Transcranial Magnetic Stimulation for Depression

Chronic depression is treatable for most people, but sometimes counseling, antidepressant medications and alternative treatments such as mindfulness meditation for depression fail to provide adequate relief. Researchers have long been seeking more effective forms of treatment, and it appears that transcranial magnetic stimulation (TMS) may provide some answers.

TMS was developed in the 1980s and approved by the U.S. Food and Drug Administration in 2008. Research is ongoing, but many studies show great promise. One long-term study involving 250 patients indicated that 68 percent showed improvement after one year, and 45 percent showed complete remission of symptoms. These results were presented to the American Psychiatric Association in 2013.

Patients who are interested in TMS treatments will first undergo physical and psychological assessment to ensure the treatment is appropriate. TMS may not provide answers for everybody, and it’s impossible to tell ahead of time if it will work or not.

A TMS Session involves placement of an electromagnetic coil near the forehead. The coil delivers an electrical pulse to the prefrontal cortex, the region of the brain involved in mood and depression. The pulse may also activate other areas of the brain that display decreased activity associated with depression.

Treatments, often offered at specialized, private depression clinics or rehabs for depression, are prescribed by a TMS doctor and performed by the physician or a trained technician. TMS sessions, which take 30 to 40 minutes, are completely noninvasive and require no surgical procedures. Patients are awake and alert throughout the treatment, and are able to return to normal activities immediately.

TMS is safe for most people, but there are some possible side effects. The most common are mild headache, lightheadedness and minor discomfort or tingling where the electrodes were placed. Some patients report hearing loss, as the TMS machine is very loud. However, this rarely happens if the ears are properly protected. In very rare cases, patients may experience mania or seizures.

A course of treatment generally requires three to five sessions per week for four to six weeks. Some people may need occasional “booster” treatments if symptoms reappear.

Does TMS Work for Addiction and Substance Abuse?

Research on TMS and addiction is in its infancy and it’s far too early to consider TMS as an effective treatment for addiction. Unlike depression, which is treated in an easily accessed area of the brain, addiction requires treatment much deeper in the prefrontal cortex. However, preliminary studies indicate there may be some reduction in cravings.

Some Doubt Exists

The medical community hasn’t given TMS a complete vote of confidence. Not all are convinced that it works, and some think the benefits are small to moderate. However results of newer studies are more positive and some insurance companies now cover TMS as a treatment for depression.

It appears that TMS may be worth a try for people who have exhausted other forms of treatment for depression. In some cases, TMS is most effective when used in combination with counseling, supplements, and in some cases, medication.

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