Patients and Family

The time needed for a patient to start seeing positive results differs from one patient to the other and it is quite difficult to predict. Assuming that patients have daily sessions for five days every week the majority of patients who respond to TMS start seeing positive results after a few weeks of receiving the treatment. However, some patients report positive results sooner than this and other patients can have a delayed response that at times happens towards the end of the 6th week of TMS treatment.

TMS is a well-tolerated treatment, the vast majority of patients can have TMS. People with non-removable metallic, ferromagnetic objects which is less than 30 cm from the treatment coil might not be suitable for TMS and should consult with their TMS prescriber if they have any of these items:

Around 60% of people treated with TMS respond to treatment. If people do not respond to TMS they should be evaluated by their treating psychiatrist and other treatments should be considered. This should include medication review, ECT and psychotherapy. Some patients will improve using different TMS sequences or treatment locations.

It is advisable that you have regular follow-ups with your treating clinician after you respond to TMS. This should help to consolidate your recovery and in order to agree on a treatment plan if you start having depressive symptoms again. A lot of patients who respond to TMS maintain their improvement without having additional treatments for at least a year. However, there is a group of patients who might re-experience depressive symptoms after responding to TMS. For this group of patients, the treating clinician might decide to reintroduce TMS.

The most common side effects of TMS are discomfort at the site of treatment during the treatment sessions and a mild headache for a few hours following the sessions. Occasionally patients experience discomfort in the eye, teeth or jaw and typically alleviated with over the counter analgesics.

Some patients may experience increased anxiety and sleep difficulties. All of these usually decrease following the first week of treatment.

TMS has been tried as a treatment for different mental health and neurological conditions such as, depression, obsessive compulsive disorder (OCD), post traumatic stress disorder (PTSD), anxiety, addiction, eating disorders, dementia, autism, migraine, neuropathic pain, fibromyalgia, post stroke conditions … etc. However, the current evidence to support the use of TMS in treating different conditions vary significantly. At the present time there is very strong evidence to support the use of TMS as a treatment for depression.

TMS can be very effective in the treatment of depression. For over 20 years it has demonstrated the ability to improve depression symptoms in patients in research studies as well as under more real-world conditions. In one of the largest studies of patients treated with TMS for depression, around 60% of participants reduced their symptoms by at least 50% (responded) and around 30% of participants no longer met criteria for depression (remitted).

Your doctor will discuss with you the best way to administer TMS. The session lasts between three and 37 minutes depending on the protocol used.

Antidepressants work by modifying the actions of neurotransmitters (brain chemicals) or modifying neurotransmitter receptors. TMS induces small electrical currents in the brain which improve the connections between brain cells and increase the growth of brain cells. Treatment with antidepressants involves taking medications which are absorbed through the mouth, stomach and small intestine with possible side effects throughout the body.

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.