TMS Treatment

What is Transcranial Magnetic Stimulation?

Transcranial Magnetic Stimulation (TMS) is an exciting new state of the art therapy cleared by the US Food and Drug Administration (FDA) for patients who are suffering from treatment resistant depression and have not experienced satisfactory results from previous antidepressant medications and therapies. 

TMS Therapy is conveniently performed right in your psychiatrist's office, under their supervision. One of the many benefits of Transcranial Magnetic Stimulation is that the therapy is non-invasive and does not require any anesthesia or sedation, as the patient remains awake and alert during each treatment. 

Additionally, TMS is a non-systemic, non-pharmaceutical therapy that does not circulate in the blood throughout the body, so it does not have side effects typically associated with antidepressant medications such as weight gain, sexual dysfunction, nausea, dry mouth, sedation, etc. The most common side effects reported during TMS clinical trials were mild to moderate headache and scalp discomfort, which occurred less frequently after the first week of treatment.

  

How Does TMS Work?

Transcranial Magnetic Stimulation uses energy generated by pulsed magnetic fields to activate specific cortical neurons, as well as neural structures and pathways deep in the mid-brain that control mood and depression. The treatment entails applying a device with a magnetic coil to the head over the left prefrontal cortex area. Throughout the treatment the TMS system delivers enough stimulation in the predetermined area to get the designated neurons to activate and release the necessary chemical messengers that help relieve the symptoms of depression. These activated neurons then stimulate deeper brain regions via known proximal pathways in an almost “domino effect.”  This series of events happens upwards of 3000 to 5000 times per treatment session. Over the course of the average treatment, the brain practices these positive activation patterns so many times that it becomes able to do this on its own once treatment is completed.

 

Who Can Benefit from TMS?

For decades researchers have sought out safe and effective solutions for treating depression. Unfortunately there is no universal depression treatment which has been proven to provide relief for everyone. Depression is typically treated with regimens of antidepressant medications; however, newer alternative treatments for this debilitating condition are available. These new and innovative depression therapies have been shown to work in people who haven’t received adequate benefits from medications or who are unable to tolerate the side effects caused by them. One such alternative therapy for the treatment of depression is transcranial magnetic stimulation (TMS). TMS Therapy was recently FDA-cleared for patients suffering from depression who have not achieved satisfactory improvement from prior antidepressant medications.

 

What Happens During the TMS Procedure?

Each TMS Therapy treatment session is an efficient outpatient procedure that lasts about 40 minutes. The treatment itself is non-invasive and you can simply relax in the treatment chair or chat with staff and family. Immediately after your session you can return to your normal day to day routine including heading back to work or school. Patients are able to drive themselves to and from each treatment session. Your very first treatment session will entail your psychiatrist mapping out the most effective delivery pattern for administering your treatment, so this particular session lasts a bit longer up to an hour and a half. During the treatment you will be given the same kind of earplugs that you would wear at a loud concert, as the system emits a recurring tapping sound during use.

 

Your psychiatrist will first determine the location of your motor threshold with a simple, painless test using the TMS machine. This test will determine the specific magnetic field strength that will be customized for your specific treatment. Your physician will then determine the exact place on the head where the TMS treatment will be applied and the magnetic coil will be moved to that location for the remainder of your session.

 

Over the course of approximately 40 minutes, the TMS device will deliver rapid "pulses" of the magnetic fields in 30-second intervals. These pulses deliver a tapping sensation which some patients may find mildly uncomfortable. During or after sessions, you may experience a mild headache or slight irritation at the site of stimulation. These are common side effects that often improve after the first few treatments. Patients can often offset any discomfort with an over-the-counter pain medication. Throughout the treatment your doctor may be able to make adjustments to try and increase your comfort levels as well.

 

A typical Transcranial Magnetic Stimulation regimen consists of at least 5 treatments per week over a 4-6 week period, for an average of 20-30 total treatments. In clinical trials, most patients experienced beneficial results by the fourth week of treatment. Some patients may experience this in less time, while others may take longer. You should maintain an active dialog with your physician regarding your symptoms throughout the entire course of your treatment.

 

Can I Continue Taking My Medications During Treatment?

Patients can remain on their current medications while undergoing TMS therapy. In clinical trials, TMS Therapy was safely administered with and without other antidepressant medications. Often, patients are able to significantly taper their dosages during and after TMS treatment and sometimes cease needing antidepressant meds altogether. It is important for clients to maintain good lines of communication with their personal physicians regarding their Transcranial Magnetic Stimulation and medication usage.

 

Is TMS Safe?

TMS Therapy has been shown in clinical trials to be a safe, effective treatment for patients who have had a poor response to prior antidepressant medications. Treatment with TMS Therapy is associated with very few side effects and is generally well tolerated by most patients. 

The most common side effect reported during clinical trials was slight scalp irritation at the specific treatment site and mild headache, which frequently decreased after the first week of treatment.

 

The many benefits of TMS include:

Absolutely no systemic side effects like weight gain, sexual dysfunction, sedation, nausea or dry mouth, along with no adverse effects on concentration or memory and no drug interactions.

 Patients with implants controlled by physiological signals like pacemakers, implantable cardioverter defibrillators (ICDs), and vagus nerve stimulators (VNS), implanted metallic devices or non-removable metallic objects in or around the head (including some permanent cosmetics and tattoo dye with metallic components in the ink) should not be treated with TMS. This does not include metallic fillings in teeth.

 

TMS Media Coverage

National Media

Transcranial Magnetic Stimulation (TMS) has been featured in several prominent news publications highlighting its success in treating depression. Among these publications and television shows are: Dr. OzThe Daily BuzzTIME MagazineScientific AmericanDiscover Magazine, and Good Housekeeping. See below for more news stories discussing the latest applications of TMS Therapy.