When a Psychiatrist Would Recommend TMS

Transcranial magnetic stimulation, or "TMS," is a non-invasive brain stimulation technique used to treat several mental disorders. However, it is not a first-line treatment or not the first approach psychiatrists recommend. In this article, we will take a closer look at TMS, when it is recommended, and what to expect from this treatment option.

What is transcranial magnetic stimulation?

Developed in 1985, TMS influences the brain's electrical activity by stimulating it with a magnetic coil. The brain naturally creates electricity as neurons send messages to different parts of the body. The magnetic coil used in TMS generates electricity once it is near the brain, which affects the electrical currents in the brain.h 

TMS will target a specific area of the brain in charge of mood regulation known as the left dorsolateral prefrontal cortex. Deep TMS, or "dTMS," uses a coil that can target even deeper brain structures, which can be helpful for clients with obsessive-compulsive disorder (OCD). There is also repetitive TMS, or "rTMS," in which repetitive magnetic pulses are sent to the brain.

When should you consider TMS therapy?

TMS is not a first-line treatment for any mental health condition but a supplementary treatment recommended when first-line treatments (therapy and prescription medication) do not yield results. It is usually recommended for clients with treatment-resistant depression or anxiety. If a client is struggling to find relief from the following conditions, TMS may be a viable option:

• Major depressive disorder (MDD)
• Obsessive-compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD)
• Borderline personality disorder (BPD)
• Bipolar disorder
• Eating disorders
• Schizophrenia

The U.S. Food and Drug Administration, or "FDA," has approved TMS for treatment against MDD, OCD, migraines, and smoking cessation. Research is still underway to determine other uses. However, TMS has already helped many clients achieve relief.

Ideal candidates for TMS

An ideal candidate for TMS is someone who has tried the first-line treatment for a qualifying mental disorder but to no avail. For example, if a client's depression has not responded to two to four antidepressants, they may be a good candidate for TMS. Other examples include those who cannot tolerate a medication's side effects, have certain risk factors that put medication out of reach, or continue to have symptoms that make everyday life a struggle. Note that TMS is only an option for clients aged 18 and older.

Who cannot get TMS therapy?

There are some disqualifying factors for TMS. It is not recommended to undergo TMS if the client has electronic or magnetic metal implants, such as cochlear implants, pacemakers, vagus nerve stimulators (VNS), or metal plates. Dental fillings are not a disqualifying factor, however.

Further, TMS is not recommended if a client has a history of or risk for seizures or epilepsy. However, switching medications before receiving TMS may be possible if a medication causes the patient to have seizures. Ask a psychiatrist to learn more about whether this is an option.

What to expect from TMS

Since TMS is non-invasive, preparing for it is simple. First, clients will need to remove any glasses and metal jewelry. Next, the practitioner will provide the patient with earplugs before the procedure to protect the patient's hearing. Once sat in a reclining chair, the magnetic coil will be placed, and the pulses will begin.

A single TMS session ranges from three and a half minutes to 20 minutes. TMS must be administered daily over four to six weeks for most mental health conditions to reap the benefits.

Advantages of TMS

Besides being able to treat chronic mental health conditions effectively, TMS has a range of other benefits. TMS can be administered safely with other treatment methods — including many prescription medications. The process is non-invasive, quick, and painless. In addition, there is no need for general anesthesia. This makes it an effective alternative to other brain stimulation methods such as electroconvulsive therapy, or "ECT."

TMS side effects

TMS carries a low risk of causing seizures. The Cleveland Clinic estimates this risk at about 0.01%. Other potential side effects include mild headaches, scalp and neck pain, dizziness, sound sensitivity, and ear ringing. However, these side effects should subside within minutes after removing the magnetic coil.

Consult a psychiatrist about TMS

TMS is a safe and effective technique that uses a magnetic coil to stimulate certain brain areas. This helps improve the symptoms of long-term, treatment-resistant mental health conditions. Consult a psychiatrist to learn whether TMS is right for you.

Request an appointment here: https://nycpsychiatricassociates.com or call NYC Psychiatric Associates at (917) 391-0076 for an appointment in our New York office.

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