- What is TMS?
- How does TMS work?
- Is TMS a good alternative for patients who cannot tolerate the side effects associated with antidepressant medications?
- Is TMS like other alternative therapies which use magnets to treat some illnesses?
- Is TMS like electroconvulsive therapy (ECT)?
- What is a typical course of treatment with TMS?
- What are the potential risks of TMS?
- Who should not receive TMS?
- Does TMS cause brain tumors?
- Does TMS cause memory loss?
- Is TMS uncomfortable?
- How long does the antidepressant effect last? Will I need any therapy beyond the first 4-6 weeks?
- Can I also take antidepressant(s) if I am receiving TMS?
- Will TMS be covered by my insurance and/or Medicare?
TMS stands for Transcranial Magnetic Stimulation. TMS is used to treat depression by non-invasive magnetic stimulation of the brain, similar to the magnetic field produced by an MRI machine. During TMS Therapy, a magnetic field is administered in very short pulses to the region of your brain. The typical initial outpatient course of treatment is about 30-60 minutes daily over 4-6 weeks.
TMS therapy uses short pulses of magnetic fields to stimulate the areas of the brain that are thought to function differently in patients with depression, tinnitus, bipolar disorder, obsessive compulsive disorder (OCD), or schizophrenia. The magnetic field produces an electric current in the brain that stimulates the brain cells (neurons). This results in changes in the brain that are thought to be beneficial in the treatment of these conditions.
Is TMS a good alternative for patients who cannot tolerate the side effects associated with antidepressant medications?
TMS therapy is non-systemic (does not circulate in the blood throughout the body), so it does not have side effects such as weight gain, sexual dysfunction, nausea, dry mouth, sedation, among others that are commonly found with antidepressant drugs. The most common side effects reported with TMS during clinical trials were headache and scalp pain or discomfort – generally mild to moderate – occurring less frequently after the first week of treatment. TMS Therapy may not work for all patients. You should speak with your doctor to determine if TMS Therapy is an appropriate treatment option for you.
No. TMS Therapy involves a unique method of using pulsed magnetic fields for therapeutic benefit. The intensity of the magnetic field is similar to that of the magnetic fields used in magnetic resonance imaging, or MRI. These techniques differ radically from the use of low intensity, static magnetic fields. These products deliver weak and undirected static fields that are not capable of activating brain cells.
No, the two procedures are very different. While both are effective in the treatment of depression, there are many differences in safety and tolerability.
During the TMS Therapy procedure, patients sit in a chair and are awake and alert throughout the entire procedure – no sedation is used with TMS Therapy. Patients can transport themselves to and from treatment.
In over 10,000 active treatments with TMS Therapy in clinical trials, no seizures were observed. TMS Therapy was also shown to have no negative effects on memory function in clinical studies. However, there is a remote risk of seizure with TMS Therapy.
In contrast, “shock therapy,” or electroconvulsive therapy (ECT), intentionally causes a seizure. Patients receiving ECT must be sedated with general anesthesia and paralyzed with muscle relaxants. Recovery from an ECT treatment session occurs slowly, and patients are usually closely monitored for minutes or a few hours after a treatment.
Short-term confusion and memory loss are common with ECT, and long-term disruptions in memory have been shown to occur and may persist indefinitely in some people. Because of the side effects associated with ECT, a significant amount of caregiver support is required.
In clinical trials, patients received TMS Therapy 5 times per week in 37 minute sessions over 4-6 weeks. Patients treated with TMS Therapy should receive treatment for a minimum of four weeks with additional treatments based on the psychiatrists judgment.
TMS Therapy is well tolerated and has been proven to be safe in clinical trials. Throughout over 10,000 active treatments performed in clinical trials, the most commonly reported side effect related to treatment was scalp pain or discomfort during treatment sessions. These side effects were generally mild to moderate, and occurred less frequently after the first week of treatment. Less than 5% of patients treated with TMS Therapy discontinued treatment due to side effects.
In clinical trials, over 10,000 TMS treatments demonstrated its safety, with no occurrence of seizures. However, there is a small risk of a seizure occurring during treatment. This risk is no greater than what has been observed with oral antidepressant medications.
While TMS Therapy has been proven effective, not all patients will benefit from it. Patients should be carefully monitored for worsening symptoms, signs or symptoms of suicidal behavior, and/or unusual behavior. Families and caregivers should also be aware of the need to observe patients and notify their treatment provider if symptoms worsen.
TMS Therapy should not be used (is contraindicated) in patients with implanted metallic devices or non-removable metallic objects in or around the head. TMS Therapy should be used with caution in patients with implanted devices that are controlled by physiological signals. This includes pacemakers and implantable cardioverter defibrillators (ICDs).
No, TMS Therapy uses the same type and strength of magnetic fields as MRIs (magnetic resonance imaging), which have been used for tens of millions of patients around the world and have not been shown to cause tumors. The magnetic energy used in a full course of TMS Therapy is a small fraction of just one brain scan with an MRI.
No, TMS Therapy was systematically evaluated for its effects on memory. Clinical trials demonstrated that TMS Therapy does not result in any negative effects on memory or concentration.
The most common side effect related to treatment is scalp pain or discomfort during treatment sessions — generally mild to moderate.
If necessary, you can treat this discomfort with an over-the-counter analgesic. If these side effects persist, your doctor can temporarily reduce the strength of the magnetic field pulses being administered in order to make treatment more comfortable.
Less than 5% of patients treated with TMS Therapy discontinued treatment due to side effects.
In most patients, the clinical benefit of TMS Therapy was maintained through 6 months of follow-up study. Talk to your doctor about your long-term treatment path.
Yes. In clinical trials, TMS Therapy was safely administered with and without other antidepressant medications.
TMS may be covered on a case-by-case basis, depending on your insurance plan. TMS can be paid from a healthcare flexible spending account. At this time, Dr. Stubbeman has opted out of Medicare.