Transcranial Magnetic Stimulation (TMS) uses short pulses of magnetic fields to stimulate nerve cells in the area of the brain thought to control mood. These pulsed magnetic fields may have a positive effect on the brain’s neurotransmitters levels. Treating depression with transcranial magnetic stimulation (TMS), may provide an alternative depression treatment for those who have not benefitted from prior antidepressant medication.
In studies of “real life” clinical practice, approximately 60% of patients with treatment resistant depression responded to TMS. In a similar study, medications achieved only a 17% response rate.
SeattleNTC provides the largest number of TMS treatments, and is the most experienced TMS provider in the Puget Sound area.
of patients with treatment resistant depression responded to TMS
About Transcranial Magnetic Stimulation
Transcranial Magnetic Stimulation (TMS) is a treatment approved by the US Food and Drug Administration (FDA) for patients suffering from depression who have not achieved satisfactory improvement from prior antidepressant treatment.
- Is an outpatient procedure performed in a psychiatrist’s office
- Is non-invasive, meaning that it does not involve surgery
- Does not require any anesthesia or sedation; the patient remains awake and alert during the treatment
- Is focal and non-systemic, meaning it does not circulate in the bloodstream like medications
The typical initial treatment course consists of at least 5 treatments per week over a 4-6 week period for an average of 20-30 total treatments. Each treatment session lasts between 20 and 40 minutes.
How does TMS work?
Using an electromagnetic coil, TMS generates highly concentrated magnetic fields which turn on and off very rapidly. These magnetic fields are the same type and strength as those produced by a magnetic resonance imaging (MRI) machine.
The treatment coil is applied to the head above the left prefrontal cortex. This part of the brain is involved with mood regulation, and therefore is the location where the magnetic fields are focused. These magnetic fields do not directly affect the whole brain; they only reach about 2-3 centimeters into the brain directly beneath the treatment coil. As these magnetic fields move into the brain, they produce very small electrical currents. These electrical currents activate cells within the brain which are thought to release neurotransmitters like serotonin, norepinephrine, and dopamine. Since depression is thought to be the result of an imbalance of these chemicals in the brain, TMS can restore that balance and, thus, relieve depression.
Depression is now the leading cause of disability in the world (WHO, 2012), and Transcranial Magnetic Stimulation (TMS) is increasingly recognized as an important treatment option by both clinicians and insurance companies.
As such, we are frequently asked about the relative effectiveness of medications vs. TMS vs. ECT for treatment-resistant depression. While head to head studies of the 3 treatments have not been completed, it is interesting to compare large, multi-site, frequently cited studies of the 3 treatment modalities administered to patients with similar levels of treatment resistance.
These findings are a useful reminder to regularly assess the severity of depression in our patients using depression rating scales, and to be sure that patients with treatment-resistant depression are being progressed through a series of treatment steps including, if appropriate, an evidence-based psychotherapy, additional medication trials, TMS or ECT.
Clinical trials have demonstrated the safety of TMS in treating patients who have had an inadequate response to prior antidepressant medications.
Treatment with TMS caused very few side effects and was generally well tolerated by patients. The most common side effect reported during clinical trials was scalp discomfort-generally mild to moderate and occurring less frequently after the first week of treatment.
- Fewer than 5% of patients discontinued treatment with TMS due to adverse events.
- Over 10,000 active treatments have been performed across clinical trials demonstrating its safety1
- No systemic side effects
- No weight gain
- No sexual dysfunction
- No sedation
- No nausea
- No dry mouth
- No adverse effects on concentration or memory
- No drug interactions
TMS Therapy should not be used in patients with implanted metallic devices or non-removable metallic objects in or around the head. This does not include metallic fillings in teeth.
TMS Therapy should not be used in patients with implants controlled by physiological signals. This includes pacemakers, implantable cardioverter defibrillators (ICDs), and vagus nerve stimulators (VNS).
A TMS treatment session is a short outpatient procedure that lasts between 15 and 45 minutes. During treatment, you can relax in the treatment chair. You can also speak with our TMS Clinicians whenever necessary. After the procedure, you can immediately return to your normal routine, including driving.
Your first treatment session
Because your psychiatrist needs to individualize TMS to provide the most effective treatment, your first session could last up to an hour and a half. You will be provided with protective earplugs, as the system emits a tapping sound during operation.
Your psychiatrist will first perform a test to identify your motor threshold. The motor threshold is the amount of magnetic field strength that results in a movement of your right thumb. This test is important because it identifies the magnetic field strength that will be used in your treatment. This field strength is customized for each patient to deliver the correct treatment dose.
After this initial procedure, the TMS physician will determine the place on the head where the TMS treatment will be applied and the magnetic coil will be moved to that location. This will allow you to receive optimal treatment.
The TMS Clinician will then administer TMS over an approximately 15 to 45minute period. In 15 to 30-second intervals, the device will deliver rapid “pulses” of the magnetic fields. These will feel like tapping on your scalp. If a patient finds this tapping uncomfortable, your physician will make adjustments to reduce the discomfort.
TMS Media Coverage
Transcranial Magnetic Stimulation (TMS) has been featured in several prominent news publications highlighting its success in treating depression including SeattleNTC. Among these publications and television shows are: Dr. Oz, TIME Magazine, Scientific American, Discover Magazine, and Good Housekeeping. See below for more news stories discussing the latest applications of TMS Therapy.
- ‘Nothing short of a miracle’: Depression treatment has success when medication doesn’t
- Mood-boosting magnets might help treat depression
- WebMD: Can Technology Help Treat Depression?
- Everyday Health: TMS, a Drug-Free Therapy for Depression
- Scientific American: Magnetic Stimulation May Halt Rumination in Depression
- US News Health: TMS: What Is It and Who Needs It?
- Forbes: Can Altered States of Consciousness Cure Depression?
- Journal Sentinel: Magnetic therapy gains favor in battling depression
- The Chicago Tribune: Magnetic Pulses to Battle Depression
- EurekAlert: Durability of Neurostar TMS Therapy Demonstrated in Clinical Trial
- Psych Congress: TMS Therapy Can Rapidly Reduce Suicidal Thoughts
- TIME: Doctors Treat Depression With Brain Magnets
- Wall Street Journal: New Data Shows TMS Therapy Promising Treatment for Major Depressive Disorder
- Deep TMS receives Positive Results For the Treatment of Depression in Elderly Patients
- Stimulating Neural Circuits with Magnetism
- New symptom-free treatment helps depression, reduce military suicides
- Can magnets cure depression?
- Magnetic brain stimulation helps depression
- TMS Effective for Major Depressive Disorder, Generalized Anxiety Disorder
- TMS offers hope for Treatment-Resistant Depression
Depression & TMS
For decades, researchers have sought safe and effective treatments for depression. There is no single depression treatment which has been proven to work for everyone. While depression is often treated with antidepressant medications and psychotherapy, many patients have treatment-resistant depression that does not respond to these first and second line treatments.
For these patients, alternative treatments are available. These depression therapies have been shown to work in people who do not receive benefit from medications or cannot tolerate the side effects caused by them. One alternative therapy for the treatment of depression is transcranial magnetic stimulation (TMS). TMS has been approved by the FDA for patients suffering from depression who have not achieved satisfactory improvement from prior antidepressant medications.
"I would say that SeattleNTC is an incredible partner for anyone suffering any kind of mental health issue. Again, I can primarily speak for those with depression, but I would tell anyone who’s dealing with mental health issues: SeattleNTC is on the cutting edge. The staff and the doctors are extremely caring and extremely talented people. Compassionate. Very interested in the outcome and the ongoing of all their treatment." - ECT & TMS patient - Karen (45yo)
"I started the TMS. Overnight, it's like I came back to life. So far, it's kept sticking around and I've reconnected with my church groups, my community of work." – TMS patient - Jim (62yo)
"I'm very, very satisfied with the results and I think I made the right decision. SeattleNTC and Dr. Melman came highly recommended in this field. One of the best! This gave me a lot of confidence going into the treatment. I wake up every morning with gratefulness that I am now happy. My energy level is off the charts. My family is no longer suffering due to my depression. The closeness and love we share is priceless!" – TMS patient – Jessica (41yo)
"There’s never a glitch or a moment of stress. Everybody’s attuned to you. Somebody’s there to make sure you’re ok. It’s amazing. They hold your hand through the whole procedure. I can’t say enough good about it" - ECT patient – Bertie (71yo)
"I knew that there had to be something. I couldn’t had run out of luck at this point." - TMS patient – Maria (45yo)
“TMS has taken the bottom out of my low moods and reduced my anxiety. I have noticed a marked decrease in my symptoms, and it feels as though my brain has and still is subtly rewiring itself toward a continued lessening of my depression and anxiety.”