Transcranial Magnetic Stimulation (TMS)

A Drug-Free Depression Treatment

TMS therapy is the first and only non-systemic and non-invasive TMS device cleared by the U.S. Food and Drug Administration (FDA) for the treatment of patients with major depression who have not benefited from prior antidepressant treatment. TMS therapy uses a highly focused, pulsed magnetic field to stimulate function in targeted brain regions.

The nature of the magnetic field allows it to pass through a patient’s hair, skin, and skull and into the mood-regulating area of the brain. This method allows for targeted stimulation, minimizing the stimulation of brain tissue not involved in mood.

The nature of the magnetic field allows it to pass through a patient’s hair, skin, and skull and into the mood-regulating area of the brain. This method allows for targeted stimulation, minimizing the stimulation of brain tissue not involved in mood.

How TMS Therapy Works

TMS therapy is a non-invasive medical treatment performed in a psychiatrist’s office. During the session, the patient is wide-awake while the treating clinician uses a treatment coil to deliver focused magnetic stimulation directly to the area of the brain thought to be involved in regulating mood. The magnetic field pulses of TMS therapy are the same strength as those used in magnetic resonance imaging (MRI) machines.

The nature of the magnetic field allows it to pass through a patient’s hair, skin, and skull and into the mood-regulating area of the brain. This method allows for targeted stimulation, minimizing the stimulation of brain tissue not involved in mood.

These magnetic pulses produce very small electrical currents. The amount of electricity created in the brain is very small and cannot be felt by a patient. These pulses stimulate function in targeted regions of the patient’s brain. Studies have shown that people suffering from depression have less activity in these areas of the brain. These small electric currents can cause the neurons (brain cells) to fire or become active and lead to the release of neurotransmitters (the brain’s chemical messengers). The repetitive treatments of TMS assist your brain in creating muscle memory to keep that part of that brain active releasing the neurotransmitters, and relieving the symptoms of depression.

The image on the left shows the brain activity of a person without depression and on the right is a scan of a person with depression. The activity of the brain is decreased. TMS is shown to target a certain area of the brain and bring more activity to the patient’s brain.

Is TMS therapy right for you?

Are you are taking medication to treat your depression?

Are you still depressed despite your medication?

Are you experiencing side effects from your medication?

Have you switched medications more than once due to side effects?

Are depression symptoms interfering with your leisure activities or relationships with your family and friends?

Are depression symptoms having an effect on your ability to earn a living?

Clinical Data on Transcranial Magnetic Stimulation for the Treatment of Depression

TMS therapy was evaluated for efficacy, safety, and tolerability in the acute treatment of major depression in patients who had failed to receive benefit from prior antidepressant medications. A six-week, randomized, placebo-controlled, double-blind study was conducted to evaluate the use of TMS as a monotherapy. An analysis for predictors of response demonstrated that the patients with the best response to TMS therapy were those who had not benefited from one prior antidepressant medication at an adequate dose and duration in the current depressive episode.

This clinical study population was comprised of patients with unipolar, non-psychotic major depressive disorder. Almost all of them (97%) had suffered previous depression episodes. These patients also had an extensive treatment history without satisfactory improvement. They had received a median of 4 total prior antidepressant treatment attempts in the current episode, one of which achieved treatment adequacy at or above the minimal effective dose and duration. Thirty-five percent of the patients had a co-morbid anxiety disorder and all had moderate to severe depressive symptoms.

In the indicated patient population, the following efficacy results were observed in the randomized, controlled study:

The primary efficacy measure, the Montgomery-Asberg Depression Rating Scale (MADRS) symptom score change at four weeks, was statistically significant compared to placebo (p=0.0006), for TMS-treated patients. Similar results were observed with the Hamilton Depression Rating Scale (HAMD).

TMS therapy-treated patients had statistically significant response and remission rates, which were approximately twice the rate of placebo-treated patients.
In an open-label clinical trial, which is most like real-world practice, 1 in 2 patients suffering from depression improved significantly, and 1 in 3 patients were completely free of depression symptoms after six weeks of treatment.

Is TMS Safe?

Throughout TMS therapy studies, more than 10,000 active TMS treatments were safely performed, with the following safety results observed2:

  • No systemic side effects commonly associated with antidepressant medications
  • No adverse effects on concentration or memory
  • The most common side effects reported during clinical trials were headache and scalp pain or discomfort — generally mild to moderate and occurring less frequently after the first week of treatment.
  • There is a low risk of seizure associated with TMS Therapy. The estimated risk of seizure under ordinary clinical use is approximately 1 in 30,000 treatments (0.003% of treatments) or 1 in 1000 patients (0.1% of patients).  No seizures were observed during NeuroStar clinical trials.
  • During clinical trials, there was a less than 5 percent discontinuation rate due to adverse events.

TMS therapy is contraindicated in patients with implanted metallic devices or non-removable metallic objects in or around the head.  As with any antidepressant treatment, patients should be monitored for symptoms of worsening depression.

Interested in TMS?

Are you interested in TMS treatment? If so, give us a call or fill out this form and one of our staff will contact you.