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Interventional Psychiatry Clinic
The Interventional Psychiatry Clinic provides specialized treatments utilizing interventions such as electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), esketamine, and deep brain stimulation (DBS).
We provide consultations for patients with depression who may benefit from TMS, esketamine, or ECT and patients with treatment-refractory obsessive compulsive disorder who may benefit from TMS or DBS.
In addition to these clinical interventions, active research using novel forms of TMS, DBS, IV ketamine, focused ultrasound, and other device-based interventions are available for patients.
For information about accessing care, please call our Intake department to self-refer at 650-498-9111 option 2.
Deep Brain Stimulation
DBS is a treatment for conditions including Parkinson’s disease, tremor, and obsessive-compulsive disorder. It is an invasive procedure involving neurosurgical implantation of brain electrodes connected to a pulse generator to directly modulate brain circuits and activity. Despite its invasive nature, DBS is considered reversible; it is associated with surgical side effects.
Vagus Nerve Stimulation
VNS is an FDA-approved treatment for treatment-resistant depression and epilepsy. It involves surgical implantation of a device similar to a pacemaker which is attached to a wire connecting to the vagus nerve in the neck. VNS is considered an invasive treatment since implantation of the device requires minor surgery. VNS is not widely available due to limited insurance coverage. It is associated with few side effects, the most common being hoarseness or changes in voice.
Esketamine
Esketamine (Spravato) is an intranasal medication closely related to ketamine that is FDA-approved for treatment-resistant depression and major depressive disorder with suicidality. It is rapid acting and effective in people who have not benefited from multiple oral antidepressants. Esketamine is only administered in supervised medical settings and is initially provided twice a week for four weeks.
Transcranial Magnetic Stimulation
TMS is an FDA-approved treatment for major depression and obsessive-compulsive disorder. It is non-invasive and involves the repeated application of brief magnetic pulses to the brain. TMS is a safe, non-invasive, outpatient procedure shown to help patients who have not benefited from antidepressant medication. We offer TMS at Stanford and have multiple devices capable of providing personalized therapy. TMS is associated with few side effects, the most common being mild scalp discomfort during treatment.
Electroconvulsive Therapy
ECT is a highly effective treatment most often used in severe cases of depression and catatonia. It is the oldest, most rapid, and most effective treatment for depression. It is a non-invasive procedure involving use of brief general anesthesia and electrical stimulation to induce a controlled, generalized seizure. ECT has been shown to be a rapid and robust treatment for depression when medications and psychotherapy are ineffective. It is particularly effective for treatment of geriatric depression and is often a treatment when no others are effective. ECT is associated with memory side effects which can be minimized with use of techniques such as right unilateral, ultra-brief pulse ECT.
Research and Education
Please visit the following programs for more information.
Faculty
