Both TMS and ECT are forms of neuromodulation used to treat depression. Electro-convulsive therapy (ECT) involves passing an electric current through the brain. This causes a generalized (grand mal) seizure. It therefore requires a general anesthetic. While having ECT, patients may require inpatient care or require someone to drive them to and from ECT treatments. ECT can cause short term memory loss for the period before and after each treatment session. Patients usually have 6-12 treatment sessions over three to six weeks and few patients have memory loss for this whole time period.
TMS uses an electromagnetic coil to create an alternating magnetic field over the scalp and this magnetic field induces small currents in the brain.
TMS is an outpatient procedure that does not require an anesthetic and patients can resume their normal life activity after the session.
Both TMS and ECT can lead to a rapid improvement in symptoms. Up to 70% of depressed patients who fail to respond to antidepressants respond to ECT and about 60% of patients who fail to respond to antidepressants respond to TMS.
Some patients who fail to respond to ECT will respond to TMS and some patients who fail to respond to TMS will respond to ECT. ECT is still considered the best treatment for some patients with very severe depression, psychotic depression or catatonia. Your doctor will advise you about which is the best treatment for you.