Transcranial Magnetic Stimulation, or TMS, is a process that uses short, MRI strength magnetic pulses to stimulate neurons in the area of the brain known to regulate mood. This magnetic stimulation can have a positive effect on the brain’s neurotransmitter levels.
TMS treats depression at its source.
A patient sits in a chair similar to that in a dentist’s office, and a paddle containing a magnetic coil is positioned over the left dorsolateral prefrontal cortex on a patient’s head (the left side just above the forehead). That is the area of the brain known to affect mood. In depressed patients, that area is shown to be very non-responsive compared to non-depressed patients.
The coil transmits short magnetic pulses in rapid succession. The pulses travel approximately 1 inch into the brain, targeting and stimulating neurons, causing them to fire and release neurotransmitters. In a domino-like effect, this causes other cells to fire, in turn restoring normal function to the under-performing area of the brain.
Neurons are the brain’s messengers. They use naturally occurring electrical impulses and chemical signals, known as neurotransmitters, to transmit information between different areas of the brain. If the neurons aren’t working properly, also known as firing, the pathways become sluggish and a person can become depressed.
In simpler terms, it’s like a car that isn’t working properly. If the car can only go 45 mph in a 70 mph zone, it isn’t very efficient. It will get you where you need to go, but it will take longer, and many times, cause greater problems. When the car is fixed and working the way it should, it’s easier to get where you need to go.
TMS Therapy is for those who…
While TMS Therapy is a well-tolerated treatment, it is not for those who…
Failure to follow this rule could cause the object to heat up, move, or malfunction, and result in serious injury or death.
Prior to receiving TMS Therapy your doctor or psychiatrist will carefully screen you for the presence of medical conditions or metal objects which may make TMS either unsuitable or harmful.
TMS doesn’t hurt any more than holding a magnet in your hand hurts. Because it is non-systemic and non-invasive, there are no injections, anesthesia, or sedation – nothing is circulating through your bloodstream.
The most common side-effect is discomfort from the paddle vibrating against your scalp. Modifications can be made to reduce that discomfort and it usually subsides after the first week.
Because TMS therapy is non-invasive, you are awake and alert throughout your sessions, and are free to listen to music or an audio book or read during your treatment.
TMS Therapy is an outpatient treatment that takes place in one of our clinics. Though not as common, it is possible to receive TMS at a hospital that offers the treatment.
FDA protocol for TMS therapy is 30 treatments, which are typically performed five days a week for six weeks. We have found it important to administer treatments back-to-back and provide weekends off for a breather. Depending on insurance coverage, additional sessions, called taper sessions may be included and can be stretched over two to three weeks.
While each appointment is approximately 45 minutes, part of that time is spent calibrating the machine for the patient’s protocol. The actual treatment is about 37 minutes long.
The main differences between TMS Therapy and antidepressant medications include:
KETAMINE: For depression, ketamine is administered at low doses. Changes in the brain are activated because of the medicine, but once a patient stops taking it, that activation begins to subside and isn’t long-term. The most commonly reported side effects are elevated heartbeat, nausea, slight muscle tremors, and hallucinations. They don’t usually last longer than 4 hours after treatment.
Ketamine also has some interactions with certain psychiatric medications, so you may not be able to continue taking current medications if you start ketamine therapy.
TMS: TMS engages the neurons to function on their own with long-term efficacy and without drug interaction. The most common side-effect of TMS is discomfort from the paddle vibrating against your scalp. Modifications can be made to reduce that discomfort and it usually subsides after the first week. Because TMS is non-systemic, there are no drug interactions, so it’s safe to continue your current antidepressants or other medications during treatment.
Mental health help resources can be difficult to find. There are many websites you can visit for information on mental health.
We have also compiled a list of local, national, and online resources that are available whenever you need them.