FAQs

TMS stands for transcranial magnetic stimulation. It is used to treat depression by stimulating the brain using electromagnetic fields, similar to those produced by an MRI machine. TMS is non-invasive, meaning that it does not involve surgery or scars. It does not require any anesthesia or sedation, as the patient remains awake and alert during the treatment. TMS is also non-systemic, meaning that it is not taken by mouth and does not circulate in the bloodstream—this means that, unlike medication, it does not cause systemic side effects, like weight issues, sleep problems, or sexual dysfunction.

TMS uses short pulses of magnetic fields to stimulate the area of the brain that may not function as well in patients with depression. The magnetic field produces an electric current in the brain that stimulates your brain cells (neurons). This stimulation helps your brain cells work better, which can improve your brain function and ease your depression symptoms.

While there may be some minor discomfort at the treatment site (where the device touches your head), it generally subsides within the first week of treatment. There is no sedation or impact on your alertness. You can read, watch TV, or talk with your treatment coordinator during your session, and you can drive home immediately after your treatment.

For most patients, a typical course of TMS is five times per week for 19-minute sessions over six weeks with a three-week taper. Some patients may require additional treatments, based on clinical evaluation.

Because TMS is non-systemic and does not circulate throughout the body, it does not have systemic side effects such as weight gain, sexual dysfunction, nausea, dry mouth, and sedation, which are more common with many antidepressant medications. Research shows that fewer than 5 percent of patients discontinue TMS treatment due to side effects.

TMS has been shown to be well-tolerated and has been demonstrated to be safe in clinical trials. Over 10,000 treatments have been performed in clinical trials with no seizures observed (Janicak et al., 2008). 

However, there is a small risk of a seizure occurring during treatment—but this risk is no greater than what has been observed with oral antidepressant medications.

While TMS has been demonstrated to be effective, not all patients will benefit from it. Patients should be carefully monitored for worsening symptoms, signs, or symptoms of suicidal behavior, and/or unusual behavior. Families and caregivers should also be aware of the need to observe patients and notify their doctor if symptoms worsen.

The technology behind TMS is very safe. In fact, TMS uses the same type and strength of magnetic fields as MRIs, which have been used in tens of millions of patients around the world. The magnetic energy used in a full course of TMS is a small fraction of just one brain scan with an MRI.

No, the two procedures are very different. While both are effective in the treatment of depression, there are many differences in side effects and tolerability. 

During TMS, patients sit in a chair and are awake and alert throughout the entire 19-minute procedure—no sedation is used. Patients can drive themselves to and from treatment. In over 10,000 treatments with TMS in clinical trials, no seizures were observed (Janicak et al., 2008). TMS was also shown to have no negative effect on memory function in these studies. 

In contrast, “shock therapy,” or ECT, intentionally causes the patient to have a controlled seizure, and patients receiving ECT must be sedated with general anesthesia and paralyzed with muscle relaxants. Recovery from an ECT treatment session occurs slowly, and patients are usually closely monitored for minutes to a few hours after a treatment. Short-term confusion and memory loss are also common with ECT, and long-term disruptions in memory have been shown to occur.

Yes, in clinical trials, TMS was safely administered with and without antidepressant medications.

Since the FDA clearance of TMS in 2008, insurance coverage for eligible patients has increased significantly. Most major insurance companies have recognized the effectiveness of treating depression with TMS and now cover TMS as part of their plans. These insurance companies include BCBS, United Healthcare/Optum, Humana, Aetna, Memorial Health Partners, and Beacon.

The NeuroStar TMS Therapy System that we use at Statesboro Psychiatric Associates is the first TMS device that is FDA-cleared for the treatment of major depression. It is also the only TMS system with proven long-term durability of its effects established over 12 months. In a clinical trial, two out of three patients who had either responded to treatment or completely remitted their depression symptoms reported that they remained at this level at the end of the trial, one year later. Additionally, after the trial, only one in three patients needed maintenance TMS sessions (Carpenter et al., 2012).