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Patient Jack Pinzari


Patient Jack Pinzari, who suffers from severe depression, receives a transcranial magnetic stimulation treatment at a clinic in Exeter.

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Dr. Paul Belliveau, a psychiatrist, has begun using transcranial magnetic stimulation to treat his patients who suffer from depression but don’t get relief from medication.


Patients can read a book or magazine or watch TV while receiving treatment.

EXETER – A new clinic in Exeter is offering hope for people who suffer severe depression, with a treatment that had previously only been available in more populated areas such as Boston.

There are many medications intended to treat depression, but for some they are not effective. Electroconvulsive Therapy (ECT) is another option, but it scares a lot of people.

Transcranial magnetic stimulation, or TMS, is sort of a step in between. It is intended to help people with severe depression who are not being helped by medication, but are not willing to try ECT.

TMS is a noninvasive form of brain stimulation that works by applying a magnetic field to areas of the brain known to be involved in depression. It does not require anesthesia and it is well tolerated by most patients. A person should be cleared by their doctor prior to starting treatment.

The TMS Collaborative, located at 1 Court St. in Exeter, is one of three in New Hampshire offering treatment for the first time in the area.

Wayne Barrows, TMS technician, said they opened in September and are already taking referrals from other mental health providers.

Dr. Paul Belliveau, a psychiatrist, said he heard about TMS from Barrows, a friend. He was already aware of the technology, but was not yet using it.

“The untold reality is that medications do not work for a lot of people,” said Belliveau. “I sit across from people day after day and see it. I can change their medication, but I know for some it is not going to work. A lot of people are frightened by the idea of ECT, so I decided to try TMS, as a milder, simpler treatment. I had patients who had used it, but needed to travel to Boston.”

Belliveau said for people who have tried three or more medications, the chance for improvement is 10 to 15%. He said with TMS, that percentage goes up to about 58%.

“Every person I have used this with has shown real gains,” said Belliveau. “I am seeing positive results.”

“I heard about TMS and felt it was great stuff and an emerging field of practice for the mental health field,” said Barrows. “I asked Paul why it was not happening here. We talked and decided to bring the technology to the Seacoast. People interested in using TMS had to travel to Massachusetts General Hospital in Boston or to McLean Hospital in Belmont. I believe New England is one of the last regions to adopt this treatment. TMS has been around for 30 years, but at first was used primarily in research. It was about 10 years ago that it became available commercially.”

Barrows said he understands people’s reluctance to seek to ECT.

“ECT is the gold standard, but it can be harsh,” said Barrows. “TMS is a kinder, gentler version. ECT can cause memory loss, cognitive issues and insomnia. The treatment must be done in a hospital setting. We can do TMS in our clinic.”

The treatment is approved by the Food and Drug Administration and is covered by most insurance, said Barrows, because it is used to treat major depressive disorders which is an accepted medically coded condition.

“Patients seeking TMS will have failed two to four antidepressant medication regimens,” said Barrows. “The basic thought is that the more anti-depressant drugs a person fails to see results with, the lower the percentage becomes that another will give relief either. The neuro-connectivity of the patient’s brain is not accepting the medication, is basically not open for business. So, electromagnetic tapping in the prefrontal cortex area can often make the difference, rewiring the brain so it is open for business. As the brain changes, the goal is that antidepressants will begin working for the patient.”

Patients using TMS to treat depression must have already tried traditional medication, with little to no relief. The treatment is 30 days, five times a week so it does require a certain level of commitment, said Barrows.

“There are no systemic side effects of the treatment,” said Barrows. “Some people may initially experience mild headaches, but that seems to be the worst-case scenario. We started this and I didn’t know what we would see, but the results literally blew my mind.”

Belliveau said treatment requires time, but is easy to tolerate.

“Patients come in and sit in a fancy dental chair,” said Belliveau. “A magnetic grill is placed on the side of their head and they sit and read the New Yorker or watch the Today Show, whatever they want to do.”

Brentwood resident Jack Pinzari is one of Belliveau’s patients. He said TMS had made a complete difference in his life.

“I had been completely disabled by my depression, for about 10 months,” said Pinzari. “I couldn’t work. I couldn’t leave the house. I could barely get out of bed. My doctor referred me to a TMS Center in Dover, and they denied me. They said I hadn’t been on medications for long enough yet. I was miserable and then I talked with Dr. Belliveau. He said he would be getting the TMS equipment soon and I was his first patient.”

Pinzari, 50, said he has suffered from depression since he was 22 years old. He said this is the first time he has felt good in as long as he can remember.

“I was one of the early responders,” said Pinzari. “They said some people respond quicker than others and that was me. I started noticing changes within the first set of sessions. I have almost finished the sessions now and I feel really good.”

Pinzari said he expects the treatment to last for quite some time.

“I understand I might need to go back for a ‘tune up,’ but I am fine with that,” said Pinzari, who is a certified aircraft maintenance technician. “I am actually thinking now about getting back to work. This has been the best thing I have done in a long time. Wayne and Dr. Belliveau are outstanding people and I owe them a lot.”

To learn more, there is a Harvard University report on TMS at