Common Questions About Transcranial Magnetic Stimulation (TMS)
Transcranial magnetic stimulation (TMS) is also known as deep TMS or dTMS. It is a drug-free, in-office treatment for certain patients who have been diagnosed with depressive disorders. For patients who are good candidates for TMS, this treatment can help individuals break free from the cycle of depressive symptoms. If your current depression treatment isn’t working well enough for you, consider asking your psychiatric practitioner about TMS uses and recommendations.
What is TMS?
TMS can be partially defined by what it isn’t. It isn’t a medication, doesn’t require anesthesia, and it isn’t an invasive procedure. TMS also does not cause pain. Instead, it involves applying magnetic pulses to the brain via a device with an electromagnetic coil. These magnetic pulses work by stimulating the nerve cells in the brain in order to affect how the brain works. Specifically, TMS targets the nerve cells in the region of the brain that regulates mood.
TMS is not new technology. It was first developed during the 1980s. In 2008, the FDA cleared TMS for use in patients with depression. Currently, scientists are studying the use of TMS for other psychiatric conditions, including bipolar disorder, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD).
How long does it take for TMS to work?
Every patient is unique, and so every TMS treatment is customized to meet the patient’s unique needs. At the beginning of an appointment, the provider will first target the motor cortex of the brain. The information received by targeting the motor cortex will inform the provider of the most ideal location for the electromagnetic coil. It will also help the provider determine the intensity of the magnetic pulses in order to stimulate the brain appropriately. Then, the provider will position the electromagnetic coil to target the dorsolateral prefrontal cortex.
TMS therapy can successfully affect the brain right from the first session. However, patients are not likely to notice a significant difference after just one session. Typically, relief from depression symptoms becomes apparent after three or more weeks of treatment.
How much TMS therapy will I need?
At most clinics, patients can expect to require TMS therapy five days per week. Each session lasts about 30 to 40 minutes. While you may achieve favorable results after three weeks, your provider may recommend that you receive four to six weeks of treatment. Although this is certainly an intensive therapy schedule, patients suffering from challenging depressive symptoms may find that the relief is well worth the time spent at the clinic.
Does TMS really work?
There are no guarantees in psychiatric medicine—or in any medical field, for that matter. However, about 50% to 60% of patients who try TMS therapy do enjoy favorable results. Furthermore, one-third of these patients go into complete remission (their symptoms become fully resolved).
Note that the remission of symptoms may not be permanent. On average, TMS patients enjoy continued results for a little longer than one year after stopping their treatment. At that point, patients may opt to repeat a course of treatment.
Are there any side effects of Transcranial Magnetic Stimulation?
Virtually every treatment has the potential for side effects. Transcranial magnetic stimulation is remarkably well tolerated, particularly when compared to medications. In fact, the magnetic pulses are the same type and strength of those used by MRI imaging equipment. Patients who do develop side effects most commonly report a temporary headache that may occur during or after a session. There is also the potential for lightheadedness, scalp discomfort where the device is applied, and tingling, twitching, or spasms of the facial muscles. Rarely, seizures have occurred, which is why TMS is not recommended for patients with epilepsy.
Is TMS therapy right for me?
Only your provider can determine if transcranial magnetic stimulation is appropriate for you. It’s important to fully disclose your medical history, including your history of surgeries and any other medical conditions you may have. TMS is well tolerated by most people. However, it cannot be used by those with the following:
- Patients with epilepsy
- Those with a history of head injuries
- Patients with serious neurological conditions
- Those with metal implants in the head/neck/chest region
Metal implants include but are not limited to the following: cochlear implants, implanted stimulators, aneurysm clips, stents, pacemakers, medication pumps, and deep brain stimulators. In addition, be sure to tell your provider if you may have any other metal objects in your body, such as bullet fragments or artificial joints.
In general, TMS is appropriate for patients with depression who have already tried antidepressants and either cannot tolerate the drugs or did not achieve sufficient relief of symptoms.
Starting April 1st, Integrated Behavioral Health will be pleased to offer Transcranial Magnetic Stimulation at our locations in Decatur, Madison, Montgomery, and Muscle Shoals. Our team is comprised of compassionate doctors and nurse practitioners who believe in providing evidence-based psychiatric care that is customized to the unique needs of each individual patient. New and current patients can call (855) 422-1618 to schedule an appointment. Consultations are available via our secure telemedicine platform.