Patients with metal in or around the head should not be treated with TMS therapy. Insurance plans each have their own medical guidelines which may prevent coverage for treatment. Typically, this includes a seizure disorder, neurological condition, active substance use disorder, or any other condition that may lower a person’s seizure threshold.
While TMS does not help every patient, most patients do respond favorably. In fact, as many as 70% can expect at least a 50% or greater reduction in depression their rating scales. Research indicates that TMS therapy treatment is much more effective than antidepressant medications and doesn’t come with debilitating side effects often experienced with medications.
Standard TMS treatment consists of five treatments per week for six weeks, followed by six tapered sessions over three weeks. With this treatment protocol, most patients can expect to feel benefits within the first couple of weeks. However, many patients may not respond until weeks four or five. For those who receive the SAINT protocol, benefits are typically seen the first day.
Discover answers to the most popular TMS related questions below.
Yes. TMS is an FDA-approved treatment, which means it’s completely safe to administer to patients. It’s also non-invasive and virtually pain-free.
Yes, while not yet approved by the Food and Drug Administration (FDA), there is much research that supports the efficacy of TMS for the treatment of generalized anxiety disorder (GAD).
Yes, however, there is a less than 0.1% risk of seizure associated with TMS. If a patient has a history of seizures, or if they could be withdrawing from alcohol or a benzodiazepine, the risk could be higher and the TMS provider should be notified of any increased risk potential prior to starting TMS treatment.
While not yet approved by the Food and Drug Administration (FDA), there is ample research to support TMS as an effective treatment for PTSD.
While not yet approved by the Food and Drug Administration (FDA), there is research to support TMS as an effective treatment for mild cognitive decline and patients with Alzheimer’s disease (AD).
Yes, unlike ECT, you can continue to drive your car after TMS treatments.
Training is provided by manufacturers of the device, as well as ongoing support. Many medical centers offer advanced courses on the treatment.
TMS is contraindication for any person with metal in or around the head. Additionally, patients at high risk for a seizure should not receive TMS treatment. Additionally, most insurance companies have their own guidelines that are not necessarily contraindications, but states further criteria that must be met before they will cover TMS treatment.
No. While TMS is safe, painless, and has little-to-no side effects, ECT or electroconvulsive therapy requires general anesthesia which can carry some risk. And unlike TMS, whose patients can immediately resume activities like driving and physical exercise, electroconvulsive therapy (ECT) patients require an extended recovery period and heightened risk of seizure and memory loss.
TMS has been shown to produce changes in the activity of neurons of the limbic system, which is linked to mood regulation. The procedure consists of magnetic pulses inducing brain activity in the cells of that region. These pulses activate the limbic system cells to improve symptoms of depression. TMS is most often prescribed when other treatments for depression have not been effective.
It is very unlikely for TMS to ever cause anxiety, in fact, it is used to treat anxiety off-label. However, there is a remote possibility for TMS to unmask anxiety symptoms that were underlying a severe depression.
TMS is currently under investigation for its use in treating Bipolar disorder. It is currently not FDA-approved for Bipolar Depression, but the ongoing studies are showing some positive results.
Yes, mild fatigue is not uncommon after the first few treatments of TMS, as it is like a “work-out” for the brain. However, for many patients, this is a very welcomed effect and can be a benefit for many patients who experience insomnia due to their depression.
TMS can cause scalp tenderness during the treatment pulses but typically does not cause a lasting headache. For patients who are prone to headaches, they can premedicate with ibuprofen or acetaminophen prior to treatments to prevent a headache.
Over the past decade, dozens of studies have found evidence that transcranial stimulation can improve some aspect of brain performance, including attention, memory, math proficiency, reaction time, and creativity. Some studies indicate that this treatment increases brain plasticity, which may help with learning with specific conditions or diagnoses.
Depression is considered in terms of “remission” and “recurrence.” TMS can put depression into remission for an extended period of time but there is a possibility, depending on the nature of the patient’s depression, symptoms can recur down the road. If this does occur, then patients are even more likely to respond positively to repeated TMS treatments.
There is no evidence that shows TMS can at all cause cancer. It uses the same technology as an MRI.
The basic answer to this question is that the time to respond to TMS therapy varies. Patients can see improvement in their depression symptoms any time within the first third, middle third or end, and even as far out as 3-4 weeks. It is highly recommended that patients complete the TMS course to give them the best chance possible of achieving optimal results from the treatment.
Everyone describes TMS treatment differently, but most patients find it somewhat relaxing after the first few treatments. At first, it may take a few treatments to get used to the ‘tapping’ sensation on the scalp. But, most patients tend to tolerate the treatment very well and respond favorably.