Transcranial Magnetic Stimulation (TMS) therapy is a breakthrough procedure for treating depression and other mental health conditions. The non-invasive treatment uses MRI strength magnetic pulses to activate regions of the brain that are underactive in patients with depression.
TMS therapy is particularly effective for people struggling with treatment-resistant depression or are unable to tolerate antidepressant medications due to side effects. It’s also being investigated for its potential in treating other conditions, such as anxiety, bipolar disorder, obsessive compulsive disorder, and chronic pain.
Before beginning TMS therapy, you must meet certain eligibility criteria. There are also some complicating factors that can disqualify you from receiving TMS therapy. In this article, we look at TMS therapy, what conditions it treats, who qualifies for TMS therapy, and what makes you ineligible for treatment.
What is TMS therapy?
Transcranial Magnetic Stimulation (TMS) therapy is a revolutionary FDA-approved procedure used to treat depression and related mental health conditions. During a TMS session, painless magnetic pulses are transmitted through the scalp to stimulate nerve cells in parts of the brain associated with mood regulation and depression.
TMS therapy is helpful for people with treatment-resistant depression or those who haven’t found relief or do not tolerate medications due to side effects. The treatment is non-invasive and doesn’t require anesthesia or sedation, so patients can go home and resume normal activities afterwards. Each session lasts around 20 minutes. Early in the treatment, multiple sessions are needed each week for a number of weeks. Following that, only maintenance therapy sessions are required. TMS therapy is generally well-tolerated with few side effects.
TMS therapy is sometimes referred to as rTMS (Repetitive Transcranial Magnetic Stimulation). This is due to the repetitive magnetic pulses used in the treatment.
What conditions does TMS treat?
TMS therapy has been approved by the US Federal Drug Administration (FDA) for the treatment of major depressive disorder (MDD), particularly for those who haven’t found relief from traditional treatments (also known as treatment-resistant depression). It is also FDA-approved as an ‘adjunct’ treatment for adults suffering from obsessive-compulsive disorder (OCD).
However, TMS therapy is also being investigated for its potential in treating other mental health conditions such as:
- Bipolar disorder
- Generalized anxiety disorder (GAD)
- Post-traumatic stress disorder (PTSD)
- Autism spectrum disorders
- Parkinson’s disease
- Attention-deficit hyperactivity disorder (ADHD)
- Chronic pain (i.e. migraine headaches or fibromyalgia)
- Substance dependence, including alcohol and nicotine addiction
- Schizophrenia .
It’s important to note that while TMS may be effective for some individuals with these conditions, it’s not yet considered an established treatment the way it is for major depressive disorder. Research into its effectiveness for these disorders is ongoing and its use may depend on your individual circumstances or healthcare provider recommendations.
Generally, TMS therapy is used to treat major depressive disorder and treatment-resistant depression. Patients may be referred to TMS therapy if they:
- Have not responded to antidepressant medication or other treatments
- Want to try an alternative to medication
- Cannot tolerate antidepressant medications due to side effects.
What happens during TMS therapy?
TMS therapy is a non-invasive and non-systemic treatment. A typical TMS treatment involves the following steps:
- Preparation: The patient is seated comfortably in a chair while a technician ensures their head is positioned correctly. They will answer any questions and ensure the patient is comfortable and relaxed before treatment begins.
- Placement of the coil: The TMS technician places an electromagnetic coil against the patient’s scalp, near the forehead. This coil targets specific regions of the brain associated with mood regulation, which tend to be underactive in people with depression. The target location is called the dorsolateral prefrontal cortex (DLPFC), located above the left eye near the hairline.
- Stimulation: Repetitive magnetic pulses are delivered through the coil to the targeted areas of the brain. These pulses are painless and non-invasive. They create small electric currents in the brain tissue that stimulate nerve cells. As these nerve cells are activated, they release neurotransmitters which improve communication between different parts of the brain.
- Sensation: During the session, the patient may feel a tapping or clicking sensation on their scalp as the magnetic pulses are delivered. Some patients also report feeling a mild tingling or twitching in the scalp or facial muscles.
- Monitoring: Throughout the session, the technician will monitor the patient’s comfort level and adjust the intensity of the magnetic pulses as needed. A typical TMS session lasts around 20-40 minutes, depending on the treatment protocol prescribed by the healthcare provider.
- Post-session: After a TMS session, the patient is free to resume their normal activities without any downtime or recovery period. They can drive themselves home, to work, or school and continue the day as usual.
- Follow-ups: TMS therapy is usually administered over multiple sessions, typically a total of 36 sessions over several weeks. The exact number of sessions will vary depending on each person’s condition and response to the therapy. .
Benefits & effectiveness of TMS therapy
TMS therapy offers numerous advantages when compared to traditional treatments. We outline some of these below.
High success rate
According to Harvard Medical School, more than half of people with depression who’ve tried and failed to benefit from medications respond well to TMS therapy. About one third of these experience a full remission with symptoms disappearing completely. While these results are long-lasting, TMS therapy is an acute treatment and follow-up maintenance treatments are recommended to prevent recurrence.
Long-term benefits
Research suggests that the benefits of TMS can be sustained over time to improve mood and overall quality of life. One study tracked TMS patients for a year after treatment. 62.5% of those who responded to TMS were still doing better a year later and 45.1% of those who achieved remission were still living with no symptoms. On top of that, 84.2% of patients who benefited from TMS but didn’t go into remission after their first round of treatment did so during the second round.
Few side effects
While TMS therapy does have some side effects, they are minimal compared to other depression treatments, such as antidepressants. The most common side effects reported during TMS treatment are mild headaches, scalp discomfort, fatigue, and tingling of facial muscles. These tend to be mild and short-lived, lasting only an hour or two after treatment and usually disappearing within a couple of weeks as the body adjusts to treatment.
Non-systemic
Unlike antidepressant medications, which are taken orally and circulate throughout the body, TMS therapy targets specific regions of the brain without affecting other organs or systems. This means TMS doesn’t cause systemic side effects commonly associated with medications, such as weight gain, sexual dysfunction, or gastrointestinal disturbances.
Customizable treatment
TMS therapy can be tailored to each individual’s needs and preferences. The intensity and frequency of magnetic pulses can be adjusted as needed to improve outcomes and minimize discomfort or side effects.
Who qualifies for TMS therapy?
To qualify for TMS therapy, patients must be over 18, diagnosed with major depressive disorder (MDD) or treatment-resistant depression (TRD) and:
- Have tried at least two different antidepressants from two classes (SSRIs, SNRIs, or MAOIs) without seeing results, OR
- Be unable to tolerate the side effects of antidepressant medications, OR
- Have an illness that limits their ability to use antidepressants.
Patients must also be currently experiencing a depressive episode.
TMS therapy is also a valuable treatment for anxiety disorders, bipolar disorders, and other mental health conditions. If you have one of these conditions and are unsure if you qualify for TMS therapy, it’s best to speak to a mental health professional who can assess your needs and provide tailored advice.
Who is not eligible for TMS therapy?
There are some cases where a person who meets all the above criteria is ineligible to receive TMS therapy. Factors that can disqualify you from TMS therapy include:
- History of neurological conditions, such as seizure or epilepsy
- Pregnancy or nursing
- Brain illness, traumatic brain injury, brain tumor, or stroke
- Substance abuse
- Implanted medical devices or non-removal metal objects in the cranium (i.e. bullet fragments), not including metallic fillings
- Cochlear hearing implants
- Implanted medical devices, such as pacemakers, vagus nerve stimulators, aneurysm clips, or heart stents.
Cost and insurance
The cost of TMS therapy can vary depending on where you are, your provider, and the number of treatments required. Thankfully, more insurance providers are beginning to cover TMS treatments for major depression and other mental health disorders. Before beginning treatment, it’s important to check your insurance plan.
If you have any questions about your coverage, feel free to reach out to the BestMind team and we can check eligibility. You can also view some of the most popular insurances we accept on this page.
Summary: Who qualifies for TMS therapy?
If you haven’t found relief from traditional depression treatments, or struggle with medication side effects, TMS therapy may provide the relief you’re looking for.
To learn more about this treatment, check insurance coverage, and schedule a consultation, reach out to the BestMind team or book a consultation through our online portal. We offer TMS therapy treatments from our cozy, discrete clinics in Colorado and Oregon, and we’d love to support you on your journey to better well-being.
FAQs: TMS therapy
Got some lingering questions? We answer some of the most commonly asked questions about TMS therapy below.
How many TMS sessions do I need?
In most cases, TMS therapy is prescribed for a total of 36 sessions to provide long-term relief from major depression and treatment-resistant depression. This is typically conducted over several weeks with five treatments a week. Each session lasts around 20 minutes, and you’re free to drive home afterwards and continue your day as normal.
What if I cannot come in daily?
TMS therapy research has focused on providing daily sessions over a number of weeks. We don’t have enough data to know whether TMS will be effective if delivered less frequently. If you’re concerned about your ability to attend daily sessions, speak to our team.
What is involved in a TMS induction?
Your first TMS session is called an induction. This involves brain mapping, motor threshold determination, and a TMS session. During your TMS induction, we’ll start by mapping out a region on your scalp that correlates to the dorsolateral prefrontal cortex (DLPFC), the region that’s targeted by TMS.
We’ll then test out the minimum energy required to activate your brain. This is called the resting motor threshold and it lets us know how much magnetic stimulation you’ll need during treatments. To do this, we stimulate the part of your brain that controls your right hand until we observe a muscle twitch. Once we know your resting motor threshold, we’ll begin the TMS treatment as normal.
How do I schedule a TMS therapy with BestMind?
Before you begin TMS therapy, a consultation is needed to evaluate your symptoms and needs. You can book a free consultation with our team by filling in the form on this page. You can also call any of our Colorado or Oregon clinics with the phone numbers listed on our Contact Us page.
Is TMS covered under my insurance?
TMS is covered by most health insurances for the treatment of major depressive disorder and treatment-resistant depression. If you’re not sure of your coverage, please contact our team and we can check your eligibility. You can also see a list of insurances we accept on our coverage page.
How long has TMS therapy been researched for?
TMS therapy has been researched for several decades. The first non-invasive magnetic stimulation of the motor cortex was reported in 1985 by Barker et al. Since then, researchers have been investigating the therapeutic potential of TMS for various psychiatric and neurological conditions, including depression, chronic pain, anxiety, and more.
Clinical trials focusing on the effectiveness and safety of TMS for depression started in the 1990s. The first major trial was published in the late 2000s after TMS was tested in hospitals around North American and Australia. It was this trial that led to TMS being FDA-approved for the treatment of depression in those who haven’t responded to medications.
Are there patients that don’t respond to TMS?
Yes, while TMS therapy can be effective for many people, there are some patients who may not respond to treatment or experience only partial improvement.
Can I continue to take my medication while I receive TMS?
Yes, in many cases you can continue to take your medication while receiving TMS therapy. The treatment can be used as an adjunctive therapy alongside antidepressants. That said, each case is different and we’ll carefully work with you to optimize your treatment and reduce any potential risks.
