Call it S&T.

Call it Saint.

But who do you call when your patient needs this intervention for depression?

Welcome to the Carlet Psychiatry Podcast, keeping psychiatry honest since 2003.

I'm Chris Aiken, the editor-in-chief of the Carlat's Psychiatry Report.

And I'm Kelly Newsom, a psychiatric MP and a dedicated reader of every issue.

Last week, we learned that SNT-TMS brings 80% of patients to full remission, even after

3 to 7 failed antidepressant trials.

But we still have questions like,

how does it work, how long does it last, and how do you find it for your patients?

TMS uses magnetic pulses to change the electrical rhythms of the brain.

That's called neuromodulation.

If you want a more poetic version of that, rewind to our November 3rd episode where Owen Muir

compares it to music, good memories, and psychotherapy.

All of these things change the brain's rhythm in ways that change us, that can lead to new learning.

And learning is what the brain is doing in TMS.

It's learning how to not be depressed, or to not have OCD, or not want to smoke any more cigarettes.

So when Nolan Williams set out to improve on this treatment, he looked back on

how he learned as he crammed for college exams. We've known for some time based off of

space learning theory that you can't kind of load a bunch of information to the brain without breaks.

The brain needs breaks in order to produce proteins to strengthen dendritic spines

and make longer-term effects. And so there's been basic science experiments showing

...