From the article further on.

But what about other chemicals, Glycine contributes to an increase in 5alpha Reductase which helps reduce Cortisol one of the stress hormones. It can be used in place of sugar in hot beverages and food, how much does stress contribute to depression? https://en.wikipedia.org/wiki/5%CE%B1-Reductase#List_of_conv...

And then there is Glutathione which increases light sensitivity, could this help reduce Seasonally Affect Disorder (SAD) also known as the winter blues, knowing that it also helps management of ROS, peroxides, lipid peroxides and heavy metals? Glutamine, N-Acetyl Cysteine and Glycine help to increase Glutathione in the body.

I wonder if fMRI has a similar effect on the brain to homogenising milk, namely it softens the fat walls in milk. Is fMRI having an effect in the brain or in the vascular system with plaques that contribute to atherosclerosis, because induction hobs or magnetic induction reduces inflammation https://peerj.com/articles/929.pdf does this demonstrate that depression is caused by a variety of factors not just one's linked to serotonin even though serotonin plays a part with the immune system?

Who says it won't last? Most depressions actually do get better by themselves.

How do you think humanity has survived so far?

(Most, but not all. And even if it eventually gets better without meds, there was still a lot of suffering.)

No clue whether it's the depression itself, or whether that's just a side-effect of something else that's useful.

Empirically, most clinical depressions get better by themselves today.

Similarly, most alcoholics improve by themselves.

(Of course, effective treatment is still useful!)

How happy would you choose be if you could consciously decide how happy to be?

I'm willing to trust, perhaps naively, that everyone is getting the same Prozac tablets. But how does the skill of the practitioner and maintenance of their magnetic treatment device affect outcomes? It's almost like a surgery, but I'm not sure who's actually been trained to perform it.

Which isn't to say someone shouldn't do it, just my own feelings based on limited understanding. Perhaps if I knew more I would have greater faith.

It's also of note that the treatment takes place over multiple days and there's multiple sessions in a day. During that time, patients are continuously evaluated. This trial was also only used on patients with treatment-resistant depression (i.e. have tried many different medications and forms of therapy, some included ECT) and were screened as such. From my understanding, the treatment was explored as a "last resort" for those that could find no other medical relief, but this obviously has further implications.

The FDA approved treatment is "aim at the middle of the dorsolateral prefrontal cortex". Getting more activity and connectedness improves its regulation of overall emotional activity.

This research implies that aiming instead slightly differently and a different dosing regimen may be more effective.

This is no different from any other medical treatment, where we find refinements in how and where to apply basically the same treatment to get better results.

To get some perspective on iterations of treatment, read this account of the work of August Bier.

He pioneered spinal anesthesia, something used all of the time today for epidurals during childbirth.

His experimental treatments he both performed and had performed on him by his assistant will, at the very least, raise your eyebrows.

https://en.wikipedia.org/wiki/August_Bier#Spinal_anesthesia

That’s what gives me pause.

Then again, the stuff shows benefits in trial, and presumably we get most practitioners trained up and doing the thing that's the standard of care well enough...

But in practice people just take two 500mg tablets and call it a day. Works well enough most of the time, even though it might be 'wrong' in some platonic sense of the word. (Eg you might have been helped enough with a slightly lower dose. Or perhaps 1250mg would have been better and suppressed slightly more of the pain. Who knows?)

I'm just not sure what the margin for error is, the failure modes for this magnetic therapy, or what makes a good magnetic therapist.

Not a reason to stop developing it though.

Eg. "We'll poke this red hot poker into you 10 times to cure your depression"... Many painful screams later... "So, is the depression any better now, or should we do more treatment?".. "Yes, yes, I'm pretty much cured!".

How can we be sure that this 'torture effect' isn't whats being measured here? Especially when the treatment appears to have unpleasent side effects, and the success of the treatment is measured with patient feedback...

Part of being depressed is you don't even have the will to resist being treated in a way that you don't like.

In fact, I'd say that feeling powerless against conditions that you don't like is the core of what depression is.

It's why someone who is depressed doesn't feel like doing anything, because they feel like no matter what they do nothing will ever change so nothing they do is ever worth the effort.

Just mildly uncomfortable .. for a period of time longer than one would be willing to tolerate.

Something like being at the dentist when you have many cavities in your teeth.

You can tolerate one or two sessions. But the idea of doing it every day for two weeks straight is unbearable enough that you decide on the third day to report feeling well.

For future reference, assuming this is a clinical trial, data from clinical trials is available online. This is the kind of statistic that you'd be able to find.