What is TMS?
Transcranial magnetic stimulation (TMS) is a safe, non-invasive, FDA-approved treatment for depression, obsessive-compulsive disorder (OCD), and other conditions in patients who have not found adequate relief from medication management and therapy.
How TMS works in the brain to relieve depression
TMS helps reduce symptoms of depression by sending magnetic pulses to the left dorsolateral prefrontal cortex (DLPFC), found during the brain mapping process, which is an underactive area of the brain in people with depression.
The pulses sent during TMS treatment activate the neurons in the DLPFC, making this area more active over time to improve depression symptoms. The DLPFC processes a variety of cognitive functions. In addition to working on short-term memory, this area governs a person’s emotional response to people, places, and events. This part of the brain is also active when making risky and difficult decisions.
The activation of the DLPFC also sends signals to different areas of the brain involved with depression. These signals increase and decrease activity levels in these areas, correcting for imbalances and, over time, improving depression symptoms.
The effectiveness of TMS for depression and other mental health conditions
TMS has been proven to be a highly effective treatment for depression. Studies show that:
- About 66% of patients experience significant improvement in symptoms (50% or greater improvement).
- About 33% of patients achieve complete remission (minimal to no symptoms).
These success rates are higher than those from medication and therapy alone. The best results come from combining TMS with antidepressants and therapy to provide comprehensive care.
Most TMS patients notice improvements by the second week of treatment, though some may take longer to experience positive changes. Some patients with a longer or more severe depression history may need more than one TMS treatment series to alleviate depression symptoms.
The FDA has cleared TMS to treat depression in people age 15 and older, OCD, and smoking cessation as an additional treatment alongside therapy or other interventions.
TMS is being studied for other conditions, including cognitive deficits, post-stroke recovery, and pain. Research is also exploring its potential for treating bipolar depression.
Potential side effects and what to expect during treatment?
An average TMS treatment series includes 36 outpatient treatments over six to nine weeks. Each treatment lasts about 20 minutes. Patients can drive themselves to and from their appointments and continue with daily activities, such as work or school.
While side effects are significantly less than those of medications, occasionally, patients report side effects such as a minor headache, feeling tired immediately following treatment or discomfort at the site of treatment. Typically, these side effects resolve within a week of treatment as patients adjust.
TMS for older adults and pregnant patients
TMS is considered a safe and effective treatment for older adults, especially those who have medical conditions that limit their medication options.
Studies also show that TMS is a safe treatment for pregnant and postpartum patients who want to avoid medication due to concerns about their baby’s health. Pregnant patients experience success rates comparable to those of the general population who receive TMS treatment.
