Transcranial Magnetic Stimulation (TMS).
Non-invasive therapy for treatment-resistant depression.
Scientists believe depression is caused by an imbalance in the neural networks that regulate emotion and motivation in the brain. By modulating neurotransmission, antidepressant medications may provide relief. Unfortunately, for many people, antidepressants are not effective, or cause intolerable side effects. These people have treatment-resistant depression (TRD).
Transcranial Magnetic Stimulation (TMS) — a safe, non-invasive therapy approved by the FDA since 2008 — offers new hope to such individuals.
Indication for TMS Therapy
NeuroStar Transcranial Magnetic Stimulation (TMS) therapy is indicated for the treatment of Major Depressive Disorder in adult patients who have not achieved satisfactory improvement from prior antidepressant medication.
Although not all patients benefit from NeuroStar TMS, this therapy has proven to be effective.
In one clinical trial, patients who received NeuroStar TMS therapy were 4 times more likely to achieve remission of depression symptoms than the control group. One-third of patients in the trial achieved complete remission. And a further one-half of patients had “significant improvement” in their depression symptoms.
The effects of NeuroStar TMS treatment have also shown durability. In a clinical trial, two-thirds of patients who responded to treatment retained their improvements at the end of 12 months. Only one-third needed to return for “maintenance” TMS sessions.
How Transcranial Magnetic Stimulation Works
NeuroStar TMS therapy uses short magnetic pulses to stimulate nerve cells near the brain’s left prefrontal cortex — the area of the brain involved in mood regulation.
The pulses are generated by an enclosed magnetic coil, which touches the outside of the patient’s head. The coil turns on and off rapidly, with relatively low intensity. It is NOT “shock therapy” or electroconvulsive therapy (ECT).
The magnetic coil in NeuroStar TMS therapy is highly focused. It sends pulses only 2-3 centimeters into the brain, directly below the coil. These magnetic pulses do NOT directly affect the whole brain.
The pulses DO create small electrical currents that activate brain cells thought to release neurotransmitters like serotonin, norepinephrine, and dopamine.
Since depression is thought to result from an imbalance of these chemicals in the brain, TMS therapy can restore that balance, positively affect mood, and relieve feelings of anxiety and depression.
Importantly, Transcranial Magnetic Stimulation is:
Non-invasive. There is no surgery or sedation — you remain awake and alert.
Non-systemic. You do not ingest anything and nothing goes through your bloodstream.
FDA-approved.
Performed in our office as an outpatient procedure. You can even drive yourself.
What to Expect from NeuroStar TMS Therapy
The typical treatment course for Transcranial Magnetic Stimulation therapy is five treatments per week for 4-6 weeks. Each treatment lasts about 20-40 minutes, as determined by the doctor. (Though your first session can take up to 90 minutes, to customize the magnetic field strength and pulse location for you.)
In each TMS therapy session, the magnetic coil will deliver rapid pulses in 30-second intervals. These pulses will feel like tapping on your scalp. You will be given protective earplugs, but you may find the tapping uncomfortable. If so, your doctor can make adjustments to try to reduce your discomfort.
Throughout TMS therapy, you will remain awake and alert. You can relax in the treatment chair, talk to the TMS technician, read, or listen to music.
After the procedure, you can immediately return to your normal routine, including driving.
In clinical trials, most patients who benefited from NeuroStar TMS therapy experienced positive results by the fourth week of treatment.
Transcranial Magnetic Stimulation Safety
The U.S. Food and Drug Administration (FDA) approved NeuroStar TMS for patients who do not respond well to antidepressant medications. Over 10,000 NeuroStar TMS treatments were performed in clinical trials, demonstrating the safety of the therapy.
The magnetic pulses generated in TMS therapy are like those in an MRI (magnetic resonance imaging). But a full course of TMS therapy uses only a fraction of the magnetic energy used in a single MRI brain scan.
NeuroStar TMS causes very few side effects and is generally well tolerated. (See more under Side Effects.)
You should not undergo NeuroStar TMS treatments if you have an implant that controls a physiological signal, like a pacemaker, or a non-removable metallic object in your head (NOT including tooth fillings).
Side Effects of NeuroStar TMS Treatments
Less than 5% of NeuroStar TMS patients have discontinued treatments due to adverse effects.
NeuroStar TMS therapy does NOT cause weight gain, nausea, dry mouth, poor concentration/memory, drug interactions, tumors, or sexual dysfunction.
The most common side effect of NeuroStar TMS is scalp discomfort during treatment. This effect is generally mild to moderate, and occurs less frequently after the first week of treatments. (If necessary, you can treat this with over-the-counter analgesics, or your doctor can temporarily reduce the magnetic pulse strength.)
Because NeuroStar TMS is non-systemic (it does not circulate through your bloodstream), it does NOT have the side effects often associated with antidepressants. It also does NOT cause intentional seizures or require long recovery periods like “shock therapy,” or electroconvulsive therapy (ECT).
In over 10,000 treatments during clinical trials of NeuroStar TMS, no patient seizures were observed. There is a statistically small risk of a seizure occurring during treatment, but the risk is no greater than that of oral antidepressant medications.
TMS Therapy has been shown to have no negative effects on memory function.