Category: Transcranial Magnetic Stimulation

Transcranial Magnetic Stimulation Vs. Electroconvulsive Therapy: Is There A Difference?

Transcranial Magnetic Stimulation Vs. Electroconvulsive Therapy: Is There A Difference?

When it comes to depression treatment, various options exist, each with its own benefits and considerations. Transcranial Magnetic Stimulation (TMS) and Electroconvulsive Therapy (ECT) are two distinct approaches that have gained recognition for their effectiveness in managing treatment-resistant depression.

In this article, we will explore the differences between TMS and ECT, shedding light on their mechanisms, side effects, and overall efficacy. By understanding these contrasting therapies, individuals can make informed decisions regarding their depression treatment journey.

The Basics of Transcranial Magnetic Stimulation

Transcranial magnetic stimulation stimulates particular brain areas linked to depression by using magnetic fields. TMS is a minimally invasive technique that involves pressing a coil against the scalp and delivering magnetic pulses through it. These pulses aim to activate or modulate the neural circuits involved in mood regulation. TMS is typically administered on an outpatient basis and does not require anesthesia, allowing individuals to resume their daily activities soon after the treatment session.

The Basics of Electroconvulsive Therapy

Electroconvulsive Therapy, on the other hand, is a more invasive approach that involves the controlled induction of seizures to alleviate severe depression. During ECT, an electrical current is passed through the brain, triggering a brief seizure under general anesthesia. ECT sessions are conducted in a hospital setting and require careful monitoring by a trained medical team. ECT is often reserved for individuals with treatment-resistant depression or those who cannot tolerate other forms of treatment.

Efficacy and Treatment Course

Both TMS and ECT have shown efficacy in treating depression; however, their response rates and treatment courses differ. TMS is typically administered as a series of sessions over several weeks, with patients undergoing daily treatments.

The response to TMS may be gradual, with improvement reported over time. ECT, on the other hand, often yields faster results, with significant improvement observed after just a few sessions. ECT is usually administered two to three times a week for a few weeks, followed by maintenance treatments as needed.

Side Effects and Safety Considerations

TMS is generally well-tolerated, with minimal side effects. Some individuals may experience mild scalp discomfort or headache during or after the procedure, but these effects are typically temporary and resolve on their own. ECT, however, may be associated with more pronounced side effects. These can include memory loss, confusion, and headaches. It is important to discuss potential risks and benefits with a healthcare professional when considering ECT as a depression treatment option.

Anesthesia and Hospitalization

TMS does not require anesthesia or hospitalization, making it a more convenient and accessible treatment option for many individuals. The non-invasive nature of TMS allows patients to drive themselves to and from treatment sessions, minimizing disruptions to their daily routines. ECT, in contrast, requires general anesthesia and necessitates hospital visits, potentially impacting work or personal commitments.

Treatment Considerations

TMS and ECT have different considerations based on individual needs and preferences. TMS is well-suited for individuals seeking a non-invasive approach with minimal side effects and the ability to maintain their daily activities. ECT, on the other hand, may be recommended for individuals with severe depression or those who have not responded well to other treatments. The decision between TMS and ECT should be made in consultation with a healthcare professional, taking into account the severity of the condition and individual circumstances.

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Transcranial Magnetic Stimulation: How Much Does It Cost?

Transcranial Magnetic Stimulation: How Much Does It Cost?

Transcranial Magnetic Stimulation (TMS) has emerged as a promising alternative for individuals seeking effective treatment for depression. As the popularity of this innovative therapy grows, it becomes crucial to consider the financial aspect of TMS.

In this article, we will delve into the cost of transcranial magnetic stimulation, exploring the factors influencing pricing and discussing potential avenues for financial assistance. By understanding the financial implications of TMS, individuals can make informed decisions about their depression treatment journey.

Understanding Transcranial Magnetic Stimulation

A non-invasive technique called transcranial magnetic stimulation uses magnetic fields to stimulate particular parts of the brain linked to depression. Typically administered as a series of sessions over several weeks, each session lasts around 20-40 minutes. TMS is generally safe and well-tolerated, providing an alternative for individuals who have not responded well to other depression treatments.

Factors Influencing TMS Cost

The cost of transcranial magnetic stimulation can vary based on several factors, including geographical location, the specific TMS device used, the number of treatment sessions required, and additional services provided by the treatment center. Prices can also differ between outpatient clinics and hospital settings. It is advisable to inquire about these factors and obtain a comprehensive cost breakdown from the TMS provider.

Average TMS Treatment Cost

On average, a full course of TMS treatment in the United States can range from $6,000 to $12,000. This estimate generally includes the initial evaluation, treatment sessions, and any necessary follow-up visits. The number of sessions required may vary depending on individual needs and treatment response. Some clinics may offer package deals or discounts for upfront payments or multiple session purchases.

Insurance Coverage

Insurance coverage for transcranial magnetic stimulation varies depending on the specific insurance plan and location. While some insurance providers offer partial or full coverage for TMS as a depression treatment, others may consider it an elective or investigational procedure and provide limited or no coverage. It is essential to contact the insurance company directly to understand the extent of coverage, including deductibles, copayments, and any pre-authorization requirements.

Financial Assistance Programs

To make TMS more accessible, some treatment centers offer financial assistance programs or flexible payment options. These programs may provide reduced-cost treatments or assist in navigating insurance coverage. Additionally, certain research studies and clinical trials may offer TMS treatment at a lower cost or even for free. Exploring these options can help alleviate the financial burden associated with TMS treatment.

Reassessing Overall Cost

When considering the cost of TMS, it is crucial to evaluate the broader financial impact. Traditional depression treatments often involve ongoing medication costs, therapy sessions, and potential hospitalizations. TMS, as a non-pharmacological option, may offer a cost-effective long-term solution by potentially reducing reliance on medications and subsequent healthcare expenses.

Weighing Benefits and Costs

While the cost of transcranial magnetic stimulation may seem significant, it is important to consider the potential benefits and overall impact on an individual’s quality of life. For those who have struggled to find effective depression treatment through other means, the positive outcomes associated with TMS may justify the financial investment. Engaging in open discussions with healthcare providers can help assess the potential benefits and weigh them against the associated costs.

TMS offers a promising option for individuals seeking effective depression treatment. While the cost of TMS may vary depending on several factors, it is essential to consider the potential benefits and available financial assistance options. With insurance coverage, financial assistance programs, and flexible payment options, individuals can explore avenues to make TMS more affordable.

By understanding the financial implications of TMS and engaging in transparent discussions with healthcare providers, you can make informed decisions and access the potential benefits of this innovative depression treatment.

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How Long Do The Impacts Of TMS Treatment For Depression Last?

How Long Do The Impacts Of TMS Treatment For Depression Last?

Depression is a mental health condition that has been steadily growing in its prevalence, especially among younger people, both in the United States and worldwide. Usually, treatment through therapy and medication is the standard approach for many of these patients, and it has good results. However, people with Major depressive disorder (MDD) could be resistant to conventional treatment. For many patients, who have tried various pharmaceutical interventions,  TMS treatment might be the only option. It has more impactful results for patients whose symptoms persist under standard treatment.

What is TMS For Depression?

TMS is an acronym for Transcranial Magnetic Stimulation, a non-invasive magnetic treatment that changes the mood of patients dealing with depression. Also known as repetitive TMS, the therapy involves exciting and stimulating neuronal brain cells through the delivery of pulses from a magnetic field. The stimulation is painless and causes no physical sensations in the patient’s brain throughout the session. The pulses cause the release of vital neurotransmitters because they imitate the brain’s neurons.

How Does TMS Work?

The science behind the therapy is groundbreaking and quite intriguing because it is a lot like hacking into the biology of the patient’s brain. The procedure usually starts with the doctor attaching the TMS device close to the left prefrontal cortex of the patient’s brain. This part of the brain has low metabolic and functional activity in patients dealing with depression.

  • The Science

The device contains a magnetic coil that creates the magnetic field, produces the pulses, and continues until the end of the session. A session runs for about nineteen minutes but with the introduction of accelerated TMS a treatment session lasts just under 4 minutes.  During that time, the electric currents stimulate chemical reactions in the brain that improve the patient’s mood. Many doctors recommend thirty sessions of repetitive TMS over six weeks. Also, the magnetic impulses may cause physical discomfort from the weight or the device’s material at the treatment site.

What Are the Benefits of TMS?

Firstly, TMS is quite effective in patients with treatment-resistant depression, which is the first and most critical benefit. It is also the best way to deal with symptoms for patients with unipolar major depression who have been unsuccessful with one drug. Moreover, although there are other products that are similar to TMS, none of them are as safe. It is because the pulses are not deep penetrating, preventing adverse effects and being more precise.

How Long Do the Effects Last?

The results from the TMS treatment can last long, and patients who get this treatment report significant improvements in their moods. On the other hand, for those whose symptoms remain, they often notice a significantly lower intensity in their moods, making it easier for them to deal with them. The therapy results vary depending on the unique condition each patient is dealing with at the time.

However, the average time for the results is between six months to a year. The vast difference accounts for the variation in the intensity of depressive symptoms. There have also been cases where the results lasted over a year, especially for patients with mild depressive symptoms.

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Why You Should Consider Transcranial Magnetic Stimulation Therapy (TMS) For Your Depression

Why You Should Consider Transcranial Magnetic Stimulation Therapy (TMS) For Your Depression

Transcranial magnetic stimulation (TMS) is a non-invasive magnetic coil treatment to determine your brain’s natural electrical activity. Here is a review of why you should consider Transcranial Magnetic Stimulation Therapy (TMS) for your depression.

When is Transcranial Magnetic Stimulation Applied?

TMS usually is a treatment that may assist when other treatments fail to work. It’s additionally a crucial choice as it’s noninvasive. This implies it doesn’t need surgery or interventional procedure. 

TMS may additionally provide another choice over treatments, including electroconvulsive therapy (ECT), when ECT is not an option or fails to work.

The ailments that TMS is approved for treatment vary from country to country. TMS holds approval from the U.S. Food and Drug Administration (FDA) to treat four disorders:

  • Major depressive disorder (MDD) (like treatment-resistant depression).
  • Obsessive-Compulsive Disorder (OCD).
  • Smoking Cessation.

To add to the approved conditions, research is continuing to check if it can treat other conditions. Transcranial magnetic stimulation (TMS) is a non-invasive magnetic coil treatment by influencing the brain’s electrical activity. These encompass, but aren’t restricted to:

  • Alzheimer’s Disease.
  • Bipolar Disorder.
  • Borderline Personality Disorder (BPD).
  • Chronic Pain.
  • Eating Disorders.
  • Essential Tremor.
  • Parkinson’s Disease.
  • Post-Traumatic Stress Disorder (PTSD).
  • Stroke Complications.
  • Tinnitus or Auditory Hallucinations.
  • Traumatic Brain Injury.

What Are the Advantages of TMS?

TMS holds some benefits that render it an excellent treatment. TMS is a useful clinical tool that is effective in patients with depression.

  • It’s Non-Invasive. You don’t require surgery to get the procedure, and you can go on working when a session ends. It doesn’t need any anesthesia.
  • It’s safe. Your chance of getting a TMS seizure is less than 0.01% for every session. Alternative side effects are often minor.
  • It’s effective. The success statistics of TMS vary with each condition, but the research now proves it is effective especially for the treatment of Depression.
  • It may rescue lives. One of the conditions that TMS treats, Major Depressive Disorder, might result in death by suicide. TMS may save lives as this can cause improvements in depression symptoms or stops depression entirely.
  • TMS may work cooperatively with many other treatments including but not limited to medications, mental health therapies, and more.

What are The Risks, Side Effects, or Complications of Transcranial Magnetic Stimulation?

TMS has very few side effects, dangers, or complications. The highly probable severe side effect of TMS is going through a seizure. The risk of getting a seizure from a TMS treatment is 0.01% or lower than 1 in 10,000.

The highly probable complications, many of which are minor or don’t last more than a few minutes following a session, are:

  • Pain, often in your neck or scalp,
  • Dizziness and nausea.
  • Tingling of the muscles in your scalp or face.
  • Temporary Tinnitus (ringing inside your ears).
  • Very high sensitivity to sound (Hyperacusis).

What Is the Recovery Period from Transcranial Magnetic Stimulation?

Many users may resume their daily activity or routine instantly following a TMS session. Several users may require a few minutes to allow the side effects to subside, but this is rare.

When Should I See My Healthcare Provider or Get Medical Assistance?

You must consult your treating doctor as soon as you experience any side effects. Skipping sessions can render this treatment to fail.

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Transcranial Magnetic Stimulation (TMS) Therapy

Transcranial Magnetic Stimulation (TMS) Therapy

According to WHO, Depression is a common illness worldwide, with more than 300 million people affected. Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. Especially when long-lasting and with moderate or severe intensity, depression may become a serious health condition. It can cause the affected person to suffer greatly and function poorly at work, at school and in the family. At its worst, depression can lead to suicide. Close to 800 000 people die due to suicide every year. Suicide is the second leading cause of death in 15-29-year-olds.

 While there are many effective treatments for depression, first-line approaches such as antidepressants and psychotherapy do not work for everyone. In fact, approximately two-thirds of people with depression don’t get adequate relief from the first antidepressant they try. After two months of treatment, at least some symptoms will remain for these individuals, and each subsequent medication tried is actually less likely to help than the one prior.

What can people with depression do when they do not respond to first-line treatments? For those individuals and the many others who have had an inadequate response to medications and therapy alone, there is a newer treatment option called transcranial magnetic stimulation (TMS).

What is TMS?

Transcranial magnetic stimulation (TMS) is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. TMS is typically used when other depression treatments haven’t been effective.

This treatment for depression involves delivering repetitive magnetic pulses, so it’s called repetitive TMS or rTMS.

How does it work?

During an rTMS session, an electromagnetic coil is placed against your scalp near your forehead. The electromagnet painlessly delivers a magnetic pulse that stimulates the nerve cells in the region of your brain involved in mood control and depression. It’s thought to activate regions of the brain that have decreased activity in depression.

What are the different types of TMS treatments available?

Repetitive transcranial magnetic stimulation (rTMS) 

  • rTMS is used to treat patients with unipolar depression.
  • In rTMS an electromagnetic coil is held against the patient’s left side of the scalp while short electromagnetic pulses are administered through the coil. The magnetic and repeating pulses cause small electrical currents that stimulate nerve cells in the targeted region of the brain. 

Deep transcranial magnetic stimulation (dTMS) 

  • The procedure uses specialized coils, called H coils, which reach about 2 inches beneath the surface of the skull and are designed to target different brain areas.
  • During a dTMS session, a person wears a cushioned helmet, which generates brief magnetic fields.
  • dTMS is used to treat patients with unipolar depression and obsessive compulsive disorder.

Risks

Repetitive TMS is a noninvasive form of brain stimulation used for depression. Unlike vagus nerve stimulation or deep brain stimulation, rTMS does not require surgery or implantation of electrodes. And, unlike electroconvulsive therapy (ECT), rTMS doesn’t cause seizures or require sedation with anesthesia.

Generally, rTMS is considered safe and well-tolerated. However, it can cause some side effects.

Common side effects

Side effects are generally mild to moderate and improve shortly after an individual session and decrease over time with additional sessions. They may include headache, scalp discomfort at the site of stimulation, tingling, spasms or twitching of facial muscles, lightheadedness

Your doctor can adjust the level of stimulation to reduce symptoms or may recommend that you take an over-the-counter pain medication before the procedure.

Uncommon side effects

Serious side effects are rare. They may include Seizures, Mania, particularly in people with bipolar disorder, Hearing loss if there is inadequate ear protection during treatment

Preparation 

Before having rTMS, you may need a physical exam and possibly lab tests or other tests and a Psychiatric evaluation to discuss your depression. These evaluations help make sure that rTMS is safe and a good option for you.

Tell your doctor or mental health provider if you are pregnant or thinking of becoming pregnant, if you have any metal or implanted medical devices in your body. In some cases, people with metal implants or devices can have rTMS. However, due to the strong magnetic field produced during rTMS, the procedure is not recommended for some people who have the following devices such as Aneurysm clips or coils, Stents, implanted vagus nerve or deep brain stimulators, implanted electrical devices, such as pacemakers or medication pumps, electrodes for monitoring brain activity, Cochlear implants for hearing, any magnetic implants, bullet fragments or any other metal device or object implanted in your body. Also let your doctor know if you are taking any medications, if you have a history of seizures or a family history of epilepsy, if you have other mental health disorders, if you have brain damage from illness or injury, such as a brain tumor, a stroke or traumatic brain injury, if you have frequent or severe headaches, you have any other medical conditions, or you have had prior treatment with TMS, and whether it was helpful in treating your depression.

Repetitive TMS isn’t invasive, doesn’t require anesthesia and can be performed on an outpatient basis. You don’t need to arrange for someone to drive you home after treatment — unless, for the first treatment, you prefer a driver until you get a sense of how you’ll feel afterward.

Before considering treatment, check with your health insurance company to see whether rTMS is covered. Your policy may not cover it.

Repetitive TMS is usually done in a doctor’s office or clinic. It requires a series of treatment sessions to be effective. Generally, sessions are carried out daily, five times a week for four to six weeks.

After each treatment you can return to your normal daily activities after your treatment. Typically, between treatments, you can expect to work and drive.

Does TMS work?

Approximately 50% to 60% of people with depression who have tried and failed to receive benefit from medications experience a clinically meaningful response with TMS. About one-third of these individuals experience a full remission, meaning that their symptoms go away completely. It is important to acknowledge that these results, while encouraging, are not permanent. Like most other treatments for mood disorders, there is a high recurrence rate. However, most TMS patients feel better for many months after treatment stops, with the average length of response being a little more than a year. Some will opt to come back for subsequent rounds of treatment. For individuals who do not respond to TMS, ECT may still be effective and is often worth considering.

Can TMS help with other conditions?

TMS is being studied extensively across disorders and even disciplines with the hope that it will evolve into new treatments for neurological disorders, pain management, and physical rehabilitation in addition to psychiatry. There are currently large clinical trials looking at the effectiveness of TMS in conditions such as pediatric depression, bipolar disorder, smoking cessation, and post-traumatic stress disorder. While promising avenues for research, TMS for these conditions is not yet approved and would be considered “off-label.”

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