Am I a candidate for TMS therapy?
A clinical guide to determining whether Transcranial Magnetic Stimulation is the right next step for your depression recovery. TMS is offered at our Orland Park office.
Key Clinical Takeaways
- The first FDA clearance for TMS (2008) covers adults with major depressive disorder who have not improved enough with a prior antidepressant at an adequate dose and duration in the current episode.
- People who have had trouble tolerating antidepressant side effects may also want to ask about TMS; your provider will decide whether it is appropriate.
- Insurance coverage and requirements vary by plan; many plans ask for records of prior medication trials before approving TMS.
- Conductive, ferromagnetic, or other magnetic-sensitive metal implanted in or near the head is a contraindication, so tell your provider about any implants.
The Primary Clinical Criteria for TMS
TMS was first cleared by the FDA in 2008 for adults with Major Depressive Disorder (MDD) who have not achieved satisfactory improvement from one prior antidepressant medication at an adequate dose and duration in the current episode. When two or more adequate antidepressant trials have not helped enough, the condition is often called Treatment-Resistant Depression (TRD).
TMS may be worth discussing with your provider if any of the following apply to you:
- ✓Ineffective Medication Trials: You have taken one or more antidepressants at an adequate dose and for an adequate length of time without enough improvement.
- ✓Difficult Medication Side Effects: You have had trouble tolerating antidepressants because of side effects such as fatigue, weight gain, emotional numbness, stomach upset, or sexual dysfunction.
- ✓Preference for a Non-Medication Option: You would prefer a treatment option that is not a medication.
Important Medical Contraindications
Because TMS uses strong, focused magnetic fields, safety screening for metal and implanted devices is required. According to FDA guidance for TMS devices, TMS is contraindicated in people who have conductive, ferromagnetic, or other magnetic-sensitive metal implanted in their head or within 30 centimeters (about 12 inches) of the treatment coil.
- Aneurysm clips or coils in the brain
- Cochlear implants or deep brain stimulators
- Metallic fragments or shrapnel in or near the head
- Epilepsy or a history of seizures (this needs careful evaluation, because TMS can rarely trigger a seizure)
Note: Some TMS device labeling states that standard amalgam dental fillings are not affected by the magnetic field. Tell your provider about all dental work, braces, and any implants or devices elsewhere in your body, such as stents or pacemakers, so they can check whether these affect your eligibility.