How Effective Is TMS? The TMS Therapy Success Rate
By: Corrina Horne
Updated May 21, 2020
Depression is a serious health concern. The condition is something of a chameleon, in that it affects everyone differently, and looks dramatically different in every personality it touches. For this reason, depression often goes undetected-or is misunderstood-which can exacerbate symptoms and endanger lives. Despite more than 300 million people living with depression worldwide, many aspects of depression are still not entirely understood, and treating depression can prove difficult.
Treatment for depression varies widely, based on a person's needs, comfort level, and economic ability. Though there are countless ways to treat depression, ranging from lifestyle alterations to simple talk therapy, several areas of study have emerged to focus primarily on depression treatment. One of these therapies is Transcranial Magnetic Stimulation or TMS.
What Is TMS?
Transcranial Magnetic Stimulation-or repetitive Transcranial Magnetic Stimulation (rTMS)-is a depression treatment that uses a magnetic force to alter the patterns of your brain to decrease the symptoms of depression. Placing a magnetic coil against the side of a patient's head, practitioners then apply a series of pulses within the magnet to stimulate the nerves in your brain responsible for mood control. The theory behind this particular type of therapy suggests that stimulating and awakening areas of the brain that are usually less active in depressed individuals will help alleviate the symptoms of depression and improve a patient's quality of life.
Because this procedure is noninvasive and merely utilizes magnetic pulses, TMS is considered a safe treatment for depression, without any dramatic or alarming risks. That being said, there are some mild possible side effects brought on by TMS sessions, which can include headaches, lightheadedness, facial tingling or numbness, and discomfort during the procedure. Unlike many other treatment options, however, these side effects usually dissipate immediately after concluding a session, or shortly thereafter. While many people use TMS as a last resort, only engaging a therapist after other avenues have been exhausted, its low-risk process could be an ideal alternative for individuals who are sensitive to standard medication or seemingly inoculated against traditional talk therapy.
A qualified TMS therapist should administer TMS. This particular treatment type is not taught as a regular part of earning a psychology certification and is considered a specialty. This plays into the overall cost of TMS and means that all credentials should be thoroughly checked before enlisting the assistance of a practitioner. The equipment involved in TMS requires delicate handling and a thorough understanding of the brain and could prove painful if not used correctly.
What Does A Standard TMS Session Look Like?
There is some variation within the practice of TMS, but the basic mechanism is the same: a magnet is placed against the scalp-traditionally, near the forehead-and magnetic pulses are delivered. A patient's first session is usually the longest, as practitioners need to assess how much therapy is likely to be required and establish a starting point for an individual's needs. Initially, a practitioner will administer therapy to determine a patient's pain tolerance and comfort level, then move on to "mind mapping" to make sure each session is targeting the correct area of the brain. Once a treatment plan has been established, appointments typically last between 20-40 minutes.
During this time, patients are placed in a comfortable chair and given earplugs to deaden some of the sound emitted by the magnetic machine. The magnet will be activated for a few seconds, which makes a clicking or tapping sound and produces a similar sensation against the skin, before the magnet will be deactivated for a few beats, and reactivated. Sessions continue in this vein for the duration of treatment and are performed on an outpatient basis. Some patients report slight dizziness or headaches immediately following a session.
Most practitioners recommend regular treatment with TMS, which usually means five sessions per week, for a 4-6 week period. Treatment can veer outside of this standard but usually requires at least this great a time commitment. Improvement in symptoms can take several weeks, but some patients report feeling changes as early as the first treatment. Once treatment has concluded, patients typically go on to use traditional treatment methods, such as talk therapy or medication, to maintain TMS results.
What Is The Expected TMS Therapy Cost?
The cost of TMS therapy is difficult to discern, as it is still considered somewhat experimental to some insurance companies. For this reason, many patients are only able to undergo insurance-covered treatment after traditional methods have not worked; TMS is often not covered as a primary treatment option. If insurance is not able or willing to cover TMS treatment costs, patients can expect rates between $400 and $500 per session. Fortunately, many insurance companies allow doctors and clients to lobby declined treatment options, and alternative treatments might be more favorably decided upon if no other form of healing depression has worked.
How Effective Is TMS In Treating Depression?
TMS has a 30% success rate, which places it just below traditional antidepressants, which typically see a 50% success rate. Individuals who seek TMS treatment and do experience improved symptoms are instructed to continue seeking regular "maintenance" therapy via a traditional therapy modality or medication, to make sure the results delivered by TMS remain intact.
Although the exact efficacy of TMS is not known, as it is still a fledgling practice, some studies have shown that it does demonstrate consistency in treating patients with depression, though it seems less likely to assist with other psychiatric disorders. Part of its efficacy may lie in the time commitment required for treatment; reportedly, many depression patients stop using therapeutic techniques as early as one month after diagnosis, and TMS requires a minimum of 4-6 weeks to conclude treatment. The consistency of treatment, then, may be a significant contributor to its use as a depression treatment.
Who Is TMS Not For?
One of the reasons TMS therapy is gaining popularity is its nature as a noninvasive treatment. Though this might be great for some, others are considered poor candidates for TMS. These include individuals with pacemakers, stents, aneurysm coils, metallic implants in the upper body, monitoring tools inserted in the head or neck, bullets or shrapnel in the upper body, or tattoos using metallic ink. Because the technique uses a magnet, there is the possibility of disruption in implanted devices, such as pacemakers, during treatment. Metallic implants are similarly problematic, in that the consistent pulse of a powerful magnet could dislodge or otherwise alter the positioning of an implant.
TMS is also not an ideal match for patients seeking to treat Tourette Syndrome, schizophrenia, post-traumatic stress disorder, or obsessive-compulsive disorder. Although many of these occur concurrently with depression, clinical studies demonstrated that TMS was not an effective therapy for these issues, as patients reported little to no changes in symptoms of each of these disorders following treatment. Instead, TMS has shown improvement in depression and major depression disorders specifically.
Due to the likelihood of insurance companies turning down TMS therapy as a first option, TMS is also not an ideal solution for people who have not tried to talk therapy, cognitive therapy, or medication. These individuals are unlikely to receive insurance coverage, and out-of-pocket expenses for the process can be prohibitive.
Is TMS Worth The Trouble?
TMS is certainly worth looking into if you do not respond to more traditional routes of depression treatment. Although it does not function as a miraculous cure for all symptoms of depression, ongoing studies do suggest that it is a low-risk, non-invasive source of depression treatment, and can be a wonderful option to explore for people who are unable to find relief via standard therapies. TMS therapy can also be helpful for individuals who do not feel safe or comfortable utilizing talk therapy, as TMS does not require the same amount of vulnerability or discussion that talk-based therapies do, and can provide relief without necessarily having to recall painful memories or suppressed information.
TMS can also prove helpful for individuals who experience intense side effects on regular antidepressant medication. While not all antidepressants possess dramatic risk favors, several of the most popular options do run the risk of significant side effects-which can include increased feelings of depression and consideration of self-harm. The possible side effects of TMS are mild and typically dissipate quickly. While it is not common to experience dramatic side effects of common medications, a history of antidepressant use and subsequent unpleasant side effects could prompt an individual to seek out a qualified TMS practitioner.
While TMS might not be a treatment for everyone, it has shown immense promise in its field and has given researchers some hope for establishing useful, effective treatments for mental disorders using biological alterations to the brain. While it has not shown any sort of application for other mental health ailments, TMS could be a great option for men and woman trying to seek out alternatives to the tried-and-true methods of depression treatment.