Transcranial Magnetic Stimulation is growing in popularity across the US for its benefits to support patients with severe mental health disorders such as treatment-resistant depression and OCD.
Understanding the pros and cons of TMS can help patients make an informed decision on whether it is the right treatment fit for them.
Understanding Transcranial Magnetic Stimulation
TMS is a noninvasive treatment that is thought to stimulate nerve cell activity in the brain. It is FDA-approved for severe cases of Major Depressive Disorder & OCD. It is also gaining recognition as an off-label use for conditions such as bipolar disorder, PTSD, and chronic pain.
The magnetic fields found on the coil send short and rapid electric impulses to the brain. This is thought to stimulate neurons in the cerebral cortex. Research has found that certain disorders such as depression are associated with low activity in parts of the cerebral and prefrontal cortex and TMS is designed to increase activity in these regions.
How Does TMS Work?
In your TMS session, an electromagnetic coil will be placed on the scalp of your head. This coil is designed with electrodes to deliver magnetic pulses, thought to stimulate nerve cells in the region of the brain that impacts emotional regulation, mood control, and depression.
During your TMS, here is what you can expect:
- Your technician may provide you with earplugs to minimize the sound that the TMS machine makes. You´ll sit back in a comfortable chair and will be awake throughout the session.
- For your first session, your provider will measure your head for the magnetic coil.
- The technician will place the coil above the front area of your head, this will stimulate the region of the pre-frontal cortex during treatment.
- After the TMS machine is turned on you may hear a loud clicking sound. You will also feel slight tapping sensations below the coil on your scalp. This will not hurt.
- Treatment sessions last about 30-60 minutes. You can drive and resume normal activities as usual after your session.
Unlike other therapies for treatment-resistant depression, such as ketamine, you will need to repeat the procedure 5 days a week for 4-6 weeks. However, this will vary based on your response to TMS and the condition being treated.
Pros and Cons of TMS
| Pros | Cons |
| Non-invasive | May require multiple sessions over weeks or months to find relief |
| Effective for treatment-resistant mental health disorders | Not as widely available as other conventional therapies |
| Low to minimal side effects | TMS can be extremely expensive if it is not covered by insurance |
| Most TMS treatment is covered by insurance | Some patients may experience slight discomfort when the coil is placed on their head such as headaches or muscle twitching |
Who Should Consider TMS?
There are several conditions TMS is approved to treat. The most widely used reason for TMS is Major Depressive Disorder, especially if you have tried conventional treatments with no relief.
You may be a good candidate for TMS if:
- You are diagnosed with Major Depressive Disorder or OCD
- You have tried other treatments such as medication or conventional therapies such as CBT
- You struggle with side effects from your current medications
You may not be a good candidate for TMS if:
- You have an implant or metal device in your head
- Implants controlled by physical signals (pacemakers, nerve stimulators, etc)
- You have epilepsy, a brain tumor, or other neurological conditions
The Harper Clinic Approach to TMS
TMS must be approved by a licensed mental health professional before treatment can be administered. Harper Clinic offers a 3-step consultation process to patients looking for treatment.
- Get in touch with Harper Clinic either by text, phone call, a form on their website, or through their direct Vagaro booking.
- Schedule your first consultation with a provider so they can help you design a treatment plan tailored to your specific health needs.
- In your first individual assessment, your provider will verify insurance, and learn your medical history, goals of treatment, and what you have already tried in the past.
Your provider may recommend a different treatment such as medication, or conventional therapies first such as CBT, DBT, or EMDR. However, this is on a case-by-case basis. If you meet the criteria as a successful TMS candidate, they will approve you for treatment and schedule your sessions.
Sources
Rizvi, S., & Khan, A. M. (2019). Use of Transcranial Magnetic Stimulation for Depression.
