Before I decided to pursue TMS, I did a lot of research. I am going to share that research here.
I also will quickly explain TMS therapy. TMS helps depression, anxiety, and other conditions by stimulating parts of the brain that are underactive and calming down parts of the brain that are over-active. It uses MRI strength magnetic pulses to do this. There have been studies of TMS for its positive impacts on depression, anxiety, OCD, smoking cessation, PTSD, stroke rehabilitation, schizophrenia, Parkinsons and Alzheimers, and it even can help chronic pain conditions like fibromyalgia and multiple sclerosis. Not all of these are FDA approved [such as the ones for Parkinsons and Alzheimers] but the future of TMS treatment is constantly changing and expanding! It is usually covered by insurance as long as your depression is treatment resistant and the TMS center has approved you as a patient. If antidepressants and psychotherapy don't work for you, Medicare will cover TMS therapy.
With traditional SSRI medications, the more medications you try, the lower your chance of remission goes. On your first try with meds your chance of remission is 27.5% and it goes to 21.2% on the second med and 16.2% on the third med, and finally your chance is 6.9% by your fourth medication.
With TMS, the more you try it, the higher your chance of remission becomes. Remission rates for TMS range from provider from 70% to 80% and some even have an average remission rate in the 90s. Additionally, the more failed treatments you have going into TMS the more successful it is expected to be. About 50% get complete remission after one full treatment round of about 30 days. Some papers say 2/3 of patients get full remission and some say 1/3 of patients do, so just between 1/3 and 2/3 of patients get full remission. Remission Rates for TMS
TMS is a large time commitment. It involves going to an office for 30-36 days every day for 30-60 minutes, but the good news is there are very little side effects. I will compare the side effects [and their prevalence rates] with SSRI medications.
While with meds usually you have to be on it for several weeks to feel anything, and its common to need to change meds at least once before you find the right medication, TMS works in 30 days or less. A third of patients may see a change in the first third of the treatment course. A third of patients might see improvement in the middle third. A third of patients may note benefits in the final third portion of the course.
The only serious side effect is a seizure, 0.1% of people [usually with a prior history] get this side effect. TMS does not increase your risk of suicide or self harm, which does happen with SSRIs, unless you have BPD. In clinical trials with the neurostar, fewer than 5% of people discontinued treatment due to adverse events. The most common side effect was temporary pain or discomfort at or near the treatment site during therapy that usually resolved within the first week of treatment. Other side effects (occurring in ≥5% of people and twice the rate of placebo) included eye pain, toothache, muscle twitch, facial pain, and skin pain. Neurostar Side Effects Deep TMS, which treats OCD, has a few more side effects than the TMS for depression. The most prevalence side effect was headache occurring in 47% of patients, these are not permanent. Bainsway Deep TMS Side Effects It is common for side effects to go away after the first few treatments, or be present because the power is too high.
The biggest safety issues with SSRIs are: serotonin syndrome [a temporary illness due to too much serotonin], withdrawals after stopping SSRIs, increased risk of suicide and self harm, and drug interactions. There is also a slight risk of taking SSRIs during pregnancy.
In a survey of 700 patients, only 25 percent of the side effects were considered "very bothersome" or "extremely bothersome." 38 percent reported a side effect as a result of taking their prescribed SSRI. Regardless of how bothersome the side effects were, however, only 40 percent of patients mentioned the side effects to their prescribing physicians SSRI Side Effects Study
In another study, the common side effects reported by patients were flatulence (64%), somnolence (59%), memory impairment (51%), decreased concentration (50%), yawning (47%), fatigue (45%), dry mouth (45%), weight gain (45%), light headedness (43%), and sweating (38%). Patients treated with escitalopram had significantly higher incidence of headache, pruritus, memory impairment, decreased concentration, and dizziness. Second SSRI Study
This is a great general article that discusses the many uses for TMS! Im addition, more types of TMS are being researched such as TMS to treat chronic pain, tinnitus, and tics/tourettes
This is a great link that will discuss what preparing for TMS and the technical process is like, as well describing the actual experience pretty well. I recommend this for anybody who plans to do TMS and wants to see what it is like.
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