TMS Therapy Side Effects: What You Need to Know

TMS Therapy Side Effects: What You Need to Know

What Is TMS Therapy?

Transcranial Magnetic Stimulation (TMS) is a noninvasive treatment for patients with treatment-resistant depression and other mental health conditions such as obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). This non-invasive treatment method uses an electromagnetic coil to deliver magnetic pulses to targeted brain regions, particularly the prefrontal cortex, which is responsible for mood regulation and brain activity.

TMS therapy is considered a safe option for those who have not responded to antidepressant medications or other forms of treatment. Unlike electroconvulsive therapy (ECT), which can cause severe cognitive side effects, TMS does not require anesthesia and has minimal side effects.

Common Side Effects of TMS Therapy

While TMS is an effective treatment for major depression and other psychiatric disorders, some potential side effects can occur.

Mild Side Effects

Patients commonly experience mild discomfort, scalp pain, or facial twitching during the initial sessions. These therapy side effects are usually temporary and improve as weeks of treatment progress. Some may also experience jaw pain, neck pain, or facial pain due to the muscle contractions caused by the magnetic stimulation of nerve cells.

Moderate Side Effects

Some individuals report cognitive side effects, such as temporary cognitive function changes, including mild memory issues or difficulty concentrating. Other moderate effects include auditory processing sensitivity due to the noise during treatment, as well as hearing issues, particularly for patients without proper ear protection.

Serious Side Effects

Though rare, TMS therapy carries a risk of seizures, particularly in individuals with a history of epilepsy or a seizure disorder. Other adverse events may include hypomanic symptoms in patients with bipolar disorder or an increase in OCD symptoms for those undergoing rTMS treatment for compulsive disorders. Individuals with a family history of seizures or preexisting conditions such as brain tumors or aneurysm coils should consult a healthcare provider before beginning treatment.

Mechanism of Action

TMS therapy works by stimulating brain cells using electromagnetic pulses, which target the brain responsible for mood control. The electrical stimulation provided by the treatment coil influences neural pathways in the motor cortex and prefrontal cortex, leading to changes in brain function that help alleviate depressive symptoms.

Types of TMS Therapy

Repetitive TMS (rTMS)

This treatment method involves a pulse train of magnetic waves delivered to the prefrontal cortex. rTMS treatment is commonly used for treatment of depression and has shown an impressive success rate in patients with severe depression.

Deep TMS (dTMS)

Deep TMS uses a specially designed treatment coil to reach deep brain stimulators, targeting areas associated with OCD symptoms and depressive disorder. This method allows for deeper magnetic stimulation, which can be beneficial for individuals with treatment-resistant depression.

Understanding Eligibility for TMS Therapy

Criteria for Patients

Patients with depression who have not responded to at least two antidepressant treatments may be eligible for TMS. However, patients with implants controlled by electronic devices, such as cochlear implants, cardioverter defibrillators, vagus nerve stimulators, or deep brain stimulators, should avoid TMS due to potential risks from the electromagnetic pulses interfering with these medical devices.

Considerations for Specific Conditions

Individuals with metal devices in the head, such as metal plates, dental fillings, aneurysm clips, aneurysm coils, or bullet fragments, may face additional risks. Pregnant women and elderly patients should also consult a healthcare provider before considering TMS therapy.

Treatment Schedule and Expectations

A treatment plan typically consists of weeks of treatment, with a week of treatment involving five therapy sessions. Each treatment session lasts 20 to 40 minutes, depending on the pulse strength and individual response. The clinical response varies, with some experiencing relief in depression symptoms within the first few weeks, while others require additional treatments.

Safety Precautions Before Starting TMS

Patients should undergo a medical history review before starting TMS therapy. Those with a history of seizures, brain stents, or motor dysfunction need to be assessed for potential long-term effects. Proper ear protection is essential to prevent hearing loss due to the ambient noises created by the electromagnetic coil.

Managing Side Effects During TMS

For scalp discomfort and scalp pain, adjusting the treatment coil placement can reduce patient discomfort. Counter pain relievers such as over-the-counter pain medication can help with headaches and muscle contractions. Individuals experiencing cognitive function issues should discuss any adverse effects with their consulting provider.

Comparing TMS Therapy to Other Treatments

Medications

TMS therapy provides an effective depression treatment without the adverse side effects of depression medications. Many patients with treatment-resistant depression opt for TMS after experiencing antidepressant side effects such as weight gain, negative side effects, or effects of medications on daily activities.

Psychotherapy

While psychotherapy is an important part of mental health treatment, it may not be sufficient for patients with severe depression. Combining TMS therapy with therapy sessions can enhance emotional responses and improve the success rate of depression treatments.

Alternative Therapies

Other treatment options include electrical activity-based treatments, magnetic resonance imaging-guided therapies, and holistic approaches like lifestyle changes. However, TMS therapy remains one of the most effective treatments for mental illness and depressive disorder.

Conclusion and Considerations for Patients

TMS therapy is an effective treatment for patients with depression who have not responded to standard antidepressant treatments. With a personalized approach, this noninvasive procedure offers life-changing results for those struggling with mental health disorders. While minimal side effects occur, it is important to discuss potential risks with a health care provider before starting treatment. Insurance companies and insurance providers may cover TMS therapy as an option for depression, making it more accessible for those seeking an alternative to invasive procedures.

For potential patients considering TMS, consulting a treatment team can help determine the best treatment plan for brain health and normal activities.