Transcranial Magnetic Stimulator: A Non-Invasive Treatment for Depression
What is Transcranial Magnetic Stimulator?
Transcranial Magnetic Stimulator (TMS) is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. During TMS, a magnetic coil is placed near the head to allow painless pulses of magnetic energy to pass through the scalp and stimulate nerve cells in the regions of the brain involved in mood regulation.
How Does TMS Work?
TMS works by inducing electric currents in specific regions of the brain using magnetic fields. It targets areas of the prefrontal cortex that are underactive in depression. The stimulation alters the nature and extent of activity in those brain regions. Repeated treatments reset the balance of neural activity in mood-regulating circuits, which can lift depression. The magnetic pulses are painless and do not require surgery. Transcranial Magnetic Stimulator offers a new mechanism of antidepressant action compared to medications or electroconvulsive therapy (ECT).
Is Transcranial Magnetic Stimulator Effective for Treating Depression?
Numerous clinical trials and meta-analyses have found TMS to be an effective treatment option for depression. A typical course of treatment involves daily sessions, 5 times a week, for 4-6 weeks total. Results show that over 35% of patients achieve remission or a significant response in depression symptoms after a full course of TMS. The antidepressant effects are comparable to some first-line medications. TMS may provide relief for individuals who have not benefited enough from pharmacological antidepressants alone. Additionally, the treatment effects seem to last beyond the end of the treatment sessions for many patients.
How is TMS Administered?
During TMS treatment, patients sit in a comfortable chair. The magnetic coil is positioned against the scalp region targeted for stimulation, usually over the left prefrontal cortex. Short pulses of magnetic energy are then delivered, inducing electric currents deep in the brain. Most sessions last about 30 minutes. The magnetic pulses are triggered automatically and consist of rapid, repeated clicks that patients describe as moderately loud tapping sensations. No piercing or painful feelings are involved. The sessions can be as frequent as daily treatments over several weeks depending on the treatment protocol for each individual.
Are There Any Side Effects of TMS Therapy?
In general, TMS is very well-tolerated with minimal adverse effects. The most common side effects are mild headaches or discomfort at the site of magnetic pulse delivery during a small fraction of treatment sessions. Other occasional transient side effects may include fatigue, scalp pain or twitching, nausea or lightheadedness. Serious complications are extremely rare. TMS does not cause seizures and there is no evidence it worsens psychiatric conditions in susceptible individuals. No long-term side effects involving cognition or other brain functions have been demonstrated.
Which Patients Benefit Most from Transcranial Magnetic Stimulator?
Good candidates for TMS include individuals with major depressive disorder who:
- Have not experienced an adequate response from at least one antidepressant medication already tried.
- Cannot tolerate or did not respond to ECT.
- Prefer a non-systemic treatment option without the side effects of medications.
- Are interested in multi-week maintenance treatment to prevent depressive relapses.
TMS is also being studied for other conditions such as schizophrenia, bipolar disorder and post-traumatic stress disorder. Further research will determine how broadly applicable and beneficial this technology can be across different types of mental illness.
Is TMS Covered by Health Insurance?
In the United States, most private health insurers and some state Medicaid programs provide at least partial coverage for TMS procedures performed on an outpatient basis. Medicare part B also covers TMS for treatment-resistant depression. However, out-of-pocket costs and approval processes can vary significantly depending on the insurance plan and provider. It is important for patients to check their specific coverage policies, limitations and documentation requirements pre-approval for TMS reimbursement. The acceptance and availability of TMS continues to expand as more clinical data demonstrate its safety, effectiveness and favorable cost profile compared to alternative treatment escalations.
Considering Transcranial Magnetic Stimulator?
Transcranial magnetic stimulation offers a unique non-systemic option for the treatment of resistant depression without medications or surgery. Supported by numerous clinical trials, TMS can provide lasting therapeutic benefits for relapse prevention. As an FDA-cleared technology performed on an outpatient basis, it expands treatment approaches for this prevalent and burdensome mental disorder. Proper patient selection considering clinical history alongside diagnosis and severity contributes to optimal outcomes. By resetting mood-regulating networks in the brain, TMS may restore balance and lift depression symptoms for eligible individuals seeking non-invasive relief.
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