If you are considering TMS therapy, you should know that it is one of “the big three” when it comes to treating depression – in other words, one of the three majorly accepted depression treatments. The other two are drug medications (antidepressants) and electroconvulsive therapy (ECT). The very purpose of TMS therapy is, in fact, to help patients who have treatment-resistant depression and are not being successfully treated by antidepressants. For these people, TMS has proven to be more effective at battling depression.
So where exactly does the medical community stand on all your options? Should you choose TMS over ECT? What has a greater probability of success in treating your symptoms? As always, every individual case is different and your personal physician will play an important role as an advisor. However, it is important to examine the research for yourself and understand TMS in the context of other treatments and why it stands out above the rest.
When doctors talk about the “efficacy” of treatment, they are referring to how well a therapy leads to the decrease or disappearance of your depression symptoms. This is otherwise known as “remission.” Clinical studies show high success rates for TMS patients, with 60% of TMS patients having overall positive clinical improvement and nearly one-third experiencing total remission. Because of its lack of medication, including anesthesia, TMS is considered to be the “best tolerated” treatment and has a more “favorable balance between efficacy and acceptability” as compared with ECT. Therefore, in terms of efficacy, research points to TMS as the best option for treatment-resistant depression.
Side effects from antidepressants are often the number one reason why people turn to TMS therapy for their depression. Drug medications tend to come with well-known adverse effects such as nausea, sexual dysfunction, dry mouth, drowsiness, weight gain, and trouble sleeping. When these negative effects become unbearable, patients seek out TMS or ECT as alternative treatment options.
In studies comparing ECT with TMS, negative effects from ECT are more prevalent and of a much more intense nature than any effects associated with TMS. In one study, up to 60% of ECT patients reported memory loss and other troublesome side effects. By comparison, only 30% of TMS patients experienced side effects and they were described as “short-term” and “minor” — scalp discomfort or a headache which went away within a few hours. There are no other “common” side effects of TMS. The most serious side effect of TMS is very rare, which is a seizure observed in less than 1 in 30,000 treatments with NeuroStar’s Advanced Therapy system. Most antidepressant medications are actually known to cause more seizures more frequently than TMS.
Therefore, in terms of side effects, research points to TMS as potentially better for your treatment than ECT.
Cost of treatment is perhaps the biggest deciding factor for patients. Ongoing use of antidepressant medications on treatment-resistant depression only results in symptoms worsening and your wallet disappearing. TMS therapy, on the other hand, has proven to be more cost-effective than both antidepressants and ECT alike. Lower costs and better outcomes were found “in all age ranges” of people who tried repetitive TMS therapy in a lifetime study. Yet another study showed that ECT was costlier per quality year of life gained and that TMS gave a “substantial economic benefit over ECT” in treating depression.
Finally, in terms of cost savings as well, research illustrates that TMS may be the better option for you. It will be important to check with your insurance provider to understand what the actual cost will be with your particular policy and medical situation, but the likelihood is that it will be much more cost-effective in the end than either ECT or continued use of antidepressants. Combined with overall superiority in efficacy and side effects, TMS therapy is well worth trying as your next treatment option.