Transcranial Magnetic Stimulation (TMS) is quickly becoming the preferred method for treating Major Depressive Disorder and OCD across the board. There are many reasons why TMS is the talk of the town, notably its efficacy as a non-medicinal, non-invasive, and non-surgical procedure. TMS utilizes targeted magnetic fields to stimulate nerve cells in problematic areas of the brain thought to be responsible for MDD. TMS is particularly effective when other methods of treatment have failed, such as medication and therapy. When the treatment is administered multiple times, by way of repetitive magnetic pulses, it becomes known as rTMS or repetitive TMS.
How Effective Are Antidepressant Medications?
There is a split in the medical community (and among patients) regarding the efficacy of antidepressants. There are those who believe that they are highly effective, essential treatment regimens. And, there are those who believe that antidepressants aren’t as effective as they ought to be for treating depression. Truth be told, it isn’t a one size fits all solution. Antidepressants can have side effects, and these can vary in severity from patient to patient. While the goal is to treat depression, fatigue, sleep deprivation, suicidal thoughts, and irritability, antidepressant medications can also create problems. Severe side effects are rare but include epileptic fits, heart problems, sexual dysfunction, unsteadiness, dizziness, and suicidal thoughts.
Whenever a chemical substance is introduced into the body, it may be tolerated well or poorly. It also interacts with other medications and substances that a patient may be taking. For these reasons, it is important to consult with a general practitioner or psychiatrist to ensure that any untoward side effects are reported. Despite the possible downsides, antidepressants such as SSRIs and SNRIs are statistically more likely to prevent relapse within 1-2 years, and they are more likely to result in an improvement of depressive symptoms within 6-8 weeks. These studies were confirmed by NCBI. For example, without antidepressants, relapses occurred with 50/100 people within 1-2 years. With antidepressants, 23/100 people had a relapse within 1-2 years.
rTMS Coupled with Medication
Repetitive Transcranial Magnetic Stimulation sessions are characterized by specialized electromagnetic coils positioned against the patient’s skull, alongside the forehead. Magnetic pulses are then delivered painlessly and targeted at nerve cells in the part of the brain that is responsible for mood. With depression, there is likely decreased activity in that part of the brain. The TMS then activates those regions of the brain, to ease symptoms of depression, and improve the patient’s mood. rTMS is often the go-to solution when therapy and medication are not effective at treating symptoms of depression. Naturally, a degree of skepticism is healthy, given that this is a breakthrough technology.
What are the Risks Associated with Repetitive Transcranial Magnetic Stimulation?
Risk is elevated whenever medication is being ingested, or surgical procedures are being undertaken. Medications can have unwanted side effects, some of which are severe. Surgical procedures such as Deep Brain Stimulation (DBS), Vagal Nerve Stimulation (VNS), and Responsive Neurostimulation Devices (RND) can bring about side-effects, such as complications from anesthesia, risk of infection, scar tissue, incorrectly performed procedures, and their attendant risks, et al. Yet, TMS is not a surgical procedure. There is no anesthesia, and therefore no risk of infection, and extremely limited risk of injury. The traditional form of rTMS treatment is based upon a figure 8 coil design. Deep TMS™ utilizes a proprietary H-Coil helmet design which is able to directly stimulate deeper brain structures. This wider scope of treatment largely reduces targeting-related issues, increases efficiency, and enhances outcomes.
As for risk factors associated with Deep Transcranial Magnetic Stimulation and Repetitive Transcranial Magnetic Stimulation, they are mild. According to the Mayo Clinic, the following side effects have been reported with TMS in general:
- A headache
- A feeling of lightheadedness
- Discomfort at the site of TMS stimulation
- Twitching of facial muscles, or slight tingling of the scalp
Fortunately, these common side effects typically pass once the treatment has ended. On rare occasions, uncommon side effects may result. These are more severe and may warrant medical attention:
- Patients may experience seizures
- Patients with bipolar disorder may experience mania
- If inadequate ear protection is worn, hearing loss may result
Doctors are careful to conduct a thorough medical examination prior to administering rTMS or Deep TMS with patients. For example, it is important to inform doctors if you have implants such as stimulators, have been treated with VNS or deep brain stimulators, electrical devices, magnetic implants, or have bullet fragments in your body, etc. Other potentially disqualifying criteria include specific medical conditions, severe headaches, brain damage, seizures, or additional mental health disorders.
Why is TMS Getting So Much Attention Nowadays?
According to FDA.gov, the US Food and Drug Administration approved the marketing of the Brainsway Deep Transcranial Magnetic Stimulation System for treating Obsessive-Compulsive Disorder in August 2018. The director of the division of neurological and physical medicine devices in the FDA’s centers for devices and radiological health, Dr. Carlos Peña had this to say, ‘Transcranial magnetic stimulation has shown its potential to help patients suffering from depression and headaches.’ Naturally, a glowing endorsement from the FDA has helped to introduce Deep TMS as a legitimate, credible, and efficacious treatment option for depression and anxious depression, as well as the only FDA-cleared treatment for OCD and Smoking Addiction.
The FDA based its determination on an in-depth randomized, multi-center study of 100 patients. 51 of these patients were receiving a sham treatment with the Deep TMS device and 49 patients received the authentic BrainsWay treatment. According to the outcomes, 38% of patients responded favorably to the BrainsWay device treatment. Just 11% of patients responded favorably to the sham device that was used. FDA approval fast-tracked the acceptance of TMS throughout the medical community. But ultimately, it is the pain-free, non-surgical, outpatient procedure (20 minutes – 40 minutes per session, several times a week, for several weeks) that won accolades from patients and the medical community alike. If patients are currently on medication, then the TMS is administered alongside the medication. Likewise, with psychotherapy. However, TMS on its own does not cause adverse chemical reactions like SSRIs or SNRIs, and there is no surgical risk whatsoever. Those are the main reasons why people are charmed by the possibilities with TMS!