TMS Therapy
If you have depression, but medication and therapy have not worked, this in-person treatment may be right for you.
Is TMS Available In My State?TMS Therapy
If you have depression, but you have not seen adequate results from medication and therapy, this in-person treatment may be right for you. Transcranial Magnetic Stimulation (TMS) therapy primarily targets depression, providing a non-invasive treatment option. Especially recommended for depression resistant to medication, TMS is also used for secondary mental health conditions like anxiety disorders, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and certain types of chronic pain. TMS delivers magnetic pulses to specific brain areas linked with mood regulation, stimulating nerve cells to alleviate symptoms. This therapy presents a safe alternative with minimal side effects, particularly beneficial for individuals unresponsive to traditional treatments.
What is TMS Therapy?
TMS Therapy is an in-office procedure that can relieve symptoms of treatment-resistant depression. This safe, effective treatment uses electromagnetic waves to stimulate specific parts of the brain. It works by delivering magnetic pulses to specific areas of the brain associated with mood regulation. These pulses stimulate nerve cells in the brain, which can help alleviate symptoms of depression in individuals who have not responded well to traditional treatments like medication or therapy.
This type of therapy can seem intimidating to those unfamiliar with it. Some people may confuse it with electroconvulsive therapy (ECT), which can have significant side effects, including memory loss. The two procedures could hardly be more different.
It is essential to understand that it is a non-invasive procedure with few side effects. It is also only used in cases where no other intervention has worked.
TMS therapy is FDA approved for the treatment of Major Depressive Disorder (MDD) in individuals who have not responded adequately to prior antidepressant medications.
Many insurance companies cover TMS therapy for depression because it’s considered medically necessary. However, coverage limits may vary by insurance provider, so you should check with your benefits administrator before scheduling sessions. Most insurances cover TMS after a patient fails to respond to two to four medications.
What Happens in a TMS Session?
During a Transcranial Magnetic Stimulation (TMS) session, the patient typically sits in a comfortable chair or recliner. The TMS technician will then position a special electromagnetic coil against the patient’s scalp, usually near the forehead. This coil emits magnetic pulses that penetrate the scalp and skull to reach specific areas of the brain associated with mood regulation.
Once the coil is properly positioned, the TMS machine delivers a series of repetitive magnetic pulses to the targeted brain regions. These pulses are painless and generally feel like tapping or clicking sensations on the scalp. The intensity and frequency of the pulses are carefully controlled by the technician based on the patient’s individual treatment plan.
Throughout the session, which typically lasts about 16-22 minutes, the patient can relax and engage in quiet activities such as reading, listening to music, or simply resting. After the session is complete, the patient can immediately resume their normal activities without any downtime or recovery period.
TMS does not require anesthesia nor cause pain. Patients can drive themselves to and from a session. While electromagnetic waves may sound intimidating, they are just like the technology used in an MRI.
TMS therapy typically involves multiple sessions over several weeks, with the frequency and duration of treatment determined by the patient’s response and the recommendations of their healthcare provider. Over treatment, many patients experience a gradual improvement in their depressive symptoms, although individual responses may vary.
LifeStance Health specializes in TMS Therapy with multiple locations in 10 states. Services vary by location.
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What Does TMS Treat?
TMS is an FDA-approved treatment primarily for patients with depression who do not respond to other treatments. Depending on the equipment used, TMS is also FDA-approved to treat anxiety and OCD. TMS has been explored as a potential treatment for OCD, particularly for individuals who have not responded well to traditional therapies like medication or cognitive-behavioral therapy (CBT). Research is underway to see whether TMS can work effectively on other disorders, treating ADHD, schizophrenia, bipolar disorder / depression, PTSD, and substance use disorders such as nicotine addiction and alcohol dependences.
TMS is best suited for people who have tried other interventions for depression without success. This may mean that several different medications did not relieve symptoms or that the medications’ side effects were too much to handle. TMS patients have usually also tried talk therapy.
References
A.K. Memon. Transcranial Magnetic Stimulation in Treatment of Adolescent Attention Defecit/Hyperactivity Disorder: A Narrative Review of Literature. Innovations in Clinical Neuroscience, 2021 Jan-Mar, 18(1-2): 43-46
Dougall N, Maayan N, Soares-Weiser K, McDermott LM, McIntosh A. Transcranial Magnetic Stimulation (TMS) for Schizophrenia. Cochrane Database Syst Rev. 2015 Aug 20;2015(8)
Gold AK, Omelas AC, Cirillo P, Caldieraro MA, Nardi AE, Nierenberg AA, Kinrys G. Clinical Applications of Transcranial Magnetic Stimulation in Bipolar Disorder. Brain Behav. 2019 Oct;9(10)e01419.
Gorelick DA, Zangen A, George MS. Transcranial Magnetic Stimulation in the Treatment of Substance Addiction. Ann N Y Acad Sci. 2014 Oct;1327(1):79-93
Hamlin D, Garman J. A Brief History of Transcranial Magnetic Stimulation. American Journal of Psychiatry Residents. Vol 18.3.
Harris A, Reece J. Transcranial Magnetic Stimulation as a Treatment for Posttraumatic Stress Disorder, A Meta-Analysis. J Affect Disord. 2021 Jun 15;289:55-65.
Rossi S, Hallett M, Rossini PM, Pascual-Leone A; Safety of TMS Consensus Group. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol. 2009 Dec;120(12):2008-2039.
Rush et al, STAR*D Investigators Group. Sequenced treatment alternatives to relieve depression (STAR*D): rationale and design. Control Clin Trials. 2004 Feb;25 (1):119-42
TMS Therapy FAQ
Research has shown that 37% receiving TMS achieve remission and 58% have at least a 50% decrease in symptoms. Other patients see positive results that last for a long time. With this strong response, TMS can be a suitable option (as early as possible in treatment planning) for patients with treatment-resistant depression.
Working in regular therapy on techniques that help build coping mechanisms is an excellent way to supplement TMS.
A padded device covers your head for about 16-22 minutes per session. Sessions take place five days a week for 4 to 6 weeks. These figures are averages so your treatment plan may vary depending on your needs.
It is advised to bring OTC analgesics in case you have a slight headache afterward. At the start of the session, the medical staff will tell you to remove any magnetic accessories and provide you with optional earplugs. Keeping your purse or wallet away from the TMS machine is advisable as well since the device can demagnetize credit card strips.
In some cases, individuals have some mild scalp pain or a light headache after their first session. These symptoms often lessen after the first few sessions. This is a non-invasive procedure, so there will be no incisions made in your skin.
No, anesthesia is not required for TMS treatment.
Research around TMS began in the 1980s. This research centered on which areas of the brain control certain functions and which areas might not be functioning correctly in mood disorders such as depression.
Specialists studied TMS and its effects for many years before being available for use with the general public. It was finally approved for use by the FDA in 2008 and is now a standard treatment used successfully across the country.
Separate areas of our brains control different tasks, such as memory or impulse control. Thanks to imaging technology, researchers know which areas of the brain do not work as well in cases of depression. What TMS does is stimulate these areas to bring them “back to life” in a sense. This increased activity allows the brain to rebuild key neuropathways so that the patient feels fewer of the symptoms of depression.
There are minimal side effects associated with TMS. After their first few treatments, some patients have a slight headache, which they can treat with OTC analgesics. Around ten percent of patients experience mild pain or tingling in the scalp, which you can treat with pain relievers. It is recommended that patients wear earplugs during a session to protect their hearing. TMS does not cause epilepsy. If an individual is prone to having seizures, there are rare cases where TMS can trigger a seizure in these individuals. However, all patients are carefully screened and monitored for this risk before any sessions begin.
This list of side effects is far less than what many patients experience when they take antidepressants long-term.
TMS should only be administered by trained medical professionals, including doctors, PAs, and nurse practitioners.
