Understanding TMS Therapy
Transcranial Magnetic Stimulation therapy, also known as TMS, is an alternative many psychiatrists utilize when therapy and medication have not been successful to adequately treat symptoms of depression. TMS is a safe procedure first approved by the FDA in 2007. It utilizes rapidly changing magnetic fields next to the scalp to stimulate or inhibit different structures in the brain. It is the safest psychiatric treatment for depression with proven benefits, outside of counseling. It is not similar to electroconvulsive therapy (ECT), which though is safe and effective, has had a bad reputation over many decades.
TMS is a noninvasive procedure and requires no anesthesia.
The History of TMS
The research behind TMS began in the middle of the 1980s when scientists gained a better understanding of the function of the brain. It became apparent that several areas of the brain which affect mood might be valid therapeutic targets in the treatment of depressive disorders. The FDA approved TMS as a treatment for depression in 2007, and it is now used routinely for treatment resistant depression all over the world.
TMS & Other Disorders
Mental health professionals primarily use TMS to treat therapy and medication-resistant depression. Researchers are currently looking into its effectiveness for other disorders as well. The Brainsway TMS machine used in our facility has also recently been FDA approved for use in treatment of obsessive-compulsive disorder (OCD) and smoking cessation. Additionally, research is being done on TMS treatment for migraines, ADHD, and schizophrenia, as well as other disorders.
How It Works
The left frontal lobe of the brain is the target region for the Brainsway deep TMS device when treating depression. This part of the brain is underactive in people who suffer from depression. TMS treatment for depression activates this area of the brain through repetitive magnetic stimulations, and produces an antidepressant effect.
The Specifics of TMS
An electromagnetic coil is placed on the patient’s scalp. The coil is housed in a helmet that is placed on the patient’s head (by the TMS technician) in the correct position for their anatomy. The coil creates a magnetic field that stimulates a very specific region of the brain. No anesthesia is required and the patient is fully awake and alert during the procedure. TMS is a quick outpatient procedure that patients can fit into any schedule. Patients can drive themselves to and from treatment and go to work for a full day right after their treatment.
How Long is a TMS treatment
Each TMS treatment takes 20-30 minutes. There are 36 treatments over a 12-week period.
The results of TMS can last a long time. Some patients never experience a recurrence of depression, while others require intermittent or maintenance treatment to sustain benefit. In our experience, 50- 80% of clients have a positive response to treatment.
The Safety of TMS
TMS is the safest treatment for depression aside from counseling. It is safer than any of the medications used to treat depression. There are no known long-term side effects.
Some patients experience discomfort in the scalp during treatment. For most patients, this is quite tolerable. Patients may choose to wear earplugs during TMS treatment if they find the noise of the machine uncomfortable.
There is an extremely rare risk of seizure during treatment — much lower than the risk of having a seizure with any of the routinely prescribed antidepressant medications (which is also extremely rare).
When patients have experienced adverse effects with medications or are seeing a limited response to treatment, TMS can be a very effective treatment alternative. TMS is a beacon of hope for many who have made few inroads with traditional interventions to combat depression.
TMS is also a good alternative to ECT, which requires anesthesia and has more side effects. In TMS treatment there is no post-procedure recovery time as the patient is awake and able to go home or to work right after the treatment.
What to Expect During Your First TMS Treatment
The first TMS treatment can feel intimidating, but your medical care team will do everything they can to help you feel at ease.
Preparing for Your Session
Unlike other medical procedures, patients do not need to do any prep for TMS treatment, such as avoiding foods or liquids. Patients will need to remove any accessories that react to magnetism or are magnetic themselves. TMS can also affect credit cards.
The medical staff can give you earplugs to wear during the procedure. Make sure that you have an over the counter medication available for a possible headache after your TMS treatment.
You will not need someone else to drive you to your appointment or home/work afterwards.
You can stop the treatment at any time if you are uncomfortable. There is no obligation to follow through with the treatment once started.
Please avoid drinking more than one alcoholic beverage per day, as more than that has been associated with adverse side effects during TMS.
Benzodiazepines such as Xanax, Klonopin, Ativan, and Valium affect the way TMS interacts with the brain. If you are taking one of these medicines, you will need to speak with your TMS doctor about how to dose these appropriately.
Good luck with your TMS treatment!