Transcranial Magnetic Stimulation FAQs?
TMS Therapy is a new and alternative therapy cleared by the FDA in the treatment of Major Depressive Disorder, specifically when medicines have not yielded satisfactory results.
TMS Therapy utilizes an electromagnetic pulse to activate regions of the brain that are made dormant by depression. The subsequent raising of neurotransmitter levels in these regions is thought to be what lessons the symptoms of depression.
It usually takes time for healthcare insurers to establish coverage policies for newly approved treatments such as TMS Therapy. To date, many commercial and Medicare plans have included at least partial coverage for TMS Therapy, with more providers adding coverage every year. See here for a full list of insurance plans that cover TMS.
Is TMS Therapy a good alternative for patients who cannot tolerate the side effects associated with antidepressant medications?
TMS 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, etc. The most common side effects reported during clinical trials were headache and scalp discomfort - generally mild to moderate - occurring less frequently after the first week of treatment.
No. TMS Therapy utilizes a highly focused electromagnetic pulse with an intensity similar to that of an MRI machine. Other popularized uses of magnets for health benefits involve using a static magnetic field. These products deliver weak and undirected static fields which are not capable of activating brain cells.
While both TMS and Electroconvulsive Therapy (ECT) are effective in the treatment of depression, there are many differences in safety and tolerability. Both are designed to treat depression through the application of energy into the brain, but the similarities quickly dissolve.
ECT is a much more intensive and invasive procedure than is TMS Therapy. ECT applies electicity to the brain, which is designed to create seizures and requires hospitalization. The side effects from ECT are much more intense and occur in more instances. TMS utilizes electromagnetic pulses, and is an outpatient procedure with little side-effects.
The ability for TMS to provide relief of symptoms varies greatly from person. Therefore the length of a TMS Therapy course can vary greatly. Your doctor will recommend a schedule of sessions based on your individual need and response to treatment. So while patients typically receive 20-30 treatments over a 4-6 week period, the actual number of treatments can range anywhere from 10-60 treatments over a 4-10 week period. Treatments are performed during the weekdays usually five days a week and each procedure lasts approximately 30-60 minutes.
TMS is a generally safe procedure with over two decades of intense clinical and scientific research behind it. In 10,000 treatments during clinical trials, the most common side effects is mild to moderate scalp discomfort and mild headaches, both of which usually went away in the first week of treatments. In a very small percentage of instances there were reports of acute memory loss, minimal cognition interruption, facial twitching, and seizures. These side effects were acute and TMS showed no long-term issues.
No, Most TMS devices create the same type and strength of magnetic fields as MRIs (magnetic resonance imaging), which have been used in 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.
In clinical trials by manufacturer Neuronetics, their NeuroStar TMS Therapy system was systematically evaluated for its effects on memory. Clinical trials demonstrated that NeuroStar TMS Therapy does not result in any negative effects on memory or concentration.
No, the most common side effect related to treatment was scalp discomfort during treatment sessions. This side effect was generally mild to moderate, and occurred less frequently after the first week of treatment.
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 NeuroStar TMS Therapy discontinued treatment due to side effects.
How long does the antidepressant effect last? Will I need any therapy beyond the first treatment regimen?
Maintenence TMS is a large area of study with this technology. Too date, only the NeuroStar TMS system is proven to be durable and maintain its effects over 12 months. In a clinical trial, 2 out of 3 patients who had either responded to treatment or completely remitted their depression symptoms reported 12 months later that they remained at the level they were at the end of the trial. Additionally, after the trial, only 1 in 3 patients needed to return for 'maintenance' TMS sessions.
Patients may continue to take antidepressant medication while receiving TMS therapy if determined appropriate by the physician.
The FDA has cleared the NeuroStar TMS system for treatment of Major Depressive Disorder in cases where medications have failed to yield satisfactory results. Other device manufacturers are working for this clearance, but for now Neuronetics devices are the only one with such clearance. All other devices and any other uses are not currently cleared by the FDA.