How Effective Are Antidepressants?

As a practicing psychiatrist for over 20 years, I have experienced both good and frustrating results with psychiatric medications, and my results are consistent with the STAR*D clinical research, a large multi-center study sponsored by the National Institutes of Mental Health. This definitive study on the treatment of depression showed that only one in three patients reach remission with their first antidepressant drug attempt.  With each successive attempt, the chance of success decreased, and the probability of problems tolerating the drug treatment increased.


You can see by the graph below that drug treatment’s success diminishes with each successive trial, and the data also shows that there is an increased chance in the number and intensity of side-effects.

Star D Graphic

*Note: As you can see, by the fourth drug trial, the odds of getting to remission were less than 7%.


We have found a Better Option- TMS Therapy: 

TMS therapy was cleared by the FDA in 2008. As the Austin area’s leading TMS provider, we have even seen excellent results in patients who have suffered for years with both chronic depression and anxiety.  Approximately 74% of our patients treated with TMS therapy have a significant improvement in symptoms or have achieved remission. These are excellent results considering that this patient group experienced a baseline IDS-SR30 score of 42.6 (severe depression) and had been on average of 5.5 medications before coming to TMS.

To learn more about TMS Therapy – visit our website at

Here Our Response and Remission Rates for

TMS Therapy at Austin TMS Clinic for Depression

Mild to moderate Outcomes


About Dr. Marilyn Vaché and Austin TMS Clinic for Depression

Dr. Vaché is the Medical Director of the Austin TMS Clinic, Medical Director of Austin Recovery and Chair of the Travis County Medical Society’s Physician Health committee. She is a graduate of the University Of Arizona College Of Medicine, and completed a psychiatry residency and substance abuse fellowship at Stanford. She is board-certified and licensed in Arizona, California and Texas. She is a strong advocate of TMS Therapy for the treatment of depression, and specializes in the treatment of addictions, anxiety disorders, bipolar disorder and other psychiatric illnesses.

Since 2009 she has been recognized twice by peers as an Austin Top Doc in Psychiatry. She and her staff have also received recognition from patients in on-line surveys: as one of the Top 10 Doctors in Psychiatry, as a Compassionate Doctor, and as an On-Time Doctor.

About TMS Therapy

TMS Therapy or Transcranial Magnetic Stimulation is a breakthrough treatment for depression in which an MRI-strength magnetic creates an electrical current directed over the areas of the brain affected by depression. It is performed in our office under the guidance of Dr. Vaché. Results have been excellent: Two thirds of our patients have had significant improvement in their depression and over half have had complete remission. Side-effects are essentially nonexistent. The typical initial treatment course consists of at least 5 treatments per week over a 4-6 week period, for an average of 20-30 total treatments. Each treatment session lasts approximately 40 minutes.

Benefits of TMS Therapy

  • Non-invasive, meaning that it does not involve surgery. It does not require any anesthesia or sedation, as the patient remains awake and alert during the treatment
  • Non-systemic, meaning that it is not taken by mouth and does not circulate in the blood stream throughout the body. TMS does not have the risk of side effects commonly seen with medications such as weight gain, sexual dysfunction, tiredness, or nausea.

Who Can Transcranial Magnetic Stimulation Help? 

  • If antidepressants are not working to provide FULL relief of symptoms
  • If too many medication are causing side effects – limiting quality of life
    • Sexual dysfunction
    • Weight gain Dry mouth
    • Confused thinking
  • Pregnant or nursing females
  • Non-mental health medications that conflict with antidepressants

We are one of the few centers,  in the US to have recorded and published our success rates with TMS Therapy since its introduction in 2008.

Marilyn Vaché, MD
TMS Clinic for Depression, Medical Director
3724 Jefferson Street, Austin, Texas 78731


To learn more about TMS Therapy – visit our website at




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