What is TMS therapy & how does it treat depression?
An evidence-based overview of Transcranial Magnetic Stimulation: mechanism, clinical evidence, patient experience, and candidacy. TMS is offered at our Orland Park office.
Key Clinical Takeaways
- TMS (Transcranial Magnetic Stimulation) is an FDA-cleared, non-invasive neuromodulation therapy for depression.
- It uses focused magnetic pulses, not medication, to stimulate nerve cells in brain regions involved in mood regulation.
- Sessions typically last from a few minutes to about 40 minutes, and most people can resume normal activities, including driving, afterward.
- It may be considered for depression that has not improved enough with antidepressant medication; your provider will evaluate whether it is right for you.
Understanding Non-Invasive Neuromodulation
Transcranial Magnetic Stimulation (TMS) is a non-invasive treatment first cleared by the US Food and Drug Administration (FDA) in 2008 to treat major depressive disorder in adults who had not improved enough with one prior antidepressant medication. Unlike medications, which circulate throughout the body, TMS focuses stimulation on specific brain areas involved in mood regulation.
Brain-imaging research has linked depression with reduced activity in the left dorsolateral prefrontal cortex (DLPFC), an area involved in mood regulation. During TMS, a magnetic coil placed against the scalp produces a magnetic field about as strong as an MRI scanner's. The pulses pass through the scalp and skull and induce small electrical currents that stimulate nerve cells in the targeted area, which is thought to change activity in mood-related brain circuits over a course of treatment.
The Patient Experience: A Typical Session
A TMS session is an outpatient procedure. You sit in a treatment chair while awake and alert, and a trained member of the care team positions the magnetic coil against your head, usually on the left side.
Key Aspects of Daily Treatment:
- • Auditory & Physical Sensations: The device makes loud clicking sounds, so you wear earplugs or other hearing protection, and you may feel a tapping sensation on your scalp.
- • Awake & Alert: You stay awake throughout the session, which lasts from a few minutes to about 40 minutes depending on the device and protocol.
- • Immediate Resumption of Activities: TMS does not require anesthesia or sedation, so most people can drive and return to their usual activities right after a session.
Where TMS Fits in Depression Treatment
For people whose depression has not responded to antidepressants, other options have included switching or combining medications and electroconvulsive therapy (ECT), which is done under general anesthesia and can cause memory loss, especially around the time of treatment.
TMS offers another option. Because the stimulation is focused on a specific brain area rather than carried through the bloodstream, TMS does not cause medication side effects such as weight gain, sexual dysfunction, or stomach upset. The most common side effects are scalp discomfort at the treatment site and mild headache, which usually lessen over the course of treatment. Seizures are a rare but serious risk.