We here at Solace Psychiatry are happy to offer TMS therapy to our patients. Our priority is to help patients achieve the relief they seek from depressive symptoms. If you are interested in these services, ask about our TMS therapy today!
What is TMS?
TMS stands for “Transcranial Magnetic Stimulation.” TMS is a non-invasive, FDA-cleared medical procedure for the treatment of depression in adults. TMS is a brain stimulation technique that relies on the generation of brief magnetic fields using an insulated coil that is securely placed over the pre-frontal region of the head. These magnetic fields are the same type and strength as those used in magnetic resonance imaging (MRI) machines. The pulses generate a weak magnetic current in the brain that briefly activate neural circuits at the stimulation site. TMS has been shown to serve as a safe and well-tolerated procedure that is an effective way to treat adult depression for those who have not been able to benefit from antidepressants. The potential benefit of TMS is the relief of depressive symptoms. Like all forms of medical treatment, some patients experience benefits quickly with long-lasting symptom relief, while others recover briefly and later relapse due to external factors, and others may fail to respond at all to TMS therapy. The advantage of TMS treatment is that it the side effects are minimal to none, and it does not interfere with any medication.
TMS Faq’S – TMS Basics
What is the science behind TMS?
Once the TMS device is positioned, it creates a deep magnetic pulse that targets the left pre-frontal cortex. This pulse comes in rapid succession and is thought to stimulate regions of the brain that are linked to emotion. In depressed patients, these emotion-baring regions are shown to be very non-responsive compared to healthy patients.
What is TMS?
Transcranial Magnetic Stimulation is an MRI-strength magnetic pulse designed to stimulate the brain. In depression treatment, the left pre-frontal cortex is stimulated. This is the area of the brain that is responsible for connecting to a variety of important functions, but it’s particularly integral to our emotional responses.
Who can receive TMS?
TMS therapy is an appropriate treatment for adult patients with major depressive disorder who have failed to achieve satisfactory improvement from antidepressant medications at or above the commonly effective dose and duration. If you or a loved one has been diagnosed with clinical depression or Major Depressive Disorder, then TMS Therapy may be able to help.
Who should not receive TMS?
TMS Therapy is a very well tolerated treatment and there are very few limitations as to who can receive it. However, not all patients are appropriate candidates for TMS Therapy. Patients with a history of seizures or who have metal implants or objects in or near their head are not appropriate candidates for TMS Therapy. To determine if TMS Therapy may be right for you, your supervising doctor or psychiatrist will carefully screen for the presence of medical conditions or metal objects which may make TMS harmful.
What if I cannot receive TMS?
If it is determined that you are not a candidate for TMS Therapy, there are other options for treatment of depression such as ECT and Vagus Nerve Stimulators (VNS). As with everything, please consult with your supervising doctor or psychiatrist to determine the best course of treatment of your depression.
Benefits & Safety
How soon until the benefits are felt?
It is commonly reported that patients need 30 to 40 sessions of TMS to derive the most benefit in the treatment of their depression symptoms. In clinical trials, 1 in 2 patients achieved significant relief of symptoms after four weeks of treatment and 1 in 3 experience complete remission after six weeks of treatment. Some patients may experience results in less time, while others may take longer.
Is TMS safe?
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 number 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.
What if I experience a side effect from TMS Therapy?
If you experience a side-effect, alert your TMS technician and assessing doctor. If symptoms persist, the TMS physician can reduce the strength of the magnetic field pulses being administered to make treatment more comfortable.
Less than 5 percent of patients treated with TMS Therapy discontinued treatment due to side effects.
TMS Therapy VS Others
Is TMS like ECT?
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 is designed to create seizures and requires hospitalization. The side effects from ECT are much more intense and occur in more instances. TMS is an outpatient procedure with little side-effects.
What is the difference between TMS and antidepressants?
Antidepressants have numerous side effects such as nausea, diarrhea, insomnia, sedation, lack of emotion, and sexual problems; TMS has very little to no side effects.
Antidepressants are systemic, meaning that the medicine enters the body and blood stream; TMS is non-systemic.
TMS is usually prescribed when antidepressants fail.
Is TMS Therapy a good alternative to antidepressants?
Most doctors and psychiatrists agree that TMS Therapy is also a good alternative for patients who cannot tolerate the side effects associated with antidepressant medications or do not wish to take them. Many patients suffer intolerable side effects to commonly used antidepressants, such as nausea, diarrhea, insomnia, sedation, lack of emotion, and sexual problems. TMS is non-systemic, so nothing enters your body or your bloodstream. That means that TMS is free of side effects typically associated with these medications. This also means that patients can immediately return to regular activity after TMS sessions.
Should I take my medicines while receiving TMS?
Patients may continue to take antidepressant medication while receiving TMS therapy if recommended by their physicians.
What is the chance of a seizure occurring whilst using the Rapid² Therapy System?
Magnetically stimulating the brain can induce seizures. The risk is estimated, using scientific papers and clinical evidence, at 1 in 1000 patients. To minimize this risk, patients should be properly screened for medical contraindications, be monitored at all times and have their motor threshold re-determined following any changes in medication.
Is it safe to use TMS with concomitant medications?
TMS Therapy has not been studied as an adjunct to antidepressant treatment in controlled trials but it has been administered safely in the presence of antidepressant medication. In randomized controlled trials varying levels of antidepressant medication have been used primarily to keep the patient’s state stable. Changing medication treatment during a course of TMS therapy is not recommended as it may change the brain’s excitatory threshold. Likewise, tricyclic antidepressants, neuroleptic agents or any other drugs (including heavy consumption of alcohol) that could lower seizure threshold should not be used in conjunction with the Rapid² Therapy System.
What about maintenance therapy?
Each patient’s course of treatment is highly individual. After the initial treatments, roughly half of patients experience relief and one third achieve remission of symptoms. Relapses do occur and therefore the need for additional TMS therapy should be gauged by the prescribing physician. Some people seek regular ‘top-up’ treatments while others are happy to receive maintenance therapy as and when the need presents itself.