TMS Transcranial Magnetic Stimulation: The Latest in Physiatry

TMS therapy, also known as Transcranial Magnetic Stimulation,  is one of the most innovative medical procedures in psychiatry today for major depressive disorder. Traditionally, medications are the first line of treatment, but effectiveness varies among people with major depressive disorder. When not effective, new medications must be prescribed, patients must be closely monitored and, when all else fails, Electronic Convulsive Therapy (ECT) is often the final choice. Today, TMS therapy has moved to the forefront due to many advantages and is now considered the second line approach when initial medications fail or for those who do not wish to take medication.

TMS has offered a means for people with major depressive disorder to experience freedom from the condition for an enhanced quality of life since it was approved by the FDA in 2008.  So, we turned to those who have leveraged their expertise to offer TMS Therapy in order to get their take on TMS Therapy. As Dr. Karl Lanocha of Portsmouth, New Hampshire explains, “TMS therapy has been a major leap forward for people with major depressive disorder. This leap forward has changed the way I evaluate and treat patients. Formerly, treatment consisted of brief monthly visits. Today, TMS Therapy provides me with more time to spend with patients, the opportunity to incorporate mindfulness meditation and cognitive psychotherapy and to potentially achieve enhanced results. I use TMS Therapy for both major depressive disorder and bipolar disorder. Results have been equally impressive for both disorders.”

What are the Biggest Advantages in TMS?

As Dr. Denise Lin MD of Paso Robles CA, explains, “TMS therapy offers a promising solution for people who have major depressive disorder, with the advantages of no anesthesia, no downtime, no medication, and no change in cognition or memory following treatment.”

What is the difference between TMS and ECT?

As Dr. Kevin DiCesare, a psychiatrist of Derry New Hampshire explains, “TMS treatment is sometimes confused with ECT. While both treatments offer brain stimulation, TMS treatment is  a safe outpatient, non-invasive alternative that is not associated with side effects of ECT. ” Alternatively, ECT requires hospitalization and anesthesia and has been linked to  side effects that may inhibit cognition and memory.

Who is an Ideal Candidate for TMS Therapy?

As Dr. John Deirmenjian of  Beverly Hills, CA explains,  “For those who do not respond to anti-depressant medication or are unable to tolerate medication, TMS is is a positive non-invasive treatment modality for depression. ”

What Might Disqualify a Patient from TMS?

As Dr. Richardson of Alpha Behavioral Care PA of Summit, New Jersey explains, “Most patients with major depressive disorder qualify for TMS Therapy when they have not responded to alternative traditional treatments, such as medication or ECT. There are factors that may affect candidacy for treatment.  People with brain tumors or medical devices in their brain are not candidates for TMS Therapy.  Affordability is another factor.  The results of TMS Therapy may be variable, but some patients respond very well for TMS Therapy and feel better.”

What is the Best First Call to Action for People with Depression?

As Dr. Kevin Kinback, of Mission Viejo CA explains, “People need not be intimidated about coming to a psychiatry office for an evaluation. Diagnosis is a diligent process and treatment for major depressive disorder needs to be treated quickly and aggressively for results that can be enhancing for quality of life.”

What are Some of the Common Misconceptions about  Depression Diagnosis and Therapy?

As Dr. Gary L. Malone , Advanced TMS Clinics of Texas, Distinguished Fellow in the APA and a member in the American Academy of Pain Management, explains, “People don’t realize that psychiatry is a science just like chemistry and biology which requires a precise formulation. In psychiatry, I have found that the vast majority of patients in deep depression are more receptive to a combination of therapy and medication. For my patients in severe depression, optimal  treatment plans involve the coupling of western medication and TMS therapy. TMS is likely to be the leading treatment in five to ten years. ”

During TMS treatment, you can lay comfortably relaxed as a band wrapped around your head emits magnetic energy pulses through specific tapping points on your head for approximately thirty-five minutes to stimulate brain function.  Your initial session may last up to one and a half hours in order to customize the level of pulse energy required for an optimal outcome, while helping to ensure you can be as comfortable as possible during treatment. Following the procedure, you can return to all normal activities.  Repeat sessions are required to experience results, which occurred for the vast majority of patients within four weeks of initial treatment during clinical trials. In other cases, results from treatment may become evident over time up to 36 weeks or more.

It’s wonderful that people who are depressed and, in some cases, those with bipolar disorder, can now have an approach that is unlike a drug or ECT that may produce short or long term side effects. The treatment is non-systemic, meaning that there is no requirement of oral medication or surgery and there is no medication that enters your circulatory system through the bloodstream.  After nearly twenty years of research, TMS has been deemed safe and effective in the treatment of major depressive disorder and is pending approval for the treatment of bipolar disorder.   In fact, insurance companies now have the option to offer coverage for people interested in TMS.

It is important to recognize that there are benefits and risks associated with all medical procedures and drugs. It is also important to recognize that all information contained on this website cannot be considered to be specific medical diagnosis, medical treatment, or medical advice. As always, you should consult with a physician regarding any medical condition.