Transcranial Magnetic Stimulation is an innovative non-invasive treatment. It’s used for severe depression, post-traumatic stress disorder (PTSD), neurological disorders, and more. During TMS sessions, we use a machine with a wand that channels magnetic impulses into your brain. We’ve used this treatment to help hundreds of patients live better lives. But what are the pros and cons of TMS? Let’s talk about why you should or shouldn’t get TMS Therapy. 

 

TMS is FDA-approved for treatment-resistant depression and obsessive-compulsive disorder (OCD). It works by stimulating areas of the brain to form new connections and patterns. A TMS machine channels magnetic impulses into the scalp and brain. When these impulses repeat quickly, they create a second electrical field. This is what changes nervous system tissue during TMS. This is also why you may see TMS called rTMS or Repetitive TMS. 

 

The theory behind TMS therapy is that these changes help alter thought patterns. People with depression and PTSD have problems with repeating unhelpful thoughts. They’re wired to go down patterns of painful emotions. And it’s hard to un-train our brains from these patterns on our own. Therapy and medications can help, but they take time. Some people still don’t experience relief. 

 

TMS stimulates new neural pathways in the brain and forges new patterns. This helps people with treatment-resistant mental illnesses to think differently. In research, TMS has been more effective than SSRIs for people with severe depression. It’s also helpful for Obsessive-Compulsive Disorder (OCD), and PTSD.2 

 

Want to learn more about how TMS works? Check out our blog. 

 

But TMS is still a newer treatment, and you might not have heard much about it before. Aren’t there pros and cons to channeling magnetic impulses into our most precious organ? 

 

KarmaTMS offers Transcranial Magnetic Stimulation therapy to patients with treatment-resistant mental illness. We know that you might not have heard much about this treatment. But you should have all the answers before you invest time and energy into TMS. There are pros and cons to every treatment, and you should understand them before you get started. 

 

So let’s jump into the good and bad of TMS therapy for depression, OCD, bipolar, and more. 

TMS Therapy Pros and Cons 

Every treatment has risks and benefits. First, let’s get into the pros of TMS therapy, and why you may want to consider it. 

What Are the Benefits of TMS?

TMS therapy has shown to be effective for depression, OCD, PTSD, and other mental illnesses. It’s also relatively fast-acting and has few risks compared to other medical treatments. Let’s get more clear on what each of these benefits mean. 

TMS is Effective

TMS’s greatest benefit is that it’s effective for a range of mental illnesses. Even people who haven’t been helped by other methods can still find it with TMS. 

 

Up to a third of people who get treatment for depression don’t find relief from medications alone. This is a discouraging experience. TMS offers hope to these people that life can get better. 

 

TMS has been so effective for depression that some experts argue that patients should have access to it sooner rather than later. If TMS can help, patients shouldn’t have to go through the suffering and cost of medications. TMS is FDA-approved only for patients who have undergone other treatments. But in the future, it may be one of the first recommendations for people with depression. 

 

But TMS isn’t only helpful for people with treatment-resistant depression. TMS has also shown to be effective for these diagnoses:

• Obsessive-Compulsive Disorder (OCD)
• Post-Traumatic Stress Disorder (PTSD)
• Anxiety
• Bipolar Disorder

 

But how long does TMS take compared to other treatments? That question brings us to the next benefit of TMS therapy, which is how quickly it can help. 

TMS Can Be Faster Than Other Options

Another benefit of TMS is how quickly it can work for many patients. Symptoms can improve after just a few treatments, or within two weeks in trials., Compare this to SSRIs, which take several weeks to build up in the body enough to have effects. 

 

But if it works so fast, what are the risks? That brings us to another benefit of TMS. 

TMS Therapy Has Few Risks and Side Effects

There haven’t been any serious side effects reported after TMS therapy. It has few risks for most patients., In contrast, psychiatric medications can cause a host of unpleasant side effects. These include weight gain, dry mouth, and sexual problems. 

 

There are a few side effects you may encounter during and right after your TMS session. More on those later. Another benefit of TMS is that you likely won’t have to stop your medications during your regimen. 

TMS Doesn’t Interact with Other Treatments

Unlike SSRIs, TMS won’t cause problems from interacting with food or medications. Many patients stay on their antidepressants during a TMS regimen. This makes TMS accessible more quickly than other options like switching medications. Switching from an SSRI can take months, but starting TMS takes just a few weeks. 

 

Now that we’re clear on the main benefits of TMS therapy, let’s talk about the drawbacks you should consider. 

What Are The Disadvantages of TMS?

TMS therapy can be hard to access because it’s approved for patients who have already tried other treatments. It can be inconvenient to have to go to a clinic every few days, and you may notice some annoying side effects. You’ll also need to avoid alcohol and cannabis during your regimen. Let’s talk more about these drawbacks. 

Only Certain Patients Qualify for TMS Therapy

The major drawback for TMS therapy is that it’s not available to everyone with depression, PTSD, or bipolar. Most insurers cover TMS therapy, but they require that patients try at least two medications before approval. Some require psychotherapy as well. If you were recently diagnosed with depression and you haven’t tried other treatments, your insurer may not cover TMS. 

TMS Sessions Can Be Inconvenient

A typical TMS regimen includes sessions up to five times a week for about six weeks. These sessions last about 40 minutes, and patients drive themselves to and from their sessions. This can feel like a life interruption, especially for patients with kids and busy lives. Arranging transportation to these sessions can be hard if you don’t drive. 

 

Our patients make their regimens work by coming in on their lunch break or arranging child care for an hour while they’re in their session. And most find that the temporary inconvenience is worth the long-term benefits. But are there any unpleasant side effects you should look out for? Let’s talk about them. 

TMS Side Effects Can Be Annoying

TMS has fewer side effects than other medical treatments, and these usually resolve within 24 hours. Check out the most common side effects of TMS:

 

• Headaches
• Facial tingling or twitching
• Lightheadedness
• Tenderness or discomfort at the stimulation site
• Ear ringing after treatment

 

Patients who have these side effects mostly report that they go away after the first few sessions. 

 

TMS doesn’t interfere with most medications. But there are substances that we ask our patients to avoid during their regimen, so let’s get clear on them. 

Avoiding Alcohol & Cannabis During TMS Therapy

You’ll need to avoid alcohol and cannabis during TMS treatment. Both of these substances change the way the brain reacts to TMS therapy. Alcohol can increase your risk for seizures, so it’s especially important that you avoid it. And that brings us to our last disadvantage of TMS, which is the risks of therapy. 

TMS Has Some Rare Risks

Risks are rare, but you should still be aware of them. Here are a few risks to know about before starting TMS therapy:13 

 

• People with a history of seizures may have an increased risk of seizing during TMS therapy. 
• People with bipolar have a small risk of triggering mania and hypomania after TMS. 
• Hearing loss is a risk if ear protection isn’t applied correctly.

Psst. . . worried about the risks of TMS? We have a whole blog about them. Check it out here. 

 

Every treatment has risks and benefits, and TMS is no exception. Our patients tend to think that the pros outweigh the cons, but that decision is up to you. Now let’s answer a common question we get from patients who are still worried about life after TMS therapy. 

Can You Get Worse with TMS?

Not according to research. TMS is a non-invasive treatment, and studies have yet to find evidence of people getting worse afterward. 

 

Some patients do report a dip in their mood after starting TMS. This may happen mid-way through your regimen and can feel like your depression is coming back. These effects are generally temporary. It’s important that you make sure your psychiatry team is aware of your symptoms. 

Where Can I Get More Information About TMS?

Everyone’s story is unique, and you probably have questions about whether TMS can work for you. We prescribe TMS alongside medications, psychotherapy, and integrative treatment strategies. Our compassionate staff members are happy to answer your questions and get you set up with a consultation so we can understand your goals. 

 

If you’re interested in getting help for PTSD, depression, or another mental health diagnosis, call our office. 

 

Resources:

Siebner HR, Hartwigsen G, Kassuba T, Rothwell JC. How does transcranial magnetic stimulation modify neuronal activity in the brain? Implications for studies of cognition. Cortex. 2009 Oct;45(9):1035-42. doi: 10.1016/j.cortex.2009.02.007. Epub 2009 Mar 3. PMID: 19371866; PMCID: PMC2997692.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2993526/

 Gustavson DE, du Pont A, Whisman MA, Miyake A. Evidence for Transdiagnostic Repetitive Negative Thinking and Its Association with Rumination, Worry, and Depression and Anxiety Symptoms: A Commonality Analysis. Collabra Psychol. 2018;4(1):13. doi: 10.1525/collabra.128. Epub 2018 May 17. PMID: 30761388; PMCID: PMC6370308.

 Voigt, J., Carpenter, L., & Leuchter, A. (2019). A systematic literature review of the clinical efficacy of repetitive transcranial magnetic stimulation (rtms) in non-treatment resistant patients with major depressive disorder. BMC Psychiatry, 19(1). https://doi.org/10.1186/s12888-018-1989-z

 Kessler RC, McGonagle KA, Zhao S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Arch Gen Psychiatry. 1994;51:8–19.

https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-018-1989-z

Mann SK, Malhi NK. Repetitive Transcranial Magnetic Stimulation. [Updated 2022 Mar 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK568715/

Berman RM, Narasimhan M, Sanacora G, et al. (2000) A randomized clinical trial of repetitive transcranial magnetic stimulation in the treatment of major depression. Biol Psychiatry. 2000;47(4):332–7.

 Minzeberg, M., Yoon, J. (2020). Transcranial magnetic stimulation: A clinical primer for Nonexperts. Journal of Psychiatric Practice, 26(5), 423–428. https://doi.org/10.1097/pra.0000000000000490

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6592198/

Nyffeler, T., & Müri, R. (2010). Comment on: Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research, by Rossi et al. (2009). Clinical Neurophysiology, 121(6), 980. https://doi.org/10.1016/j.clinph.2010.04.001

 Hunter AM, Minzenberg MJ, Cook IA, Krantz DE, Levitt JG, Rotstein NM, Chawla SA, Leuchter AF. Concomitant medication use and clinical outcome of repetitive Transcranial Magnetic Stimulation (rTMS) treatment of Major Depressive Disorder. Brain Behav. 2019 May;9(5):e01275. doi: 10.1002/brb3.1275. Epub 2019 Apr 2. PMID: 30941915; PMCID: PMC6520297.

Mayo Foundation for Medical Education and Research. (2018, November 27). Transcranial magnetic stimulation. Mayo Clinic. Retrieved January 30, 2023, from https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625

Turco CV, Arsalan SO, Nelson AJ. The Influence of Recreational Substance Use in TMS Research. Brain Sci. 2020 Oct 18;10(10):751. doi: 10.3390/brainsci10100751. PMID: 33080965; PMCID: PMC7603156.