Antidepressants provide relief for millions of people with depression. They are especially useful when treating patients diagnosed with moderate, severe, and chronic depression. However, antidepressants don’t work for everyone and some patients dislike the side effects they experience while on antidepressants, leading them to look for an alternative treatment.
Transcranial magnetic therapy is a medication-free therapy that provides relief from depression symptoms, without the side effects associated with antidepressants. TMS therapy in NYC is an effective treatment option for patients diagnosed with major depression.
What is transcranial magnetic stimulation (TMS) treatment aka rTMS?
Transcranial magnetic stimulation, most commonly called TMS, is a non-invasive treatment that uses magnetic pulses to electrically stimulate the brain. TMS is also known as repetitive TMS or rTMS because the treatment works by sending repetitive magnetic pulses to a specific area of the scalp.
Transcranial magnetic stimulation was approved by the FDA in 2008 to treat patients with treatment-resistant depression, patients who do not see improvements of their symptoms with antidepressants. rTMS is proven to provide relief from depression symptoms, even when antidepressants don’t. One study observed the effects of TMS on patients with treatment-resistant depression in 42 clinics across the US. All patients enrolled in this study were diagnosed with major depression disorder (MDD) who had tried antidepressants without seeing results. Of the 257 patients that completed a course of TMS therapy, 120 patients responded to treatment or achieved remission. Moreover, 62.5% of patients who responded to treatment or achieved remission continued to show signs of improvement, even one year after completing the initial course of treatment.
How is TMS administered?
Transcranial magnetic stimulation is administered by a licensed psychologist or nurse in a doctor’s office. During a TMS session, the patient sits comfortably in a chair. A magnetic coil is then positioned over a certain area of the scalp. A TMS treatment session lasts about 19 minutes. During this time, the patient will hear clicking sounds, similar to an MRI machine. Patients are usually offered earplugs to help dull the noise of the clicking sounds. Patients can return to work immediately following a TMS treatment session.
TMS is administered as a nine-week course of treatment. During the first six weeks of TMS therapy, patients receive one treatment session a day for five days. The last three weeks of treatment are considered the taper period. During week seven, patients receive one treatment a day for three days; during week eight, one treatment a day for two days; and during week nine, one final treatment.
Results without side effects associated with medication
Because TMS is a medication-free treatment, it does not enter the bloodstream and it is not associated with the side effects of antidepressants. TMS has not demonstrated any serious side effects. Side effects associated with TMS are usually mild, and do not affect all patients. Some side effects seen with TMS include:
- Mild headache
- Scalp discomfort
- Tingling or twitching of facial muscles
The side effects of TMS typically reside within a few hours after a treatment session. For patients who do experience a mild headache or scalp discomfort, they can find relief with over-the-counter pain medications, like Advil or Tylenol.
TMS can be used alone, as an augmentative treatment with antidepressants, or with other medication free treatments such as talk therapy and exercise.
Talk therapy is a useful treatment for depression. Working with a therapist can help ease the burden of depression symptoms and can help healthcare providers and patients identify the early signs that depression may be getting worse.
A specific type of therapy, called cognitive behavioral therapy, is especially helpful for patients diagnosed with depression. Cognitive behavioral therapy is a type of therapy that helps patients identify patterns (behaviours and thoughts) that contribute to certain conditions, including depression, and help them find ways to change these patterns. For example, patterns of negative thoughts, like ‘I’m not good enough,’ can distort a person’s reality and contribute to depression.
Research shows that cognitive behavioral therapy is just as effective as certain antidepressants at relieving depression symptoms. A major review of the results of dozens of clinical trials published over the course of 25 years shows that cognitive behavioural therapy is ‘equally effective’ as second-generation antidepressants in reducing depression symptoms. Second-generation antidepressants include SNRIs (serotonin-norepinephrine reuptake inhibitors) and SSRIs (selective serotonin reuptake inhibitors).
Other types of therapy used to treat depression include interpersonal therapy and psychodynamic therapy. Talk therapy may be used as a standalone treatment for depression, but it offers greater value when used in conjunction with other primary treatments like antidepressants and TMS.
Science has linked exercise to significant antidepressant effects. An analysis of randomized trials published in 2018 reveals that aerobic exercise has large antidepressant effects on patients diagnosed with major depression. Among 11 studies analysed, the average amount of exercise performed throughout the trials was 45 minutes of moderate intensity exercise, three times a week, for 9.2 weeks. The results seen in this analysis suggest that aerobic exercise is an effective antidepressant therapy.
One review sheds lights on why exercise is helpful for patients with depression. This review analyzed the findings of numerous studies that analyzed structural brain abnormalities in people with depression and the effects of exercise on brain structure. The brain regions discussed in this review include the hippocampus, Prefrontal Cortex/Anterior Cingulate Cortex, striatum, and white matter. Noted among multiple studies, is the reduction of volume in these brain regions among people with depression. Evidence from randomized trials shows that exercise increases volume in the hippocampus, the prefrontal cortex and the anterior cingulate cortex. It was also found that exercise influences depression later in life – brain regions positively affected by exercise retained their volume years later. The findings published in this review suggest that exercise provides both therapeutic and protective benefits for patients with depression. (9)
Exercise is not a stand alone treatment for depression. It is a supplemental treatment to be used alongside a primary treatment, like TMS treatment.
Speak with your doctor
If you aren’t seeing results with your antidepressant, or if you find it difficult to take your medication due to unwanted side effects, ask your doctor or your psychologist about TMS therapy in NYC and whether it may be right for you. Your doctor may also recommend other medication-free supplemental treatment options, such as talk therapy and lifestyle changes.
Tommy Williamson did his degree in psychology at the University of Edinburgh. He has an ongoing interest in mental health and well-being.