Is TMS Therapy Safe?

Is TMS Therapy Safe?

Author: GIA Chicago
Published: September 8, 2022

Since TMS is a recent therapy, you might be questioning its safety. A better understanding of the therapy and how it works may help you understand its low risks.

What Is TMS?

Transcranial Magnetic Stimulation (TMS)is a non-invasive brain stimulation used for therapeutic treatment.

TMS uses electromagnetic induction to stimulate nerve cells or underactive neurons. This brain stimulation improves symptoms of neurological or mental health disorders, such as obsessive-compulsive disorder, major depressive disorder, or bipolar disorder. It has also been used to treat drug cravings, alcoholism, smoking cessation, and post-traumatic stress disorder.

TMS is most commonly used to treat depression and has shown a clinically meaningful response among patients, especially for those who have not experienced adequate relief from antidepressant medication or other first-line treatments for it.

Is TMS Therapy Safe?

Studies across patient populations over the last decades have proven TMS very safe if guidelines are followed. Unlike other brain stimulation therapies, TMS does not use any other medicines. Unlike vagus nerve stimulation and deep brain stimulation which require the implantation of electrodes or surgery, and electroconvulsive therapy (ECT) which requires sedation with anesthesia, TMS requires none of the above.

Even though major depressive disorder is present among around 7% of the general population, 30% of these people do not respond to first-line treatments. Not only do patients with major depression experience an improvement in depression symptoms after TMS treatment, but they also do not undergo all of the usual side effects that are common with antidepressant medications. This means no nausea, sedation, weight gain, dry mouth, sexual dysfunction, and more. TMS also does not cause withdrawal when discontinuing therapy.

How Does TMS Therapy Work?

TMS involves short treatment sessionsaround five times a week, for a duration of six weeks.

TMS is based on electromagnetic induction. Magnetic pulses are produced by an electrical current from a coil. The magnetic pulse flows through the skull, producing an electrical field underneath it. Short, brief currents from magnetic stimulation reach underactive brain cells or the regions of the brain involved in mood control. The excitation of these neurons causes them to release more neurotransmitters, and this affects the communication network and connectivity among neurons.

Types of TMS

Repetitive transcranial magnetic stimulation (rTMS) has shown changes in neuron activity in the prefrontal cortex, effectively treating depression. rTMS treatment can be repeated over time. While conventional TMS treatments are very effective, express TMS has been used for improving learning, which lasts around three minutes of treatment compared to forty. 

Deep TMS works with a bigger pulse range, thereby targeting both the left and right dorsolateral prefrontal cortex. A narrower range of conventional TMS treatment is overcome by deep TMS. By reaching deeper structures of the brain directly, such as the limbic system, deep TMS is more effective in treating an obsessive-compulsive disorder or treatment-resistant depression.

Are There Any Side Effects?

There are very mild side effects to transcranial magnetic stimulation, and they fade away as therapy continues. These include mild headache, tapping sensation in the scalp, scalp discomfort, rednessat the site of stimulation, tingling of facial muscles, lightheadedness, and neck pain.

People may have some anxiety before or during the treatment. Someone may experience a "TMS dip" more or less halfway through treatment, which consists of a temporary worsening of depression or anxiety symptoms. This usually fades after some sessions and it is important to know that it is temporary. 

Severe effects are very unlikely, and the most severe effect of TMS is probably its very low risk of seizures during treatment. This is more common for people who have undergone head injury, and the risk for seizure is not more than that of oral antidepressant medications.

What Happens During a TMS Therapy Session?

TMS treatment follows simple steps. A person can resume normal activity after treatment, including driving themselves home if needed.

  1. During TMS, a person sits in a reclining chair. In the first TMS session, measurements are made to ensure that the TMS coil is in the right position over a person's head, and the electromagnetic coil is then suspended over the scalp.
  2. A TMS physician measures the motor threshold by releasing some brief impulses. The motor threshold is different from person to person and is usually indicated by a twitch in the thumb.
  3. A person may hear a clicking sound as magnetic stimulation begins, and may feel a tapping or knocking sensation underneath the coil. A person will wait thirty minutes to one hour for the therapy to finish.

Who Should Avoid TMS Treatment?

Due to the magnetic field produced by rTMS, metal implants and devices or other circumstances may cause a mental health provider to discourage therapy for some. These circumstances include:

  • Someone having metal in or around their head, such as metal plates, cochlear implants, stents, deep brain stimulators, ocular implants, aneurism clips
  • People with implants such as pacemakers, implantable cardioverter defibrillators, or vagus nerve stimulators
  • Women who are pregnant
  • People with a history of seizures or epilepsy
  • People with a history of brain damage, a brain tumor, or stroke

Can TMS Damage the Brain?

TMS is proved safe, with no evidence related to cognitive decline or brain related damage. Clinical studies have not found negative long-term effects after TMS, including memory loss or a decline in concentration.

The magnetic fields that are used in TMS are similar to what is used in MRI scans, meaning that it is familiarly safe. Even more so, complete TMS therapy uses just a fraction of magnetism than what is used in one MRI scan.

Can TMS Cause Brain Tumors?

TMS does not cause brain tumors. A medical professional will always observe patients, to be aware of any worsening symptoms, while a pre-existing brain tumor will be picked up upon diagnosis for candidacy for TMS.

Can TMS Change Your Personality?

Even though TMS does not change someone's personality, studies have shown some dimensions of personality can respond in anti-depressive manners when receiving repetitive TMS treatment.

Where Can I Find TMS Treatments?

GIA Chicago is a mental health center that specializes in TMS. We use evidence-based therapy and cutting-edge technology at our world-class facility, and with caring and experienced staff, TMS therapy with us can help your mental wellness starting today.

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