Clinical Services

In addition to elucidating biological and neurological underpinnings of mood disorders, the Center for Brain Research in Mood Disorders is committed to the implementation and clinical outcomes of novel and advanced treatments for these refractory mood disorders.

Electroconvulsive Therapy (ECT)

Electroconvulsive therapy (ECT) is considered a very safe and effective treatment for refractory depression, mania, psychosis, and catatonia. Washington University Psychiatry has been providing state-of-the-art ECT services for over 60 years and is committed to working with referring psychiatrists in the community to bring about optimal patient care.

Repetitive Transcranial Magnetic Stimulation (rTMS)

The Transcranial Magnetic Stimulation (TMS) clinic at Washington University offers this novel brain stimulation treatment for clinical depression.

TMS uses a briefly pulsed, powerful magnetic field to re-energize deficient brain circuits involved in depression.  Via the principle of electromagnetic induction, this magnetic field generates focused electrical currents over a brain region thought to be affected in depression. The target area is called the left dorsolateral prefrontal cortex (this area rests underneath the forehead close to the hair-line).

Research indicates that this brain region is underactive in depression.TMS is non-invasive; it is administered at the doctor’s office and does not require anesthesia. Most patients find TMS very tolerable. Traditionally, depression treatment options were limited to medications, talk therapy or electroconvulsive therapy. TMS offers an alternative treatment for depression.

Treatment-Resistant Depression (TRD) Clinic

The Washington University Treatment-Resistant Depression (TRD) Clinic, established in 2008, is a referral clinic for patients suffering from treatment-resistant depression. TRD patients from throughout the United States are referred to this clinic during which they undergo a comprehensive and detailed review of their entire psychiatric treatment history. A series of treatment recommendations emerges from this review and a detailed report is issued to the referring psychiatrists. TRD patients also are given the option to be enrolled in a database that will provide them with an opportunity to be involved in future research/treatment studies.

Vagus Nerve Stimulation (VNS)

Vagus nerve stimulation (VNS) is an FDA-approved, permanently implantable device that has demonstrated antidepressant efficacy in unipolar and bipolar refractory depression. Washington University Psychiatry is a leader in the study and use of VNS for treatment-refractory mood disorders, with more than 70 individuals implanted with devices over the past 12 years.

Taylor Family Institute for Innovative Psychiatric Research

The Taylor Family Institute works in conjunction with the members of C-BriMD to develop novel treatments for neuropsychiatric illnesses in collaboration with faculty members from the departments of Psychiatry, Anesthesiology, Development Biology, and Radiology.

The institute’s current focus is the potential of neurosteroids and oxysterols as therapeutic targets. Ongoing clinical studies concentrate on glutamate receptor antagonists and neurostimulation methods as potential targets for depression treatment.

Work in the institute has played a significant role in driving the science that has led to the first human clinical trials of a neurosteroid for treatment of super refractory status epliepticus, severe postpartum depression and essential tremor.