by MADELEINE MACCAR What to know about TMS field of mental health , just like the quality of life that longtime sufferers have A non - invasive , non - pharmaceutical every other facet of modern med - been denied . approach , approved by FDA for treatment icine , is in a state of constant “ As medicine advances so fast , you need resistant major depressive disorder and The evolution . As new research and studies yield to change with the new , more current infor - anxious depression , obsessive compulsive the new treatments heralding new hope for mation , ” says Dr . Alican Dalkilic , or “ Dr . Dal , ” disorder ( OCD ) , smoking cessation , and in longtime patients , there always seems to be a board - certified psychiatrist at Depres - November 2023 , to treat chronic pain . something novel and promising in mental - sion Doctors . “ We’re always looking for Depression Doctors has both MagVenture health experts ’ toolkits to help those with that advanced , new treatment or innovation and BrainsWay TMS systems that can treat depression that has stubbornly evaded effec - because patients are coming in and asking all of the above mentioned conditions tive solutions . us , ‘ Can I try this ? Is there something else including chronic pain . Dr . Dal describes Depression Doctors , a five - location that will work for me ? ’ ” TMS like “ a nudge : ” A small magnet placed practice established by two board - certi - Two of the specialized , thoroughly near a patient’s head sends painless mag - fied psychiatrists , sees patients whose treat - modern treatments offered at Depression netic pulses through the scalp to the brain’s ments address a range of psychiatric ill - Doctors that set the clinic apart are Tran - neurons , targeting areas affected by depres - nesses . And treating a constellation of diag - scranial Magnetic Stimulation , often referred sion . In a successful treatment , those under - noses — especially the treatment - resistant to as TMS , and Spravato , the nasal - spray active parts are “ woken up ” by TMS’s nudge depression that can leave patients feeling form of Esketamine that’s been available of electrical activity , helping to improve a resigned to a lifetime of shouldering the since 2018 and is closely related to ketamine , person’s mood and relieve their depressive onerous symptoms of their conditions — a medication proven to rapidly alleviate symptoms . means staying on the cutting edge of the depression cases that have eluded other “ It primarily massages the neurons on breakthrough treatments proven to restore forms of treatment . the left DLPFC area — the dorsal lateral pre - frontal cortex [ an area involved in mood regulation ] — that has been shown in mul - tiple imaging studies to be less active , or hypoactive ; after treatment with TMS , it becomes normally active , ” he explains , noting that operating the TMS machine does require certification , making it a significant clinical investment . “ We’ve kind of become specialized in that area and are offering that service for referrals as well , because not every mental - health provider can get those machines and the training and the staff to schedule those patients . That’s a unique advantage to our practice , having that available every day , all day . ” TMS itself , he adds , includes two sig - nificant considerations that differentiate it from Spravato : SOUTH JERSEY MAGAZINE volume 20 issue 10 SouthJerseyMagazine.com 8 |

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SJM_PROFILE_Depression Docs_0124_profile 1 / 24 / 24 2 : 56 PM Page 2 PROMOTION • It’s a drug - free option : TMS doesn’t require drive or use any machinery after their to eight weeks for me to begin to feel the surgery or medication , making it a great Spravato treatment , not until the next effects of it . … It’s a really good option option for a number of patients : those who morning . ” because it’s non - invasive , it’s a very short can’t tolerate antidepressants , those who are period of time — the treatment itself , for taking medications for other conditions or The patient experience me , was like three minutes . ” comorbidities and are worried about poten - For one Depression Doctors patient , who In addition to providing top - notch tial drug - to - drug interactions , and those askedto be identified only as “ Ann , ” Spravato mental - healthtreatments , the entire Depres - with a history of drug abuse , to name a few ; has proved to be the best solution yet . sion Doctors staff ensures that every indi - and “ It felt like I had been on every antide - vidualin their care feels seen , supported and • Minimal side effects and convenient ses - pressant combination out there , ” she says . likethere’s an ardent , attentive advocate on sions : Most patients experience little to no “ They would work well for a little while their side every step of the way . side effects ; when they do occur , they’re gen - andthen just kind of stop . I’ve been married “ At Depression Doctors , we , as a team , erally mild , like temporary headaches . And , for 21 years , I have a daughter who’s 19 , so believethat it’s very important to meet with as an outpatient procedure , TMS patients Iwas trying my best to be a good mom … but every individual and hear their story , what typically resume their normal daily activi - I was feeling so desperate . It was so hard to happened , when did they become depressed ties and obligations immediately after treat - get through the day then . ” or start to struggle with depressive symp - ment , which , in some instances , can only Ann had spent the better part of two toms , what their history with depression is , take five minutes . decadeson antidepressants , but her depres - if they’ve responded to certain types of sion “ really hit a wall about eight years ago . ” medications or therapy , if not what hap - What to know about Spravato Dr . Dal had referred her to Basant K . Pradhan , pened , what are their comorbid co - occurring While there are some similarities between the MD , at Cooper University Health Care for conditions , because more than 50 % of the non - medicinal TMS and the pharmaceutical TMStreatments , which was a step in the right time with depression , there is a comorbid Spravato — like a shared success as proven direction but eventually offered the same condition , like generalized anxiety disorder , alternatives in alleviating depression symp - diminishing returns she’d faced before . post - traumatic stress disorder , panic dis - toms for 70 % of patients who have histori - “ Dr . Pradham asked me if I wanted to order , obsessive - compulsive disorder , etc . ” cally found no relief from traditional anti - participatein a ketamine research study . … saysDr . Dal . “ We do a full evaluation before depressant medications — the nasal spray I did just one round and it was a game - we do anything else . Depending on the does offer some advantages of its own . changer , ” she recalls . “ It’s not perfect , it’s not individual’sneeds , we try to match them with In fact , one of the most remarkable amagic bullet and I still take other medica - thebest options , discuss all their options , and benefits of Spravato is its rapid action . “ As tion but my depression is in partial remis - even get their families involved because soon as it goes to the brain , it causes sig - sion . It really has been extremely helpful . ” some people need support through their nificant release of BDNF — brain - derived WhenAnn was prescribed ketamine for the treatments . It can be like a marathon with neurotrophic factor , which promotes new first time in 2016 , it was used as a non - FDA treatments that last for weeks . ” synaptic connections , basically new con - approvedoption . After nasal esketamine was Anempathetic undertaking makes all the nections among the neurons , ” says Dr . approved for treatment resistant major differenceto Depression Doctors ’ patients . Dal . “ The neurons making more connec - depressionin 2018 , Ann tried and benefited For Ann , who notes that she’s had some tions means a better network and better from it significantly . nightmare experiences in her decades - long communication among the neurons , and it Because everyone’s depression is dif - questto seek mental - health treatment , she can cause significant improvement in 70 % ferent , a patient seeing Dr . Dal’s peer Dr . recommendsthe clinic just as heartily as she of treatment resistant depression cases , Hatice Burakgazi - Yilmaz ( “ Dr . Y ” ) , who recommends finding hope in an always - and in 10 % , maybe 15 % of people , a sig - wishes to remain anonymous , found evolvingmedical landscape to anyone who nificant relief might occur even after a few incrediblesuccess in turning to TMS to treat feelsresigned to living with depression , just sessions of Spravato . ” the genetic depression she’s lived with like she once did . Since it , like TMS , is only used in a con - since her teenage years . “ I’ve been seeing Dr . Dal for close to 10 trolled medical setting , patient safety is “ I felt like I had no reason to be years now — I was seeing him even before ensured by close professional monitoring depressed , that’s what was so frustrating : I Spravatowas an option — and he’s fantastic , from a medical provider who can immedi - hada loving , wonderful family , two great kids , I couldn’t recommend a better doctor , ” she ately respond if there’s any adverse effects aloving husband , a job I liked — everything says . “ I’ve been to a lot of counselors and during or soon after the course of treatment . was going well , and yet I was just lower than otherpsychiatrists before that make you feel “ There’s a protocol in how the Spravato theocean floor , ” she says . “ So when Dr . Y sug - like a number , but not Dr . Dal and the rest treatment is delivered , and that’s based on gested TMS , I thought it couldn’t hurt and ofthe staff . I’ve referred Depression Doctors n multi - center , double blind , randomized , might actually help since it’s not another to a lot of friends and family members . ” and controlled studies , ” Dr . Dal continues . medication . … Since I’ve completed the “ Spravato can cause significant side effects treatment , I have been in really good shape in certain medical conditions , so we need depression - wise . I would highly recom - Depression Doctors to screen the patients , make sure they mend to anyone that they do it because it don’t have any contraindications and they really does help . ” & TMS Program are eligible to try Spravato . Each session Andwhile the effects weren’t immediate , takes about two hours , and at the end of they offered enough hope to suggest the Five locations , including those two hours , the patient can go back beginningof a promising treatment route . Cherry Hill and Eastampton home , but they need to have a safe trans - “ Itdid not work immediately , but no one ( 856 ) 350 - 5555 portation option because they cannot said it would , ” she says . “ It took probably six DepressionDoctors.com SOUTH JERSEY MAGAZINE volume 20 issue 10 SouthJerseyMagazine.com | 9

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