Transcranial magnetic stimulation (TMS) is a non-invasive procedure that uses magnetic field stimulation to treat depression. TMS is an FDA-approved treatment for people who haven’t responded to standard antidepressant therapy and who have not experienced side effects from medication. TMS has been approved by the FDA as a second-line treatment for patients with recurrent major depressive disorder (MDD) who do not respond to standard antidepressants and psychotherapy, or for those who cannot tolerate the potential side effects of antidepressants. It has also been used as an adjunctive treatment, meaning it can be used in addition to another standard therapy, like antidepressant drugs or cognitive behavior therapy. In this article we explore the benefits, risks, and effectiveness of TMS as a depression treatment.
TMS Basics
There are two types of transcranial magnetic stimulation, or TMS: – Anomalous, or non-standard, pulses: High-frequency, short bursts that stimulate the brain for 6-10 seconds – Standard pulses: Low-frequency, continuous stimulation for 30-40 minutes Researchers aren’t sure why TMS works, but studies show it might affect chemicals in the brain, like serotonin and dopamine.
How does TMS work?
TMS is a non-invasive form of electro-magnetic stimulation applied to the scalp. The magnetic pulses travel to the brain where they are thought to help increase blood flow to the area of the brain responsible for mood regulation. Because the pulsed magnetic field is able to penetrate the scalp and the skull to reach the brain, it has been hypothesized that a single session of TMS might induce lasting effects by inducing changes in the central nervous system.
Benefits of TMS
TMS has been shown to improve mood in about 70% of those who receive it. It produces fewer side effects than medication, and it can be used as a sole or adjunctive treatment (in addition to other therapies). Common benefits include: – Improved mood – Depression symptoms and overall mood tend to improve – Increased energy – This often leads to increased productivity – Improved concentration – Cognitive function improves, making everyday tasks easier – Decreased fatigue – This can help with sleep, energy levels, and overall mood – Improved relationships – Improved mood can help with relationships – Reduced feelings of guilt and shame – This is common in those with treatment-resistant depression
Side effects of TMS
While TMS does not come with the same side effects as standard antidepressant therapy, it does have some potential adverse effects. – Transient discomfort at the site of stimulation: A slight and temporary tingling or buzzing sensation is most commonly reported at the site of stimulation. This usually resolves within a few minutes, and is typically mild and tolerable. – Transient headaches: Headaches are reported in upwards of 10% of patients and tend to occur in the first few days or weeks following the treatment. These are typically mild and subside after a few weeks, and can be treated with over-the-counter pain medications. – Changes in mood: While typically only lasting a few days, a change in mood following TMS treatment has been reported. This includes feeling “high” or elated, depressed, anxious, or irritable. These feelings typically subside within a few days and are manageable with medication.
Who Can Benefit from TMS?
TMS is often an effective treatment for people with severe depression who have not responded to other treatments, including medication and CBT. It is a non-invasive, painless, and safe treatment that is often well tolerated. In general, patients with non-severe depression respond to TMS, but those with severe depression, especially those with psychotic symptoms, rarely respond to the treatment.
How to find a clinic and schedule a session?
Before booking an appointment at a TMS clinic, it is important to make sure you meet the specific criteria for the treatment. The criteria for receiving TMS vary slightly from clinic to clinic, but typically involves the following: – Being aged 18 or older – Having a diagnosis of Major Depressive Disorder (MDD) – Not having responded to at least one course of antidepressant therapy – Not being pregnant or breastfeeding – Not having a significant medical condition (e.g., unstable heart disease) that would make TMS unsafe – Having a positive response to a test pulse of TMS (i.e., a “test drive” of TMS) – Not having a history of serious mental illness, e.g., schizophrenia, bipolar disorder – Having a supportive network of family and friends
Final Words: Is TMS Right for You?
TMS is a safe and effective treatment for those with severe depression who are not experiencing a response to standard antidepressant therapy. It is a one-time treatment with lasting effects, and it provides a non-pharmaceutical option for those who cannot or do not want to take medication. With that said, there is no single treatment that works for everyone. It is important to explore treatment options and find the one that best suits your needs.
