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Thinking Psychiatry

Kevin Kennedy, MD

Thinking critically about evidence and ethics in psychiatry.

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Substack
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Latest Issues

Recent posts by this newsletter. Browse the email archive.

Cataloging the errors and deceptions in the marketing of TMS for adolescent depression

I recently did a deep dive into the FDA clearance of TMS for depression in “adolescents” age 15-21. I argued that the data for the NeuroStar device was extremely weak: a negative 103-subject RCT followed by a positive proprietary observatio...

3 days ago
7
0

Questioning the hype for TMS in adolescent depression

In March 2024, the FDA cleared the NeuroStar transcranial magnetic stimulation (TMS) device “as an adjunct for the treatment of Major Depressive Disorder (MDD) in adolescent patients (age 15-21).” This clearance was widely celebrated. A glo...

a month ago
8
2

Losing faith in the SAINT Protocol (Part 2)

A previous post evaluated the first SAINT TMS protocol clinical trial, where I raised concerns about the tiny sample, unusual outcome measures, risk of effective unblinding, and missing data for blinding integrity. I was worried that the hy...

a month ago
9
1

Losing faith in the SAINT protocol (Part 1)

I’ve been reading more TMS trials recently. Today, I’ll focus on the first SAINT protocol RCT published in 2021—probably the single most famous and influential TMS study. A subsequent post will look at the replication RCT just published in ...

a month ago
29
6

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Authors

The writers behind this newsletter.

  • Kevin Kennedy, MD

    I am an academic psychiatrist trying to improve the quality of evidence in psychiatry. I'm in favor of humility and against hype and bad science. All views my own.

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