We’re happy to answer your TMS FAQ’s. TMS stands for Transcranial Magnetic Stimulation. I’s used to treat depression by stimulating the brain non-invasively using electromagnetic fields, similar to those produced by an MRI machine. During TMS, we administer a magnetic field is in very short pulses to the part of the brain that research has demonstrated to be associated with depression. The typical initial course of treatment is about 37 minutes daily M-F over 4-6 weeks.
TMS treatment uses short pulses of magnetic fields to stimulate the area of the brain that is thought to function abnormally in patients with depression. The magnetic field produces an electric current in the brain that stimulates the brain cells (neurons). This results in changes that are thought to be beneficial in the treatment of depression.
It usually takes time for healthcare insurers to establish coverage policies — even for approved treatments such as TMS. However, most commercial and Medicare plans have recognized the effectiveness of treating depression with TMS and now cover TMS as part of their plans.
Is TMS a Good Alternative for Me if I Can’t Tolerate the Side Effects Associated With Antidepressant Medications?
TMS is a non-systemic treatment — there is nothing that circulates in the blood throughout the body — so it does not have side effects such as weight gain, sexual dysfunction, nausea, dry mouth, sedation, etc.
The most common side effects reported during clinical trials were headache and scalp discomfort – generally mild to moderate – occurring less frequently after the first week of treatment.
No. TMS involves a unique method of using pulsed magnetic fields for therapeutic benefit. The intensity of the magnetic field is similar to that of the magnetic fields used in magnetic resonance imaging, or MRI.
These techniques differ radically from the popular use of low intensity, static magnetic fields. These products deliver weak and undirected static fields that are not capable of activating brain cells.
No. The two procedures are very different. While both are effective in the treatment of depression, there are many differences in safety and tolerability.
During TMS treatment, you sit in a comfortable reclining chair and are awake and alert throughout the entire 37-minute procedure – no sedation is used with TMS. You can drive yourself to and from treatment, and do whatever you like during the rest of your day.
In over 10,000 active treatments with the NeuroStar TMS Therapy system in clinical trials, no seizures were observed. TMS was also shown to have no negative effects on memory function in these studies.
In contrast, ECT (or electroconvulsive therapy) intentionally causes a seizure. Patients receiving ECT must be sedated with general anesthesia and paralyzed with muscle relaxants in order to receive the treatment, and it is usually administered in a hospital recovery room area. Recovery from an ECT treatment occurs slowly, and patients are usually closely monitored for up to a few hours after a treatment.
Short-term confusion and memory loss are common with ECT. Long-term disruptions in memory have been shown to occur and may persist indefinitely in some people. Because of the side effects associated with ECT, a significant amount of caregiver support is required.
When ECT is administered on an outpatient basis, patients are instructed not to drive for the duration of their treatment (3 times a week for a few weeks) and usually are encouraged not to work because of the memory disruption they are likely to experience.
A typical course of TMS treatment involves daily 37-minute sessions Monday through Friday for about 4-6 weeks. Treatments can be a brief interlude in the course of a busy day and work-life. Patients can zip in and right back out to work or school or home.
Any additional treatments are based on clinical judgment.
NeuroStar TMS Therapy has been shown to be well tolerated and the Neurostar TMS Therapy system has been demonstrated to be safe in clinical trials. Throughout over 10,000 active treatments performed in clinical trials, the most commonly reported side effect related to treatment was scalp discomfort during treatment sessions. This side effect was generally mild to moderate, and occurred less frequently after the first week of treatment. Less than 5% of patients treated with NeuroStar TMS Therapy discontinued treatment due to side effects.
In NeuroStar clinical trials, over 10,000 TMS treatments demonstrated its safety, with no occurrence of seizures. However, there is a very small risk of a seizure occurring during treatment. This risk is no greater than what has been observed with oral antidepressant medications.
While NeuroStar TMS treatment has been demonstrated to be effective, not all patients will benefit from it. Patients should be carefully monitored for worsening symptoms, signs or symptoms of suicidal behavior, and/or unusual behavior. Families and caregivers should also be aware of the need to observe patients and notify their treatment provider if symptoms worsen.
NeuroStar TMS uses the same type and strength of magnetic fields as MRIs (magnetic resonance imaging), which have been used in tens of millions of patients around the world and have not been shown to cause tumors. The magnetic energy used in a full course of TMS is a small fraction of just one brain scan with an MRI.
No. The NeuroStar TMS Therapy system was systematically evaluated for its effects on memory. Clinical trials demonstrated that NeuroStar TMS Therapy does not result in any negative effects on memory or concentration.
No… and yes, sometimes. The most common side effect related to treatment was scalp discomfort during treatment sessions. This side effect was generally mild to moderate, and occurred less frequently after the first week of treatment.
If necessary, you can treat this discomfort with an over-the-counter analgesic. If these side effects persist, Dr. Calabrese can temporarily reduce the strength of the magnetic field pulses being administered in order to make treatment more comfortable.
Less than 5% of patients treated with NeuroStar TMS discontinue treatment due to side effects.
NeuroStar TMS is the only TMS system with the durability of its effects established over 12 months. In a clinical trial, 2 out of 3 patients who had either responded to treatment or completely remitted their depression symptoms reported 12 months later that they remained at the level they were at the end of the trial. Additionally, after the trial, only 1 in 3 patients needed to return for ‘maintenance’ TMS sessions.
Yes. In clinical trials, NeuroStar TMS Therapy was safely administered with and without other antidepressant medications.
Does FDA-Clearance of the NeuroStar TMS Therapy System Mean That All TMS Devices are Cleared for Use in Major Depression Within the United States?
No, the NeuroStar TMS Therapy system is the first TMS device to be cleared by the U.S. Food and Drug Administration (FDA) for the treatment of major depression.
The NeuroStar TMS Therapy system is also the first TMS device to have been evaluated in a large, multicenter, controlled clinical trial, as well as the only TMS system with the durability of its effects over 12 months established.