By Dr. David Woo - December 12, 2019

Prescription antidepressants, in combination with talk therapy, are typically the first line of treatment prescribed for depression, but they’re also associated with several side effects that can deter patients from wanting to take them. 

For patients who do not like the idea of taking antidepressants because of the side effects, transcranial magnetic stimulation (TMS) is an FDA approved medication-free alternative that offers many benefits to patients. TMS uses a magnetic field to gently stimulate certain areas of the brain associated with depression to relieve depressive symptoms. (1,2) What are the benefits of TMS treatment over antidepressants?

TMS is Effective for Patients With Treatment-Resistant Depression

TMS is clinically proven to be effective for patients diagnosed with treatment-resistant depression. Treatment resistance occurs when patients do not find relief from depressive symptoms after trying multiple antidepressants and/or while attending talk therapy appointments. It is estimated that as many as one-third of patients with depression do not respond to antidepressants and therefore do not find relief from their symptoms. (3) 

A clinical trial published in Biological Psychiatry showed that patients with treatment-resistant depression were twice as likely to achieve remission with active TMS treatment compared to placebo treatment or sham TMS. (4) A later study published in Depression and Anxiety looked at the response rate in patients diagnosed with treatment-resistant depression in a clinical setting. Researchers recorded a response rate of 58 percent and a remission rate of 37.1 percent, proving TMS to be a safe and effective treatment alternative to antidepressants. (5) You can learn more about TMS therapy success rates here.  

TMS Has a Significantly Lower Risk of Side Effects Compared to Antidepressants

Since TMS is not a medication, it does not enter the bloodstream and is not considered a systemic treatment. This means that TMS does not cause side effects associated with antidepressants. Antidepressants are known to cause numerous side effects that can severely impact a patient’s quality of life, including:

• Increased appetite that can lead to weight gain
• Sexual dysfunction
• Nausea
• Anxiety
• Insomnia 
• Fatigue (6)

TMS has very few reported side effects, which include:

• Mild headache
• Tingling or twitching of facial muscles
• Lightheadedness (7,8)

TMS Provides Long-Lasting Results With Just One Course of Treatment

TMS has been clinically proven to provide long-term results after just one course of treatment lasting six weeks. A clinical trial published in the Journal of Clinical Psychiatry reports that among patients who achieved remission with TMS treatment, 62.5 percent continued to show treatment response one year after their six-week TMS treatment. (9) 

Antidepressants must be taken for months or even years to achieve results. Once patients have full relief from depressive symptoms and enter remission, it is generally recommended that they continue to take their medication for an additional four to nine months to avoid relapse and to maintain results. (10)

TMS is Covered by Insurance

Like antidepressants, TMS is covered by most insurance plans. Learn more about TMS therapy costs. If you’ve been diagnosed with depression and have not found relief from antidepressants, you may want to consider TMS. To learn whether you may be a good candidate for TMS treatment, take our online quiz.

Resources:

1. Neurostar mechanism of action. YouTube: Neurostar Advanced Therapy. Published on Nov 29, 2016. https://www.youtube.com/watch?v=r4WISNwv3nc. Accessed November 23, 2019.

2. Transcranial magnetic stimulation. Mayo Clinic. Publication Date Unavailable. https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625. Accessed November 23, 2019. 

3. Ionescu DF, Rosenbaum JF, and Alpert JE. Pharmacological approaches to the challenge of treatment-resistant depression. Dialogues in Clinical Neuroscience. 2015 Jun; 17(2): 111–126. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4518696/. Accessed November 23, 2019.

4. O’Reardon JP, Solvason HB, Janicak PG, et al. Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: A multisite randomized controlled trial. Biological Psychiatry. 2007;62(11):1208-16.https://www.ncbi.nlm.nih.gov/pubmed/17573044. Accessed November 23, 2019.

5. Carpenter LL, Janicak PG, Aaronson ST, et al. Transcranial magnetic stimulation (TMS) for major depression: A multisite, naturalistic, observational study of acute treatment outcomes in clinical practice. Depression and Anxiety. 2012;29(7):587-96. https://www.ncbi.nlm.nih.gov/pubmed/22689344. Accessed November 23, 2019.

6. Coping with side effects of depression treatment. Web MD. Updated March 09, 2011. https://www.webmd.com/depression/features/coping-with-side-effects-of-depression-treatment#1. Accessed November 23, 2019.

7. Rossi S, Hallett M, Rossini PM, Pascual-Leone A, and The Safety of TMS Consensus Group. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clinical Neurophysiology. 2009;120(12):2008–2039. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3260536/. Accessed November 25, 2019.

8. Transcranial magnetic stimulation. The Mayo Clinic. Updated Nov. 27, 2018. https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625. Accessed November 25, 2019.

9. Dunner DL, Aaronson ST, Sackeim HA, et al. A multisite, naturalistic, observational study of transcranial magnetic stimulation for patients with pharmacoresistant major depressive disorder: Durability of benefit over a 1-year follow-up period. The Journal of Clinical Psychiatry. 2014;75(12):1394-401. https://www.ncbi.nlm.nih.gov/pubmed/25271871. Accessed November 23, 2019.

10. Depression: How effective are antidepressants? InformedHealth.org. Published January 28, 2015. Updated January 12, 2017. https://www.ncbi.nlm.nih.gov/books/NBK361016/. Accessed November 23, 2019.

Dr. David Woo

Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.