Transcranial Magnetic Stimulation (TMS): Hope for Stubborn Depression
What is depression?
Depression is a mental health disorder that causes a persistent feeling of sadness and loss of interest. It affects how you feel, think and behave and can lead to physical problems. While most people feel down or sad at times, these feelings are usually short-lived and pass within a couple of days. When you have depression, it interferes with daily life and causes pain for both you and your loved ones.
Depression is not a weakness and you cannot simply "snap out of it". There are different types of depression, and it can vary in severity. Some people have mild depression, while others have major depression. Major depression is a serious medical condition that requires treatment.
- Symptoms of depression may include:
- Feeling sad or empty most of the time
- Loss of interest or pleasure in activities you used to enjoy
- Feeling guilty, hopeless, or worthless
- Sleeping too much or not being able to sleep
- Loss of energy or feeling tired all the time
- Difficulty concentrating, remembering, or making decisions
- Restlessness or irritability
- Overeating or appetite loss
- Thoughts of death or suicide
If you have depression, you may not have all of these symptoms, but you will likely have at least a few. Depression symptoms can also vary in how long they last. Some people have short episodes of depression that go away on their own, while others have depression that lasts for months or even years. Depression is a serious medical condition that requires treatment. If you think you may be depressed, talk to your doctor or mental health professional. Treatment can help you feel better and may prevent depression from coming back.
There are different types of treatment for depression, including medication, talk therapy, and lifestyle changes. Often, a combination of treatments is the most effective. Medication can help relieve symptoms of depression, but it is not a cure. Talk therapy can help you understand and work through the emotions and behaviors that are causing your depression. Lifestyle changes, such as getting regular exercise, can also help reduce symptoms of depression. Depression is a serious condition and left untreated, can be devastating for both the sufferer and their loved ones, but there is hope. With treatment, people with depression can feel better.
What is Transcranial Magnetic Stimulation (TMS)?
Depression causes disability in American youths ages 15 and 44. While treatment for depression can help, the best treatment options for most patients may not work for everyone. Nearly 80% of people suffering from depression have no other treatment for depression. After two months the symptoms may continue in these individuals and any drug that is administered will actually have no benefit.
In 2008, the FDA cleared a new medical device technology for the treatment of major depressive disorder (MDD): transcranial magnetic stimulation (TMS). TMS is a non-invasive brain stimulation therapy that uses magnetic fields to stimulate neurons in the brain. The FDA has stated that this new device is a safe and effective treatment for major depressive disorder. If you or someone you know is struggling with depression, TMS may be a treatment option to consider. Here's what you should know about this new FDA-cleared treatment for depression.
TMS is typically used when other treatments for depression, such as medication and talk therapy, have not been effective. TMS is also sometimes used in combination with other treatments. During a TMS procedure, a magnetic coil is placed against the scalp near the forehead. The coil sends brief magnetic pulses through the skull and into the brain. These pulses stimulate nerve cells in the region of the brain involved in mood regulation (dorsolateral prefrontal cortex - DLPFC).
TMS is usually given five times per week for four to six weeks. Each session lasts for about 30-60 minutes. Most people who receive TMS do not report any significant side effects. The most common side effect is a mild headache that typically goes away after the first few sessions. Unlike some other treatments for depression, TMS does not require medication or anesthesia (used for electroconvulsive therapy - ECT). TMS is also considered to be a safe and well-tolerated treatment option with a low risk of serious side effects.
Types of TMS Treatments: repetitive TMS and deep TMS
There are two types of TMS: repetitive transcranial magnetic stimulation (rTMS) and deep transcranial magnetic stimulation (dTMS). Both types of TMS are FDA-cleared to treat major depressive disorder in adults. Recently, deep TMS has received FDA clearance for obsessive compulsive disorder (OCD).
What is Repetitive Transcranial Magnetic Stimulation?
Repetitive transcranial magnetic stimulation (rTMS) is the most common type of TMS. This form of brain stimulation involves delivering repetitive pulses of magnetic energy to the area of the brain. In the case of depression, the area is the DLPFC. A typical course of rTMS neuromodulation therapy is usually given five times per week for four to six weeks.
rTMS treatment is a safe and effective treatment for major depression that has been proven in multiple clinical trials. In one study, repetitive TMS was found to be more effective than sham (fake) TMS in treating depression. In another study, repetitive TMS was found to be as effective as antidepressant medication in treating people with depression who had not responded to medication.
If you are considering rTMS for treatment-resistant depression, it is important to consult with a psychiatrist who is experienced in administering this type of therapy. rTMS treatment is not for everyone, and it is important to make sure that it is the right option for you.
Deep Brain Stimulation
Deep TMS (dTMS) is a newer form of TMS that allows for deep brain stimulation. Deep TMS is different from traditional TMS in that it can reach deeper areas of the brain, so it may be more effective. This form of brain stimulation therapy is also cleared by the FDA to treat depression that hasn't gotten better with other treatments. Deep TMS may have fewer side effects than traditional TMS and is usually given once per day for six weeks.
How Effective is TMS in Treating Various Conditions/Disorders, Such as Depression?
There is a great deal of clinical evidence to suggest that transcranial magnetic stimulation (TMS) is an effective treatment for various conditions and disorders, including major depressive disorder. In fact, the FDA has cleared TMS as a safe and effective treatment for this condition.
Clinical trials have demonstrated that TMS is an effective treatment for depression. . In a clinical trial, TMS was found to be more effective than escitalopram, a common antidepressant medication, in treating patients with depression. In addition, a large meta-analysis of TMS trials found that in clinical trials, patients who received TMS had a significantly higher response rate than those who received a sham (placebo) treatment for depression. These studies suggest that TMS is a safe and effective treatment option for patients with depression. While the evidence supporting the use of TMS in treating depression is strong, it is important to keep in mind that this therapy is not right for everyone.
Given the growing body of evidence supporting the use of TMS in treating various conditions, it is likely that we will see even more widespread use of this therapy in the future. TMS has been used to investigate a variety of cognitive functions, including attention, perception, language, and memory. TMS has also been used to treat a number of neurological disorders, such as migraine headaches.
TMS Therapy for Depression
For people who can no longer cope with their depression, TMS therapy may be the right treatment for them. Transcranial Magnetic Stimulation is one of the most effective noninvasive therapies that focus on a region of the brain involving mood regulation. Magnetic waves are passed painlessly in the skull stimulating neurons that improve brain communication between the various brains and relieve depression symptoms. Although it may help treat treatment-resistant depression, this does not mean the treatment will help you recover.
How Does TMS Work?
Transcranial magnetic stimulation (TMS) is a noninvasive brain stimulation technique that is typically delivered using a figure-eight shaped coil that produces brief magnetic pulses. These pulses can alter the excitability of neurons in the targeted area of the brain, which can lead to changes in neural activity and behavior. By using high-frequency stimulation, TMS can excite the target area, increasing neuronal activity. Alternatively, using low-frequency stimulation, TMS can inhibit the target area, decreasing neuronal activity.
TMS works by generating a magnetic field that in turn induces an electrical current in the brain, but the mechanism by which TMS produces its effects is not fully understood. It is thought that TMS alters neural activity by inducing electrical currents within the brain. These currents can modify the firing of neurons and alter neurotransmitter release. When used to relieve the symptoms of depression, TMS is applied over the dorsolateral prefrontal cortex - DLPFC, stimulating the nerve cells in the brain that are involved in mood regulation. TMS is usually used when other treatments, such as medication and therapy, have not been effective.
What are the Benefits of Transcranial Magnetic Stimulation (TMS)?
The FDA has cleared this form of brain stimulation for the treatment of major depressive disorder. Transcranial magnetic stimulation uses a magnetic pulse to stimulate neurons in the brain and is a safe and effective treatment option for those suffering from depression. Some of the benefits of this new device include:
- TMS is a drug-free treatment for depression
- There are no side effects associated with TMS
- TMS is a non-invasive procedure
- TMS is an outpatient procedure that does not require hospitalization
- TMS is covered by most insurance plans
Are there any risks associated with TMS therapy that patients should be aware of before starting treatment sessions?
As with any medical procedure, there are some risks associated with TMS. However, the FDA has cleared TMS as a safe and effective treatment for major depressive disorder. Some of the potential risks of TMS include:
- Tingling or discomfort at the site of stimulation
- Muscle twitching
TMS is generally considered to be safe and well-tolerated. The most common side effects are headache and scalp discomfort. Rare, but more serious, side effects can include seizures. TMS is a promising tool for investigating the brain and treating neurological disorders. However, it is important to speak with a qualified medical professional to determine if TMS is right for you.
How is TMS Administered?
TMS is typically administered using a device that delivers a magnetic pulse to the patient's head. During treatment, the patient sits in a comfortable chair with their head resting against padded support. The device's electromagnetic coil is positioned near the treatment site on the head and delivers magnetic pulses to the brain. When used for the treatment of depression, the coil is positioned over the dorsolateral prefrontal cortex (DLPFC). The magnetic pulses pass through the skull and stimulate the neurons in the brain. Most people do not report any significant side effects during treatment.
TMS is usually given five times per week for four to six weeks. Each session lasts for about 30-60 minutes (As of 2016, a 19 minutes protocol for depression was FDA Cleared and as of 2018, a 3-5 minutes protocol for depression was FDA Cleared - known as Intermittent Theta Burt Stimulation or iTBS). Most people who receive any version of these brain stimulation therapies do not report any significant side effects. The most common side effect is a mild headache that typically goes away after the first few sessions.
Who is a Good Candidate for TMS?
TMS is typically recommended for people who have failed to respond to other forms of treatment, such as medication and psychotherapy. TMS is also sometimes used in people who cannot take antidepressants due to side effects or other reasons.
If you are interested in learning more about TMS and whether or not it may be a good treatment option for you, please speak with a qualified medical professional.
What are the benefits of TMS?
TMS has been shown to be an effective treatment for major depressive disorder. In one study, nearly 60% of people who received TMS had a reduction in their symptoms. TMS is also a safe and well-tolerated treatment with few side effects.
If you are considering TMS for your depression, it is important to speak with your doctor to see if you are a good candidate for the procedure. TMS is not right for everyone, and it is important to consider all of your treatment options before making a decision.
Electroconvulsive Therapy - Not a form of dTMS
Electroconvulsive therapy (ECT) is not a form of deep TMS. Though ECT is a form of deep brain stimulation, this form of brain stimulation is invasive and requires general anesthesia. Electroconvulsive therapy is based on an electrical stimulation method that involves the insertion and treatment of electrical currents in patients who are battling serious psychological conditions. This kind of therapy is usually considered only if a patient's disease has not improved after other treatments (such as antidepressant medication or psychotherapy) are tried, or in cases where rapid response is needed (as in the case of suicide risk and catatonia, among others).
ECT Side Effects
Some patients experience memory difficulties particularly when they're treated for ECT treatment. Occasionally the memory issues are severe, but usually, they improve within several days following the event. Researchers have found a link between memory and bilateral ECT, which uses electrodes on both sides of the head. In unilateral ECT, a single electrode is usually placed directly to one side, while the right side is usually the opposite of the brain's brain area to learn the brain's chemistry.
How Does it Work?
Before ECT, an individual must be injected with an anesthetizing anesthetic and muscle relaxants to reduce the pain during the operation. An anesthesia specialist monitors breathing rhythm and blood pressure in all phases of surgery conducted by a trained medical team of doctors and nurses. In general, the ECT treatment will typically take three to four days before patients' depressive symptoms improve. In addition, maintenance therapy may be required if symptoms return.
ECT: Why it's Done?
ECT is commonly used to relieve severe treatment-resistant depression, but ECT is also used for other mental illnesses including bipolar and schizophrenia. The drug is commonly used in situations where the patient cannot move or respond to external stimuli or is suicidal. ECT may reduce recidivism a patient experiences after follow-up treatment.
Though there exist numerous brain stimulation therapies, magnetic stimulation of the brain is a relatively new brain stimulation technique that has shown to be effective in reducing symptoms of MDD in nearly 60% of patients. TMS is a non-invasive procedure that can be completed in an outpatient setting. TMS does not require anesthesia or sedation, and it does not require any incisions or implants. The benefits of TMS include its safety and efficacy. The FDA has cleared TMS as a safe and effective treatment for major depressive disorder with very few side effects. If you are evaluating electrical stimulation therapies such as TMS for treatment, be sure to speak with your doctor about the risks and benefits of the procedure.