What Is TMS Therapy?

Are you wondering whether TMS could be a suitable treatment for your depression? Although there are numerous successful therapies for depression, conventional options like medications and psychotherapy may not work for everyone. TMS therapy is a newer treatment option for patients who have had little or no success using drugs and therapy alone. Read on to learn more about this type of therapy. 

What is TMS?

TMS, or transcranial magnetic stimulation, is a kind of noninvasive brain stimulation. TMS devices work outside the body, affecting central nervous system activity by delivering strong magnetic waves to particular brain parts linked to depression. TMS does not require anesthesia, and it is often well tolerated in contrast to the adverse effects commonly associated with the use of antidepressant medications. Headache is the most prevalent side effect during or after therapy. Seizures are uncommon but dangerous side effects. TMS may not be suitable for people who are at high risk, such as those who have epilepsy, have had a head injury, or have other major neurologic disorders.

How effective is TMS?

TMS produces a clinically relevant response in around 50% to 60% of people with depression who have failed to find relief with medicines. About a third of these people go into full remission, which means their symptoms disappear entirely. It is critical to recognize that although these outcomes are positive, they are not permanent. There is a high incidence of recurrence, like with most other therapies for mood disorders.

That said, most TMS patients continue to feel better for months after treatment has ended, with the average response time being just over a year. Some people will choose to return for more treatments.

What to expect with TMS?

TMS therapy is a comprehensive treatment approach that requires five treatments a week for several weeks. Depending on the equipment and clinical procedure employed, each session might take 20 to 50 minutes. Patients will check in with a technician or doctor when they arrive and then begin the stimulation procedure. Using the motor cortex as a "landmark" in the brain, the technician will establish the optimal stimulation intensity and anatomical target.

By first targeting this portion of the brain, the team can establish where to best place the stimulation coil on that individual's head and how powerful the electrical transmission needs to be to generate optimal stimulation. They will then interpret the data to get the location of the dorsolateral prefrontal cortex, the brain region with the most clinical proof of efficacy and the one implicated in depression. While one session may be adequate to improve the brain's excitability level, significant improvements generally do not appear until the third or even sixth week of therapy.

How long do TMS effects last?

Mood disorders are challenging to treat. While the exact cause is unknown, major depression may result from many factors. Genetic predisposition, extreme life stresses, drug and alcohol usage, medical disorders, and other variables all contribute to a person's predisposition to depression. People are unique, and depression is often caused by multiple circumstances that affect how the brain works.

There is no way to know exactly how long the effects of TMS treatment will be because there are many contributing factors to depression. Most patients who complete the whole course of therapy report improvement in their symptoms for more than six months to over a year. According to a 2013 study published in Medscape, 68 percent of patients had reduced symptoms, and 45 percent had gone into full remission after a year of therapy with transcranial magnetic stimulation (TMS).

These numbers may provide optimism to those who have tried medicine and psychotherapy but to no avail. The combination of TMS and medicine has shown to be most successful in certain circumstances.

Continuing treatment

The doctor may recommend standard care for depression, such as medication and psychotherapy, as a continuing treatment after the series of TMS sessions end. There is little data to know if maintaining TMS treatments will help with depression. But to avoid recurrence of symptoms, patients must continue therapy.

While TMS may be a depression treatment, it can also be a preventative measure. This application is called re-induction and is covered by several insurance carriers. Patients who experience a significant improvement in their depression symptoms after receiving TMS can talk to their doctor about ceasing or maintaining therapy.

Final note

Besides psychiatry applications, TMS is being explored widely across illnesses and disciplines by researchers in the hopes of developing novel therapies for neurological disorders, pain management, and physical rehabilitation. TMS is also being studied to determine its effectiveness for pediatric depression, bipolar disorder, obsessive-compulsive disorder, smoking cessation, and post-traumatic stress disorder.

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