Accelerated transcranial magnetic stimulation (aTMS) is a fairly recent development in the realm of depression treatments, offering quick relief from depression symptoms in as little as two weeks. The treatment is non-invasive and non-systemic, it doesn’t require any medication, and has minimal side effects. Sound too good to be true?
So far, research into aTMS has proven it promising in relieving symptoms in people with major depressive disorder and treatment-resistant depression. Unlike conventional treatments, like medication or psychotherapy, aTMS can deliver results in days instead of weeks or months. But can these results be sustained?
In this article, we explore what aTMS is, how it works, and how it compares to traditional TMS therapy. We also showcase different research into the effectiveness of aTMS in treating depression symptoms.
What is aTMS?
Accelerated transcranial magnetic stimulation (aTMS) is a revolutionary depression treatment designed to provide fast relief from symptoms. It’s a more intensive version of traditional TMS therapy, which uses magnetic pulses to stimulate specific parts of the brain involved in mood regulation. Instead of delivering treatments once a day over a period of 4 to 6 weeks, aTMS is administered several times a day over just two weeks.
Just like TMS, aTMS works by sending repetitive magnetic pulses to the brain’s left dorsolateral prefrontal cortex (DLPFC), an area known to be underactive in people with depression. These pulses help release important neurotransmitters, like dopamine and serotonin, promoting healthy neural pathways and improving mood.
aTMS is especially valuable for people who have not responded to conventional treatments, such as medication or talk therapy, or experienced unpleasant side effects (otherwise known as treatment-resistant depression). One of the main benefits of aTMS is that it’s non-invasive and non-systemic, with none of the side effects typically associated with medications, like weight gain, fatigue, or sexual dysfunction. It’s also free of the cognitive and memory-related side effects linked to electroconvulsive therapy (ECT).
See: Who Qualifies for TMS Therapy? (TMS Requirements)
What can aTMS help treat?
Just like traditional transcranial magnetic stimulation (TMS) therapy, aTMS can help treat various mental health conditions, including:
- Major depressive disorder (MDD)
- Treatment-resistant depression (TRD)
- Obsessive-compulsive disorder (OCD)
- Migraines
- Fibromyalgia
- Parkinson’s disease
- Bipolar depression.
Note: At the moment, TMS therapy is only FDA-approved for the treatment of major depression in people aged 15 and over, OCD, migraines, and smoking cessation. While research shows the treatment can effectively relieve other psychiatric disorders, its use is considered off-label.
Keep reading: Is TMS Appropriate for Treating Adolescents With Depression?
How does aTMS work?
aTMS helps treat depression and other mental health conditions by using magnetic pulses to stimulate specific regions of the brain involved in mood regulation. The key target area is the dorsolateral prefrontal cortex (DLPFC), which is often underactive in people with depression. aTMS aims to relieves depressive symptoms by stimulating this part of the brain and encouraging healthier patterns of brain activity.
During an aTMS session, magnetic pulses are delivered to the brain through a coil placed on the scalp. These pulses generate electrical currents in the DLPFC, releasing neuotransmitters like dopamine and serotonin. This helps ‘rewire’ the brain, improving mood and alleviating symptoms of depression.
Unlike other treatments, such as ECT, aTMS is non-invasive and doesn’t require anesthesia or sedation. Sessions last just a few minutes each and patients experience little to no discomfort. Because aTMS is non-systemic, it doesn’t affect the body in the way medications do, meaning there are no long-term physical side effects like those seen with antidepressants.
What to expect from an aTMS session
aTMs sessions are simple, quick, and painless. Here’s what to expect from the process:
- Preparation: Whe you arrive, you’ll be seated in a comfortable reclining chair. Your TMS technician will answer any questions you might have and give you earplugs to minimize noise during the treatment. They’ll make sure you’re nice and relaxed before starting treatment.
- Placing the coil: During your first session, the technician will measure your head to find the ideal position for the magnetic coil – your left dorsolateral prefrontal cortex. They’ll also find your ‘motor threshold’, the lowest intensity of magnetic pulses needed to initiate a motor response. This helps personalize the treatment for you.
- Stimulation: The coil will deliver targeted magnetic pulses to stimulate regions of your brain linked to depression.
- Sensation: During the treatment, you might feel a light tapping sensation on your scalp and hear a clicking sound. Some patients also feel a light twitching or tingling of their facial muscles. Don’t worry, the treatment is painless!
- Monitoring: Your TMS technician will be by your side monitoring your comfort throughout the sessions and adjusting the intensity of pulses as required.
Each aTMS session lasts about 9 minutes, and you’ll be fully awake and relax throughout the whole treatment. Once the session is over, you’ll enjoy a rest break of about 45 minutes. During your break, you’re free to do what you like, whether that’s reading, working remotely, studying, or listening to music. After the break, you can begin the next session. aTMS is usually delivered 3 to 5 times a day, five days a week, for two weeks.
aTMS vs traditional TMS therapy
Both aTMS and traditional TMS therapy are ideal treatments for people seeking relief from depression, although there are four key differences between the two treatments:
- Treatment duration: aTMS sessions are usually 9 minutes long, administered multiple times a day so that patients complete treatments within just two weeks. Traditional TMS sessions last around 20 to 30 minutes and are usually given once a day for 4 to 6 weeks.
- Time commitment: aTMS requires a shorter time commitment compared to traditional TMS, making it more accessible for those juggling busy schedules, travelling long distances for treatment, or needing quick relief from symptoms.
- Efficacy: Both aTMS and TMS therapy are effective at relieving depression symptoms, however research suggests that aTMS potentially has a higher rate of response and remission.
- Insurance: Insurance coverage for aTMS can be more limited than for TMS, which is well-established and more widely available.
Keep Reading: How TMS Helps Military Members & Dependents
Benefits of aTMS for depression
aTMS offers numerous benefits for those seeking relief from depressive symptoms, including:
Fast relief from symptoms
Compared to other depression treatments, like medication and psychotherapy, which take weeks for relief, aTMS can alleviate symptoms in just a few days. By condensing the traditional TMS process into a much shorter timeframe, aTMS allows patients to relieve symptoms and improve mental well-being more quickly.
High response and remission rates
Clinical studies have shown that aTMS can lead to higher response and remission rates in patients with treatment-resistant depression. Some studies report remission rates as high as 55 to 70%, even within the first week of treatment.
Minimal side effects
Compared to other depression treatments, like ECT or antidepressants, aTMS has minimal side effects. When side effects are reported, they tend to be mild and temporary, disappearing on their own within a few hours after treatment.
Non-invasive and drug-free
Like traditional TMS, aTMS is a non-invasive procedure that doesn’t require anesthesia or medication. This makes it an appealing option for those who experience side effects from antidpressants or prefer to avoid medication.
See More: Do Antidepressants Work and How Effective Are They?
Well-tolerated across age groups
aTMS is a well-tolerated treatment for both teens (aged 15+) and adults, offering a safe and effective alternative to those who don’t respond well to medication. It has been shown to be effective for younger patients with treatment-resistant depression.
Long-term effects
People who undergo aTMS often experience sustained improvements in their symptoms, with studies showing that the positive effects can last for several months after treatment. This means aTMS can help patients maintain their mental health in the long-term, even if additional ‘top-up’ treatment sessions are required.
Convenience
By delivering depression treatment in just two weeks, aTMS is a more convenient form of TMS therapy. It’s especially suitable for those juggling busy lifestyles or needing to travel long distances for treatment, condensing the therapy into just two weeks instead of the usual 4 to 6 weeks needed for TMS.
Is aTMS effective for depression?
If you’re considering aTMS for depression, you’ll likely want to know how effective it is in treating depressive symptoms. The good news is that, although aTMS is a relatively new approach to depression treatment, many studies have already demonstrated its effectiveness in relieving symptoms. Let’s take a look at some of the research.
Short-term and long-term efficacy of aTMS for depression
This systematic review and meta-analysis by Ruifeng Shi et al. examined how effective aTMS was in treating patients with major depressive disorder (MDD). It combined data from four randomized controlled trials (RCTs) and 10 before-and-after controlled studies, analyzing the depression symptoms of over 400 patients before and after aTMS treatment.
The findings showed significant improvements in depression scores after treatment, meaning aTMS was effective in reducing depressive symptoms. Here’s a breakdown of the key results:
- Before-and-after results: Patients who received aTMS treatments showed much lower depression scores after treatment compared to before. This shows that aTMS can effectively relieve depressive symptoms in people with MDD. clinical outcomes // hshshsh
- Subgroup analysis: Two different types of aTMS were compared in the study – repetitive transcranial magnetic stimulation (rTMS) and intermittent theta burst stimulation (iTBS). Both methods showed significant improvements in depression, but iTBS had a slightly higher impact.
- Factors affecting results: The study also examined whether factors like age, gender, or depression severity influenced clinical outcomes. Results showed that men responded better to the treatment, while age and depression severity didn’t seem to make a difference.
- Sustained benefits: The positive effects of aTMs were shown to last beyond the initial treatment period, with depression scores remaining lower even at follow-up. With iTBS, however, there was no significant difference between post-treatment and follow-up scores.
- Comparison with standard TMS: The study compared aTMS to the short-term and long-term efficacy of TMS treatment and found there was no significant difference in how much they improved depression symptoms – both treatments were found to be effective.
aTMS for treatment-resistant depression
This study by Paul E. Holtzheimer, III et al. explored the safety and efficacy of aTMS delivered over two days in depressed patients who hadn’t found relief from antidepressants. It included 9 men and 5 women ranging from 20 to 74 years old. Some of these patients had been struggling with depression for as long as 8 years and had previous psychiatric hospitalizations and suicide attempts.
aTMS was administered to these patients seven times a day for just two days. Here’s a breakdown of the key findings:
- Side effects: There were no serious side effects reported.
- Effectiveness: The treatment showed significant improvements in depression symptoms by Day 3 and this improvement continued through Week 6. Specifically, depression scores dropped by 47% by Day 3, 45% by Week 3, and 55% by Week 6, showing a great reduction in symptoms.
Overall, the study found that TMS was effective in reducing depressive symptoms in people with treatment-resistant depression.
Similar Reading: What to Do When Antidepressants Don’t Work for You (and Why)
Other research into aTMS
Beyond these two studies, other research points towards aTMS being an effective treatment option for depression. Let’s recap some of the major findings:
- One pilot study into the safety and efficacy of aTMS found that 55% of patients achieved remission within the first week of aTMS, with the remission rate rising to 70% as treatment continued. 55% of those who didn’t fully experience remission saw at least a 50% reduction in their symptoms.
- Another study into accelerated deep transcranial magnetic stimulation (deep aTMS) showed an 80% response rate amongst patients, with 51% achieving remission after just a single treatment cycle.
- A third study in the American Journal of Psychiatry explored the effectiveness of iTBS (a form of aTMS) in patients with treatment-resistant depression. 90.5% of paritcipants met remission criteria after treatment.
All of these studies show promising results in using aTMS to treat depression quickly, however more research is needed to confirm its long-term efficacy in sustaining results after treatment.
Explore aTMS for depression
aTMS is a revolutionary depression treatment that can alleviate symptoms quickly and effectively. By condensing traditional TMS therapy into a shorter period, aTMS is more accessible for people juggling busy lifestyles or needing to travel long distances for treatment. While more research is needed into its long-term effects, current results show promise, especially when compared to conventional depression treatments.
If you’d like to explore aTMS therapy for your depression, don’t hesitate to contact us at BestMind Behavioral Health. We offer aTMS therapy at our comfortable clinics in Colorado and Oregon and our team is ready to support you with personalized guidance and compassionate care.
