Transcranial Magnetic Stimulation (TMS) is a promising treatment for Major Depressive Disorder (MDD), especially for individuals who haven’t had success with medications. Below are frequently asked questions (FAQs) patients often have when considering TMS for MDD.

1. How long does TMS take to work?

TMS is not an immediate solution. Most patients begin to notice improvements after 2 to 3 weeks of treatment, though some may experience changes earlier. A full course of TMS therapy for MDD typically spans 4 to 6 weeks, with five sessions per week, totaling 20-30 sessions. However, individual responses vary—some patients may require additional sessions, while others may respond sooner.

2. Is TMS safe?

Yes, TMS is considered very safe. It is FDA-approved for the treatment of MDD, and multiple clinical trials have demonstrated its safety profile. TMS does not require anesthesia or sedation, making it a non-invasive and well-tolerated treatment. The most common side effects are mild and temporary, including:

  • Scalp discomfort at the treatment site
  • Mild headaches
  • Facial muscle twitches during the session

Serious side effects, like seizures, are extremely rare, occurring in less than 0.1% of patients, typically in individuals with pre-existing conditions that predispose them to seizures. Clinicians follow strict protocols to minimize any risks.

3. Will I be awake during TMS?

Yes, TMS does not require sedation or anesthesia. Patients remain fully awake and alert throughout the session, which lasts between 20-40 minutes depending on the protocol used. After the session, patients can return to their normal daily activities without needing downtime or recovery.

4. What does a TMS session feel like?

During TMS, patients often feel a tapping or knocking sensation on their scalp where the magnetic coil is placed. The sensation can sometimes cause mild discomfort, especially in the first few sessions, but this tends to subside as patients adjust. The quiet coil technology used in the Blossom TMS device minimizes noise and vibrations, improving the overall experience.

5. Can TMS replace antidepressants?

TMS is typically used for patients with treatment-resistant depression, meaning they have tried one or more antidepressants without success. While it can be highly effective, TMS is usually considered an adjunct therapy rather than a first-line treatment. However, some patients who respond well to TMS may be able to reduce or stop their use of antidepressant medications, depending on their doctor’s guidance.

6. How effective is TMS for MDD?

Studies show that TMS is effective, particularly for patients who haven’t responded to medications. Response rates (defined as a significant reduction in depressive symptoms) hover between 50-60%, while remission rates (complete symptom relief) are reported to be between 30-40%. For many patients, TMS offers a chance for substantial improvement when other treatments have failed.

7. How long do the effects of TMS last?

The effects of TMS can last several months to over a year. However, depression is a chronic condition, and some patients may experience a return of symptoms. In these cases, maintenance sessions or booster treatments can help sustain the benefits of TMS. Each patient’s long-term treatment plan is individualized based on their response to therapy.

8. Is TMS covered by insurance?

Yes, TMS is covered by most major health insurance providers in the United States, including Medicare. However, coverage is usually granted for patients who meet specific criteria, such as failure to respond to multiple antidepressants. Insurance companies may require documentation showing that the patient has tried other treatments before approving TMS.

9. Are there any long-term side effects of TMS?

No long-term side effects have been documented in patients who undergo TMS for MDD. The most common side effects, like headaches or scalp discomfort, are short-lived and typically resolve soon after the session or by the end of the treatment course.

Conclusion

TMS for MDD is a safe and effective option for patients who have not responded to traditional antidepressants. While results vary from person to person, many patients find significant relief from their depressive symptoms after completing a course of TMS therapy. It’s non-invasive, well-tolerated, and offers a promising solution for treatment-resistant depression.