Achieve TMS East are often asked about potential side effects associated with TMS treatment.
What Exactly is TMS?
TMS is a non-invasive treatment, approved for major depressive disorder and obsessive-compulsive disorder. Many patients seek TMS treatment after failing to respond to first line methods (pharmacology and therapy). If a patient doesn’t experience relief from their depression symptoms despite trying several medications, they may be diagnosed with ‘treatment-resistant depression’.
TMS utilizes magnetic waves, directed at a portion of a patient’s brain through a specialized helmet. Simply put, these stimulate the surrounding cells to reduce depressive symptoms. TMS is painless, requires no medication or anesthesia, and no surgery.
A Typical TMS Treatment Session
Once a health practitioner has determined a patient as a candidate for TMS therapy, they will be prescribed a series of sessions. Usually, treatment involves five sessions per week for a duration of 4-6 weeks. Standard TMS therapy is slightly different from deep TMS (dTMS), as dTMS sessions are about half the length (20 minutes) of standard TMS (approximately 40 minutes). The currents produced by the technology travel about 2.5 cm into the brain with standard TMS, versus a depth of 6 cm with dTMS.
The patient is fully alert when receiving treatment while seated in a comfortable chair. A coil is placed on the patient’s head and the pulses are delivered through the scalp to the brain. Usually, patients feel nothing during the session, but occasionally a patient will report a faint tapping sensation on the scalp. Many patients view television or listen to music during the sessions. The patient is able to return to regular daily activities immediately following the treatment session.
TMS has shown to be particularly effective for patients with treatment-resistant depression. Considering the treatment directs magnetic waves directly at a portion of the brain, some patients worry about potential side effects.
Are There any Side Effects Associated With TMS Treatment?
Despite the somewhat alarming name, TMS is completely safe and has no lasting side effects. Mild side effects can occur but are increasingly rare, and fade soon after a treatment session ends. These may include:
Some patients have reported experiencing mild headaches during or shortly after TMS treatment. The headaches are reported to go away after a session, and their frequency often decreases with subsequent sessions. These are mild headaches, and as such are often treated with over-the-counter pain relief.
Note that while TMS technology is also used to treat migraines, migraines and headaches are two different things. However, specific TMS treatments have also been used to treat headaches. Headaches associated with TMS treatment may be caused by general physical discomfort with the placement of the coil or helmet. These may be adjusted during the treatment process for added comfort without compromising the effectiveness of the treatment.
Up to a third of patients, by some estimates, report sensations on the scalp ranging from uncomfortable to mildly painful. The most common complaint is a slight tapping sensation or prickling on the scalp. Another occasional issue is irregular headaches shortly after a session. These alleviate over the course of treatment, particularly after certain adjustments are made following a first session.
Because TMS utilizes magnetic waves to stimulate portions of the brain, an unintended side effect may be mild facial twitching due to the stimulation. These are harmless, and nothing to worry about aside from the discomfort they may produce during the procedure. Like the initial discomfort on the scalp, these seem to be reduced over subsequent treatment sessions.
For patients with sensitive hearing, earplugs may be used to drown out the noise of the TMS machine. Rather than being a side effect of the treatment itself, it’s usually an issue with the TMS machine being too loud for some patients.
Wearing earplugs is often enough to reduce the discomfort by muffling the noise, thereby effectively eliminating the danger of damage to a patient’s hearing.
Occurring in less than 0.01 percent of individuals (less than 1 in 10,000) during clinical trials, seizures are a rare risk associated with rTMS (repetitive transcranial magnetic stimulation), with studies showing it seems more common in conjunction with sleep deprivation, polypharmacy (utilizing several medications), and neurological insult (birth-related nerve damage in the brain). These seizures leave no lasting effect on patients and are not considered a long-term adverse side effect. While this type of side effect is possible, it is exceedingly rare.
Despite the highly unlikely chance of occurrence, rTMS treatment facilities are equipped to help patients who experience a seizure. A systematic review of TMS-related studies from 1980 to 2015 revealed 25 instances of rTMS-induced seizures. These were seizures unrelated to specific conditions (such as epilepsy).
Transcranial Magnetic Stimulation and Metal
TMS involves the use of magnetic fields to stimulate the brain. Therefore, patients with conductive metallic objects in or around their heads are not to be treated using TMS technology.
Examples of non-removable conductive metal include:
- Shrapnel/bullet fragments
- Tattoos with magnetic-sensitive ink
- Metallic implants/medical magnetic-sensitive implants
- Non-removable electrodes
- Neuromodulation devices (vagus nerve stimulation devices, deep brain stimulation devices)
- Stents in the neck
- Aneurysm clips/coils
- Other conductive metallic objects in/around the head
Transcranial magnetic stimulation is harmless to human tissue but can cause metal objects or devices to malfunction or heat up. Some metallic devices or objects are exceptions to this because they do not react to the magnetic waves. These include braces and dental fillings. Be certain to go over your medical history with a TMS provider before opting for TMS treatment.
Furthermore, research shows that TMS treatment has no negative effect on a patient’s cognition. While TMS can potentially affect the release of serotonin, it does not share the side effects commonly experienced when using antidepressant medication. You can also read real patient reviews to help you make an informed decision about your treatment.
Achieve TMS East, Proud Provider of dTMS Depression Treatment
Achieve TMS East is a premier provider of dTMS therapy in the northeast. Our doctors and clinicians are committed to providing compassionate treatment for MDD in patients who were medication-resistant. Patients will find expert staff and a comfortable, pleasant experience Achieve TMS East centers.