What Is Transcranial Magnetic Stimulation?
Depression is one of the most common causes of disability, as well as one of the most common mental health issues, in America. It’s a condition that can afflict patients for years, severely impairing their ability to function at home and at work. And it’s not unusual for depression to not respond to traditional talk therapy or medications like SSRIs and SNRIs. Alternative treatments also exist, but some can put patients at risk of other unwanted side effects.
Transcranial magnetic stimulation, often abbreviated TMS or rTMS, is a non-invasive option for the treatment of depression. TMS is typically used only for patients who have not responded to more conventional treatments for depression.
TMS is not electroconvulsive therapy, which delivers electric currents to the brain. In TMS, a technician uses an electric coil to deliver magnetic pulses to the brain. The pulses used in TMS are the same strength and kind as those used in MRI machines.
Benefits of TMS
More than half of patients with treatment-resistant depression reported an improvement in their depression after TMS. One-third even reported total remission of their symptoms. TMS is not, however, may not be a long-term cure for depression in all patients. In many patients, the benefits of TMS lasted about a year after treatment.
While TMS doesn’t cure depression, it can provide patients with the energy they need to seek talk therapy or make lifestyle changes that will make depression easier to manage in the future. Symptoms of depression usually improve after several weeks of four to five weekly TMS sessions, but you may notice improvements within just a few sessions.
TMS can cause minor side effects like headaches, but patients typically described these side effects as moderate at worst. Seizures are a very rare side effect of TMS, occurring in about .001% of patients. For this reason, you’re unlikely to be approved for TMS if you’re at a high risk of seizure. You may also be unable to receive TMS if you have metal other than dental fillings or braces in your head or neck.
One of the benefits TMS has over treatments like ECT is that it does not require sedation, which means there’s typically no downtime for a patient after a TMS session.
Types of TMS
A variety of TMS systems are available. The most common follow:
- Repetitive Transcranial Magnetic Stimulation (rTMS): Used as a treatment for depression for more than 20 years, this procedure was approved by the FDA for treating depression in 2008. An rTMS session lasts between a half hour and an hour.
- Theta Burst Stimulation (TBS): TBS is a newer form of rTMS that uses patterned bursts of magnetic pulses to decrease session time and the intensity needed to improve symptoms of depression. TBS sessions can be as much as five times shorter than standard TMS sessions.
- Deep Transcranial Magnetic Stimulation (dTMS): This option is a version of TMS that uses a specialized coil to stimulate deeper areas of the brain. Side effects are similar to rTMS and TBS. dTMS was approved by the FDA for the treatment of depression in 2013.
What Is a TMS Session Like?
At the start of your TMS session, you’ll be asked to sit down. An electromagnetic coil — or cushioned helmet in the case of dTMS — will be placed on your scalp and begin delivering magnetic pulses, which you may feel as slight taps and hear as clicking sounds. You won’t need to be sedated for the procedure, and TMS won’t have any effect on other parts of your body. After treatment, you won’t have any significant downtime. You can transport yourself both to and from the session by car.
If you experience any discomfort, the technician can stop treatment at any time and make adjustments so that you’re more comfortable.
How long the session takes will depend on what type of TMS treatment you’re receiving. The average session will last just 30 minutes, but your first session may be closer to 60 minutes or longer. You won’t need to spend time recovering afterward.
Transcranial Magnetic Stimulation and Mental Health
TMS is becoming a very viable option for treatment-resistant depression, and many still don’t know about it. It’s a non-invasive medical procedure that has a high effectiveness rate and has been approved by the FDA. Research has also shown that it’s safe for long-term treatment, and most side effects are mild to moderate at worst. While the future of treating mental health is still not totally clear, one thing that is clear is that researchers are trying — now more than ever — to find effective alternative treatment options for illnesses like depression. And that’s a big win for many patients who are resistant or averse to traditional medications.