What is Transcranial Magnetic Stimulation (TMS) Treatment?

TMS is approved by the FDA for helping treat depression.  It's the newest, most innovative procedure in combating treatment-resistant depression and clinical studies have revealed that it may also be helpful in treating PTSD, chronic pain as well as anxiety and bipolar disorders. TMS uses a magnetic field — similar to that used in magnetic resonance imaging (MRI) — to stimulate the brain’s dorsolateral prefrontal cortex, which plays a key role in mood.  TMS causes more connectivity between nerves in the brain, an increase in the amount of neural activity, and an increase in the amount of neurotransmitters like serotonin. The increased activity of neurons in this area of the brain lessens depression.

Having your brain stimulated by a magnetic field may sound a bit scary, but the experience isn’t painful. During the 30-40 minute session, you are fully awake and sitting in a comfortable chair. You can speak, read or watch tv. After treatment, you can resume your daily activities immediately without restrictions.

While this treatment was initially found to be beneficial for those who didn't respond to one or two trials of medication or who have experienced intolerable side effects, it can be also looked at as a more natural, holistic approach to the treatment of depression. Some patients have other health issues that prevent them from taking antidepressants; it's estimated that approximately 30 percent of people who suffer from depression can't find adequate relief, TMS offers them hope.

TMS is not recommended for people with:  Poorly controlled seizures, a metallic implant close to the head, a brain tumor or brain disease, or a substance abuse disorder.

Frequently Asked Questions about TMS Treatment:

Q:  How long does it take?

  • The typical TMS session lasts about 30 to 40 minutes.  
  • TMS is typically given daily for between 10 and 30 sessions.
  • During the first phase, you’ll likely receive treatment every weekday for six weeks (about 30 times).

Q:  What exactly happens during the treatment? 

  • The doctor places the TMS coil on the top left side of your head.
  • The coil delivers stimulation for about 4 seconds, stops for about 15 seconds, then starts again.
  • This cycle repeats about 75 times per session.
  • During stimulation, you hear a tapping sound and feel a tapping on your scalp.  

Q:  How does magnetic stimulation work?

  • TMS involves a magnetic head, which converts electricity into a magnetic field, being placed against the scalp. The magnetic field sets up electrical circuits in the brain, affecting only a tiny area.
  • The region of the brain targeted depends on the condition being treated — for depression, it’s the left dorsolateral prefrontal cortex (DLPFC), where there’s reduced activity in people with the condition.
  • Beneficial effects of TMS propagate through to the deeper areas, so the entire depression circuit is treated.

Q:  How do you taper off the treatment or do you have to maintain the treatment?  

  • Research shows that regular maintenance with TMS helps prevent recurrence and reduces the symptoms should depression reoccur.
  • After the initial phase of 30 treatments or so,  the doctor tailors the frequency to meet your needs. You may get treatments every other week, monthly, or every two months. The frequency gradually decreases.

Q:  Does it cause any side effects?

  • TMS has relatively few side effects. The most frequent side effect is a headache, but it's not common and can be treated with  Advil® or Tylenol®.
  • More serious is the increased risk of seizures.  Those with a seizure disorder would not be a good candidate for this treatment.   
  • Any effect of TMS on depression is gradual, and there are some people for whom it doesn’t work at all.

Q:  What is the success rate of the TMS treatment?

  • Trials show a recovery or remission rate after TMS of 30-40%, and another 30% report a substantial reduction in symptoms.
  •  Some people become more positive and sociable after a course of TMS, a qualitative difference you don’t see with antidepressants.

Have more questions? Contact us.

 
 

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