Depression Can Take Over Your Life Without Permission But TMS Therapy Can HelpTMS therapy brings relief and remission to many people suffering from depression when antidepressants have not worked or are not tolerated due to side effects. Learn more about treatment resistant depression (TRD) and why TMS therapy treatment may be the best treatment option for you. |  |
TMS stands for transcranial magnetic stimulation. TMS is the most advanced form of treatment for several mental health conditions. How does it work? Dr Rustin Berlow discusses the mechanism of action behind TMS and its current understanding in the brain stimulation research community.
Am I a Candidate for TMS?If you have already experimented with medications for major depressive disorder (MDD) or obsessive-compulsive disorder (OCD) and are seeking a treatment that has fewer side effects, TMS might be an excellent choice for you. It provides substantial relief without the typical systemic effects that are often linked to medications. Patients with metal in or around their head should not be treated with TMS. It's important to note that insurance plans may have specific guidelines that could affect coverage. These guidelines usually apply to individuals with a seizure disorder, neurological condition, active substance use disorder, or any condition that may increase the risk of seizures. To determine if your insurance will cover TMS treatment, it's best to consult with your doctor or contact your insurance provider. | What Should I Expect with TMS?Most patients experience positive results with TMS treatment, although it may not be effective for everyone. In fact, around 70% of patients can anticipate a significant decrease of 50% or more in their depression symptoms, as indicated by a depression rating assessment scale. Studies have shown that TMS therapy treatment is significantly more effective compared to antidepressant medications, and it doesn't subject patients to the distressing side effects commonly associated with medications. Standard TMS therapy treatments involve five sessions per week for six weeks, with the final six sessions titrated over three weeks. However, there are various treatment protocols available. Some providers offer accelerated treatment options that can deliver results in just 5-10 days instead of several weeks. | When Will I Feel Better?It is common for patients to notice an improvement in their symptoms after around 10 to 15 TMS treatments. However, it's important to remember that every patient's response can differ. In some cases, patients may experience a delayed response to the treatment. This means that even during the last six treatment sessions and even after completing all 36 sessions, there is still a possibility of a decrease in symptoms for these patients. On average, remission can extend for about 12 months or one year following treatment. Yet, the duration may differ among individuals. Some may experience symptom recurrence after a few months, while others enjoy a prolonged remission lasting several years. |
 | Considering TMS Therapy? Check out these handy resources.Want to learn more about TMS therapy? We've found informative articles from reputable sources like the Mayo Clinic, Healthline, Hopkins Medical, and more. Plus, we've crafted exclusive PDFs just for the TMS Clinic Directory. Check out the resources below that are completely free to download! Have questions? Visit our Contact Us page or your local TMS therapy provider. |
Discover answers to the most popular TMS therapy related questions below.
What are the side effects of TMS?TMS therapy is generally well-tolerated by patients. Although side effects like headaches and scalp discomfort are possible, they usually diminish after a few sessions. Some people may experience involuntary eye blinking or facial muscle contraction during treatment, but these symptoms immediately subside once the treatment has ended. In very rare cases, there is a small risk of seizure, especially for those with a pre-existing lowered seizure threshold. | How long is a treatment session and how many sessions are required?A typical TMS session lasts approximately 20 minutes. The sessions continue for five days a week over a duration of 6-9 weeks. If additional treatments are needed, this will be determined by your healthcare provider. Certain TMS therapy providers provide different treatment protocols, which may include multiple 3-minute treatment sessions on the same day to speed up the treatment process. To ensure that the treatment protocol is covered by your insurance, it is essential to verify with your insurance provider. |
Is TMS Safe?Yes. Transcranial magnetic stimulation (TMS) therapy is generally considered safe and well-tolerated by most patients, and is FDA-approved. It is a non-invasive treatment that uses magnetic fields to stimulate areas of the brain that regulate mood and patients do not have to undergo anesthesia. Following treatment, patients can return to their normal activities of daily living, including driving. | Can TMS cause brain damage?TMS has not been shown to cause harm to the brain. The only potential risk with TMS is a very low 0.1% chance of seizure. This risk appears to be higher in individuals who are already prone to seizures, whether it be due to medication, a chronic illness like epilepsy, or as a result of substance abuse. |
Can TMS be repeated if Needed?Yes, a person may have maintenance treatments or a complete course of TMS therapy to maintain their state of remission. In fact, patients who respond well to TMS initially, are more likely to continue to respond positively to TMS if needed again in the future. Most insurance plans will cover retreatment as long as the health plan's medical guidelines continue to be met. | Can TMS help with anxiety?Yes, while not yet approved by the Food and Drug Administration (FDA), there is much research that supports the efficacy of TMS for the treatment of generalized anxiety disorder (GAD). |
Can TMS worsen depression?It is very unlikely for TMS to worsen depressive symptoms. However, there is a remote possibility that a patient's symptoms may worsen shortly after starting treatment, but with continued treatments this tends to resolve quickly and this small group of patients tend to respond quite favorably to TMS treatment. | Can TMS cause seizures?Yes, however, there is a less than 0.1% risk of seizure associated with TMS. If a patient has a lowered seizure threshold, history of seizures, or if they are withdrawing from alcohol or a benzodiazepine, the risk could be higher and the TMS provider should be notified of any increased risk potential prior to starting TMS treatment. |
Can TMS cure or treat OCD?Yes, TMS for the treatment of obsessive-compulsive disorder (OCD) is approved by the Food and Drug Administration (FDA). However, TMS for the treatment of OCD is not covered by all health insurance plans. It is also important to inquire about the manufacturer of the TMS treatment device or system, as there are only a few TMS device manufacturers that are FDA approved for the OCD treatment. | Can TMS help with PTSD?While not yet approved by the Food and Drug Administration (FDA), there is ample research to support TMS as an effective treatment for PTSD. |
Can TMS improve memory?While not yet approved by the Food and Drug Administration (FDA), there is research to support TMS as an effective treatment for mild cognitive decline and patients with Alzheimer’s disease (AD). | What’s the success rate of TMS?Research shows that TMS treatment offers a greater likelihood of symptom improvement and complete remission compared to antidepressant medications. Around 70% of patients can anticipate a notable decrease in depressive symptoms, with almost 60-65% experiencing complete remission. Studies have demonstrated that TMS treatment has a higher probability of improving symptoms and achieving complete remission compared to antidepressant medications. Approximately 70% of patients can look forward to a significant reduction in depressive symptoms, with nearly 60-65% reaching complete remission |
Can I drive after my TMS treatments?Yes, unlike ECT, you can continue your normal activities of daily living, including driving after each TMS treatment. | Is there training necessary to administer TMS?Manufacturers of the TMS device offer training and certification, along with ongoing support. Additionally, numerous medical centers provide advanced courses on TMS therapy and certification. Several TMS providers in the United States have completed advanced training courses, while some have obtained certification directly from the device manufacturer. When seeking TMS as a treatment option, it is recommended to always be sure to ask if the provider and TMS Technician are certified. |
Who are the candidates for TMS?TMS is contraindicated for any person with metal in or around the head. Additionally, patients at high risk for a seizure should not receive TMS treatment. Additionally, most insurance companies have their own guidelines that are not necessarily contraindications, but states further criteria that must be met before they will cover TMS treatment. | Is TMS the same as ECT?No. While TMS is safe, painless, and has little-to-no side effects, ECT or electroconvulsive therapy requires general anesthesia which can carry some risk. And unlike TMS, whose patients can immediately resume activities like driving and physical exercise, electroconvulsive therapy (ECT) patients require an extended recovery period and heightened risk of seizure, psychosis, and memory loss. |
How does TMS work?TMS has proven to have an impact on the activity of neurons in the limbic system, which plays a crucial role in regulating our mood. This procedure involves using magnetic pulses to stimulate brain activity in that specific area. By activating the cells in the limbic system, these pulses help alleviate symptoms of depression. TMS is typically recommended when other depression treatments have not yielded satisfactory results. | Can TMS cause anxiety?It is very unlikely for TMS to ever cause anxiety, in fact, it is used to treat anxiety off-label. However, there is a remote possibility for TMS to unmask anxiety symptoms that were underlying a severe depression. It's worth mentioning that if a patient with bipolar disorder undergoes TMS for the treatment of depression, there is a significant chance of experiencing a hypomanic or manic episode. If you have a bipolar disorder, you will want to be sure that the provider is treating you for bipolar and not depression. |
Can TMS be used for bipolar?TMS is currently under investigation for its use in treating Bipolar disorder. It is currently not FDA-approved for Bipolar Depression, but ongoing studies are showing some positive results. It's worth mentioning that if a patient with bipolar disorder undergoes TMS for the treatment of depression, there is a significant chance of experiencing a hypomanic or manic episode. If you have a bipolar disorder, you will want to be sure that the provider is treating you for bipolar and not depression. | Can TMS make you tired?It's quite normal to feel a bit tired after the initial TMS treatments. Think of it as a brain workout! Interestingly, some patients actually find this fatigue to be a positive outcome, especially those who struggle with insomnia caused by depression. |
Can TMS cause headaches?TMS may lead to scalp tenderness while receiving the treatment pulses, but it usually doesn't result in a long-lasting headache. Headaches and scalp discomfort typically tend to subside as the scalp becomes desensitized, which generally occurs after the first few treatment sessions. If patients are prone to headaches, they can take ibuprofen or acetaminophen before the treatment to prevent a headache. | Can TMS make you smarter?Over the past decade, dozens of studies have found evidence that transcranial stimulation can improve some aspect of brain performance, including attention, memory, math proficiency, reaction time, and creativity. Some studies indicate that this treatment increases brain plasticity, which may help with learning with specific conditions or diagnoses. |
Can TMS cure depression?Depression is considered in terms of “remission” and “recurrence.” TMS can put depression into remission for an extended period of time but there is a possibility, depending on the nature of the patient’s depression, for symptoms can recur down the road. A typical length of remission is 10-12 months. However, most insurance companies will cover a full course of retreatment within 3 months providing the patient meets the insurance medical guidelines for retreatment. | Can TMS cause brain cancer?There is no evidence that shows TMS can at all cause cancer. It uses the same technology as an MRI. |
When does TMS start working?The basic answer to this question is that the time to respond to TMS therapy varies. Many patients begin to feel some relief of their symptoms between treatments 10-15. However, some patients may not respond until the last week of treatment. There are a number of variables that can have a significant impact on when a patient responds, as well as how well they respond by the end of treatment. These can include:
It is highly recommended that patients complete the TMS course to give them the best chance possible of achieving optimal results from the treatment. | How does TMS feel?Everyone describes TMS treatment differently, but most patients find it somewhat relaxing after the first few treatments. At first, it may take a few treatments to get used to the ‘tapping’ sensation on the scalp. But, most patients tend to tolerate the treatment very well and respond favorably. |
