The University of Iowa Health Care has introduced a new treatment for depression through its outpatient clinic — Stanford Accelerated Intelligent Neuromodulation Therapy, or SAINT therapy.
The therapy was approved by the U.S. Federal Drug Administration in Sept. 2022 and is a more intense and faster form of transcranial magnetic stimulation, or TMS, another treatment for depression. UI has offered the TMS treatment since 2017.
SAINT therapy, Dr. Aaron Boes, a neurologist at UIHC, said, starts with a patient working with psychiatrists and neurologists to determine whether or not the treatment is right for them depending on the severity of the depression they are diagnosed with.
After a neurologist evaluates for any safety concerns like seizures and approves use of the treatment, an MRI scan will be conducted to identify specific areas of a patient’s left dorsal lateral prefrontal cortex correlating with their depression symptoms. This is followed by an electromagnetic stimulation, or the process of stimulating nerve cells in the brain of the patient.
“The general concept of both TMS and SAINT is…to induce a long lasting change in certain brain circuits that is responsible for psychiatric symptoms…predominantly for depression,” Boes said.
Dr. Anthony Purgianto, a psychiatrist at UIHC, said neuronavigation, or imaging to guide where the brain is stimulated, is used prior to intense simulation.
Purgianto said SAINT and TMS are offered to patients not responding to anti-depressants, but that the SAINT is faster and is a more intense form of treatment than TMS.
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The treatment is delivered once a day five days a week for 36 treatments, Purgianto said.
SAINT patients, however, receive ten treatments one hour apart for five days compared to a 6 to 8 weeks for regular TMS, Boes said.
“With TMS and SAINT, the chance for you to improve this treatment is essentially double than what can be provided with other medications,” Purgianto said.
According to the Carver College of Medicine Department of Psychiatry, UIHC Psychiatry Nicholas Trapp said early data shows major potential for the treatment.
“SAINT is one of the fastest-acting anti-depressant treatments available,” Trapp said. “It’s well tolerated by patients and early data suggests up to 80 percent of patients experience remission of their depression symptoms, with effects often lasting months.”
According to UIHC, the UI is one of the few medical centers in the U.S. and the first in the Midwest to offer the treatment. Boes said even though the treatment is only being offered in the outpatient clinic and has only treated a small number of patients, the responses show promising effectiveness for future patients.
“The clinical trial evidence looked really strong,” Boes said. “The response rates are really high and match approaching those of electrocompulsive therapy which is a much more invasive treatment. So I think if we’re able to have a very effective non invasive treatment for severe depression, I think it would be a game changer.”