Lenox Hill TMS is recognized as one of the nation’s leading providers of TMS. We designed our TMS Centers with a focus on excellence and are staffed with the most experienced team of experts in the field of TMS. At Lenox Hill TMS, our goal is to provide the best quality care and always put the needs of our patients first. We partner with our patients’ existing mental health providers by offering our expertise in TMS to form a more comprehensive team approach to treating your condition.
Transcranial Magnetic Stimulation (TMS) is one of the most effective antidepressant treatments available and has been approved by the FDA since 2008. It is a safe, non-invasive, brain stimulation therapy that has been shown to be effective in medication-resistant depression. TMS is a brief, outpatient procedure that involves using an MRI-strength magnet to produce electromagnetic pulses that stimulate an area of the brain (dorsolateral prefrontal cortex) believed to be underactive and responsible for causing the symptoms of depression. A typical course of TMS lasts 4-6 weeks and depends on a patient’s response to treatment. The procedure is delivered daily (Mon-Fri) in 30-45 minute sessions. Patients can resume normal daily activities after each session.
TMS system uses an insulated magnetic coil that is placed over the dorsolateral prefrontal cortex, the area of the brain believed to be underactive in patients suffering from depression. The coil emits brief magnetic pulses that stimulate cortical neurons in this area to help them return to normal function over the course of treatment and effectively treat the depressive illness.
TMS is a good alternative for patients who have difficulty tolerating the side effects associated with antidepressant medications. Since TMS is non-systemic (does not circulate through the bloodstream), it does not have side effects typically seen with antidepressant medications (ie. weight gain, sexual dysfunction, nausea, dry mouth, sedation, etc.) The procedure is well-tolerated with few side effects such as headache and mild scalp discomfort. TMS has been cleared by the U.S. Food and Drug Administration (FDA) for the treatment of patients with depression who have failed to achieve satisfactory improvement from prior antidepressant medication.
No, these two procedures are very different.
While both brain stimulation therapies are effective in the treatment of depression, there are many differences in safety and tolerability. During TMS, patients sit in a chair and are awake and alert throughout the entire procedure. Since there is no sedation, patients can travel unaccompanied to and from their treatment sessions.
TMS is a non-convulsive procedure and has been shown to have no negative effects on memory function. In contrast, electroconvulsive therapy (ECT), also referred to as “shock therapy,” is invasive, requires inducing a seizure to exert its therapeutic effect, and therefore has to be delivered under general anaesthesia. Short-term confusion and memory loss are common, but generally mild and transient side-effects. Anaesthesia risks, cognitive side-effects, pre-operative fasting and post-operative recovery can all make ECT a less attractive treatment option.
While treatment plans vary from patient to patient based on clinical response, a typical course of TMS is generally delivered over a 4-6 weeks. The procedure is performed daily (Mon-Fri) for 30-45 minutes. Most patients find the daily structure of treatments fits nicely into their routine and that they can resume their regular activities after treatment without any disruption.
TMS has been proven to be safe since it was first used in clinical research in the late 1990’s. The most commonly reported side effect related to treatment include mild headache, tingling and scalp discomfort; however, less than 5% of patients discontinue treatment due to side effects. There is a small risk of a seizure (approximately 1 in 10,000) occurring during treatment; however, this risk is no greater than what has been observed with oral antidepressant medications. While TMS has been proven effective in 2 out of 3 patients, not all patients will benefit from it. TMS does not worsen depression, but patients should be carefully monitored for any changes in behaviour.
The most common side effect related to treatment is scalp discomfort during treatment sessions. This side effect is generally mild and occurs less frequently after the first week of treatment. If necessary, we can treat this discomfort with an over-the-counter analgesic.
No, TMS uses the same type and strength of magnetic fields used in MRI’s (magnetic resonance imaging), which have been used in tens of millions of patients around the world and have never been shown to cause tumors. The magnetic energy used in a full course of TMS is a small fraction of just one brain scan with an MRI.
No, TMS was systematically evaluated for its effects on memory. Clinical trials demonstrated that TMS does not result in any negative effects on memory or concentration.