For those dealing with depression, especially when traditional treatments fall short, finding an effective treatment can feel like an uphill battle. This leads many to wonder how effective TMS is. Transcranial Magnetic Stimulation (TMS) has gained attention as a promising, non-invasive option for those who have not experienced success with medications or therapy. As we continue to research and learn about TMS, its potential to provide real, lasting results continues to grow.
Does TMS Actually Work?
Yes, TMS has been proven to be effective, especially for those dealing with treatment-resistant depression – meaning their symptoms haven’t improved with traditional depression treatments. Around 20% of people with depression fall into this category. TMS has been approved by the U.S. Food and Drug Administration (FDA) for treating major depressive disorder.
Reported Success Rates for TMS
The success rates for TMS are promising. Research shows that TMS can help improve depressive symptoms, and in some cases, even lead to full remission. Here are some success rates researchers have seen:
- 50-60% of people with treatment-resistant depression see improvements after TMS.
- One-third of those individuals achieve full remission, which means their symptoms disappear entirely.
- In a study on Deep TMS, after 30 sessions, nearly 80% of participants saw improvements, and 60% reached remission.
- The highest success rates were observed using the Hamilton Depression Rating Scale (HDRS), where 89% saw improvement in symptoms, and 78% achieved remission.
- A Stanford study found a 90% remission rate in a small group of participants with severe, medication-resistant depression.
Are the Results Permanent?
The results of TMS are not necessarily permanent. On average, patients see improvement in depressive symptoms for around five months before symptoms may come back. The good news is that maintenance sessions can help prolong the benefits. Some patients remain symptom-free for much longer, especially if they combine TMS with other treatments. The timeline really depends on each person’s situation.
How Many Sessions Are Typically Required?
A typical course of TMS treatment is about 36 sessions. Patients usually attend daily sessions, five times a week, for six weeks. Toward the end of the treatment, the sessions may taper off as the brain adjusts and the symptoms improve.
What Can Affect the Success Rates of TMS Treatment?
While TMS has shown to be an effective treatment for many, it’s important to remember that success rates can vary. Different factors can influence how well someone responds to treatment, including personal and treatment specific factors.
Patient-Specific Factors
Each person’s unique circumstances can affect how successful TMS is for them. For insurance, the severity and length of time someone has been dealing with depression can make a difference. People with more severe or long-lasting symptoms might need more sessions or take longer to notice improvements.
Age can also be a factor. While TMS is effective across age groups, younger people tend to respond more quickly, while old adults might take a bit longer to feel the effects, even though they often see similar overall benefits. Other factors include:
- Overall physical health
- Overall mental health
- Previous treatments and how successful they were
- Any cognitive impairments
Treatment-Specific Factors
The way TMS is delivered is just as important in determining its success. One factor is the intensity and frequency of sessions. Typical treatment requires multiple sessions per week over a period of several weeks. How consistently someone follows this schedule can affect the results.
Also, TMS works by targeting specific areas of the brain with magnetic pulses, and the precision of this targeting can affect how well the treatment works. If the correct brain regions are accurately stimulated, the chances of success increase.
Finally, TMS can be even more effective when combined with other therapies or medications. Some patients benefit from using TMS alongside their current treatments. Others might see better results when it’s used on its own.
TMS vs. Other Treatments
When deciding how to treat depression, it’s worth looking at how TMS compares to other common treatments like medication, ECT (Electroconvulsive Therapy), and psychotherapy. Each treatment has its pros and cons, and understanding them can help you choose what might work best for you.
TMS vs. Medication
TMS and antidepressant medications have similar goals – reducing the symptoms of depression – but they go about it in very different ways. Medications work by altering chemicals in the brain, which can take weeks to kick in and often come with side effects like weight gain, sleep issues, or decreased libido. On the other hand, TMS stimulates specific parts of the brain and usually comes with fewer side effects. Some people report only mild discomfort or a headache after a session, and these tend to be short-lived.
Cost-wise, TMS often has the upper hand, especially over the long term. Research shows that TMS not only improves quality of life but also costs less over time.
TMS vs. Electroconvulsive Therapy
ECT uses electrical currents to trigger a controlled seizure, while TMS uses magnetic pulses to stimulate the brain without inducing a seizure. This makes TMS far less invasive. You don’t need anesthesia for TMS, and most people can leave the clinic and get back to their regular activities right after a session. However, ECT requires hospitalization and general anesthesia, and recovery can take days or even weeks, with patients often feeling groggy or disoriented.
In terms of side effects, TMS generally has far fewer than ECT. ECT can sometimes cause memory loss or confusion, while the most common side effects with TMS are usually just mild headaches or scalp discomfort, which usually disappear quickly.
TMS vs Psychotherapy
In psychotherapy, or talk therapy, individuals work with a therapist to explore their emotions, behaviors, and thought patterns. It’s a longer process and can take time to see real progress, but it can be beneficial for many people. TMS, on the other hand, works more directly by stimulating brain activity to reduce symptoms.
Some studies suggest that combining TMS with psychotherapy can lead to even better results. One study showed that when TMS was paired with therapy, a significant number of people saw major improvements in their symptoms.
What are the Potential Downsides to TMS?
Like any treatment, TMS has some potential downsides. While it’s generally well-tolerated, there are a few risks and side effects that may come up during or after treatment. Most of these side effects are mild and temporary, but it’s still important to be aware of them before starting TMS therapy. Some downsides may include:
- Mild headaches or scalp discomfort
- Potential insurance coverage issues
- Not suitable for people with certain metal implants in their head
- Small risk of seizures
- Rare cases of hearing loss
- Temporary mood changes or mild cognitive shifts
- Fainting (syncope), though this is uncommon
While these risks exist, the majority of people undergoing TMS experience minimal side effects, especially when compared to more invasive treatments like ECT. It’s always a good idea to discuss any concerns with your doctor to make sure TMS is the right fit for your needs.
Sources:
- Efficacy of repetitive transcranial magnetic stimulation in treatment-resistant depression: the evidence thus far – General Psychiatry
- Transcranial magnetic stimulation (TMS): Hope for stubborn depression – Harvard Health Publishing
- Never Too Late: Safety and Efficacy of Deep TMS for Late-Life Depression – Journal of Clinical Medicine
- Stanford Accelerated Intelligent Neuromodulation Therapy for Treatment-Resistant Depression – The American Journal of Psychiatry
- LONG-TERM EFFICACY OF REPEATED DAILY PREFRONTAL TRANSCRANIAL MAGNETIC STIMULATION (TMS) IN TREATMENT-RESISTANT DEPRESSION – Depression and Anxiety
- In Older Adults the Antidepressant Effect of Repetitive Transcranial Magnetic Stimulation Is Similar but Occurs Later Than in Younger Adults – Frontiers in Aging Neuroscience
- A Retrospective Case–Control Study on the Differences in the Effectiveness of Theta-Burst Stimulation Therapy for Depression with and without Antidepressant Medication – Journal of Clinical Medicine
- Cost effectiveness analysis comparing repetitive transcranial magnetic stimulation to antidepressant medications after a first treatment failure for major depressive disorder in newly diagnosed patients – A lifetime analysis – PLoS One
- Transcranial Magnetic Stimulation vs. Electroconvulsive Therapy – Verywell Mind
- Simultaneous rTMS and psychotherapy in major depressive disorder: Clinical outcomes and predictors from a large naturalistic study – Brain Stimulation
