Transcranial Magnetic Stiumulation Therapy
Transcranial Magnetic Stiumulation (TMS) - Therapy for Depression
Transcranial magnetic stimulation (TMS) therapy uses magnetic pulses to stimulate the area of the brain that is involved in depression.
TMS is CE approved in Europe and FDA cleared in America for the treatment of depression, with approval by the UK National Institute of Health and Care Excellence and recommended by the American Psychiatric Association.TMS passes an electric current through a magnetic coil on top of a patient’s head. This generates a brief but intense magnetic field which influences electrical activity in the area of the brain directly beneath the coil.
You will be seated comfortably in a reclining chair and given ear plugs to protect your hearing from the loud clicking noise made by the TMS coil. You will feel a tapping sensation on your head underneath the coil.
A typical course of TMS therapy consists of treatments that are 40 to 60 minutes in duration, 5 days per week for 6 weeks. If necessary, treatments of shorter duration and lesser or greater frequency may be possible.
TMS and Depression:
Depression is a common disorder that can last for weeks to years, is often recurrent, and can have devastating effects on a person’s ability to function at work or cope with daily life. Symptoms of depression include persistent sadness, decreased motivation, feeling hopeless or worthless, and experiencing a lack of pleasure from activities that you would normally enjoy. Depression is commonly treated with antidepressant medications and psychotherapy, however not all patients respond well to these treatments.
Common side effects of antidepressant medications include dry mouth, weight gain, nausea, constipation, diarrhea, insomnia, drowsiness, blurred vision, anxiety, tremors, sweating, and sexual dysfunction.TMS, on the other hand, has few adverse effects. Stimulation may cause mild headaches in the early stages of treatment, however this can be treated with standard pain relievers (e.g. paracetamol/acetaminophen).
Are there Risks with TMS?
As with any type of brain stimulation there is the inherent risk of causing a seizure. This risk is very low with TMS when proper safety protocols are followed. As preventative measures we will perform a TMS safety screen and stimulation intensity test prior to treatment. The TMS safety screen includes medical history and a complete list of current medications. Consumption of recreational drugs and excessive amounts of alcohol is not permitted during the treatment period. The stimulation intensity procedure determines the lowest level of stimulation required for treatment, which will be safely below the level of stimulation that could cause a seizure.
In addition to mild headaches, TMS could cause temporary ringing in the ears although this is highly unlikely given that ear plugs are worn during treatment. Stimulation may cause twitching of facial muscles however this is easily stopped by changing coil orientation on the patient’s head. The risk of stimulation-induced mania is low and carefully monitored. Cognitive side effects are infrequent and even then only transient.
After each session you can resume your normal daily activities including driving or returning to work, and thus TMS is ideal for occupations that do not permit employees to be under the influence of psychoactive (brain-altering) substances such as antidepressant medications.
Who may not be Suitable for TMS?
- Patients with metal in their head or neck, including exposure to metal fragments, excluding titanium dental work.
- Patients with medical devices implanted in their head, such as cochlear implants or deep brain stimulators.
- Patients with medical devices implanted outside their head, such as pacemakers and medication pumps.
- Patients with history of neurological disorders or traumatic brain injury.
- Patients with family history of epilepsy or seizure.
- Pregnant patients will require additional consultation with their obstetrician.
- Patients under the age of 18 will require consultation with an adolescent psychiatrist.
If you are interested in TMS therapy for depression, please consult your doctor.
TMS Therapy for Depression