Transcranial Magnetic Stimulation vs. Electroconvulsive Therapy
Brain stimulation therapy is certainly not a new therapeutic option, making its modern debut in the mid-19th century when Michael Faraday first attempted to stimulate nerves and the brain using electromagnetic induction. In the nearly 200 years since, the science behind electromagnetic treatment methods has been constantly evolving.
Electroconvulsive shock therapy was developed in Italy in the 1930s for psychiatric patients suffering not only from depression, but also schizophrenia, bi-polar disorder, and catatonia. The process was extreme and by the 1960s had a negative stigma and fear associated with it. Starting in the 1970s, electroconvulsive therapy (ECT) saw improved techniques in administering and monitoring the treatment and is considered a very effective treatment for severe psychosis.
Transcranial magnetic stimulation (TMS) was first developed in 1985, offering a non-invasive option that required no sedation. TMS, cleared by the FDA in 2008, offers a simplified and generally risk-free option to ECT for treatment of medication-resistant depression. It, too, has demonstrated much success and promise in the treatment of various mental health conditions, with the bulk of the study centering on depression.
Both of these methods ultimately result in changes to the neurotransmitter levels and receptors, altering brain chemistry and helping to reset and normalize the connections that are functioning abnormally in individuals suffering from major depressive disorder (MDD).
TMS vs. ECT
When reviewing the research and literature regarding the safety and efficacy of TMS and ECT, one learns that there are some significant differences between these methods of brain stimulation. Both TMS and ECT are effective in treating MDD when traditional therapeutic methods—antidepressants and psychotherapy—have failed, but there are varying features that help determine which is the option better for a specific individual.
TMS therapy involves the patient comfortably seated and fully alert while a helmet equipped with magnetic coils is placed gently on their head. Unlike ECT, TMS does not involve applying electrical currents to the patient’s head, but instead activates a specific region in the brain through magnetically stimulation that causes electrical currents within. The pulses are delivered deep into the prefrontal cortex, activating the part of the brain associated with mood and decision-making. Patients rarely complain of discomfort or side effects and are able to continue on in their normal daily activities before and after the session. Side effects that have been reported include headache and scalp irritation. The TMS treatment plan is typically 5 days per week for about 20 minutes, lasting 4-6 weeks.
In patients who found no relief, or couldn’t tolerate the side effects, from a regimen of antidepressants have experienced a 30% rate of success using TMS to treat their depression.
ECT involves the patient first being sedated with a general anesthetic, as well as being prescribed muscle relaxants prior to the procedure to prevent fractures from intense muscle contractions. Heart rate and blood pressure are monitored throughout the procedure by a medical team. Electrodes placed at strategic locations on the scalp deliver electrical currents through the brain, which cause a seizure that lasts about a minute. The course of ECT is typically 2 or 3 times per week for 2-4 weeks, and during that period the patient is on a leave of absence from work.
Various studies show that for psychotic depression, ECT is more effective than TMS. It is also recommended for a patient who is actively suicidal. However, the side effects and risks of ECT are much higher than in TMS. In addition to the risks associated with general anesthetic, serious side effects from ECT include memory loss that may be permanent, nausea, headache, and muscle aches. ECT is generally reserved for the most severe forms of mental illness and should be considered as a last resort.
Achieve TMS can Help
At Achieve TMS our knowledgeable and compassionate staff can help guide you toward the right treatment option for you. We will take the time to explain the TMS process to you in detail, as well as check your insurance coverage for you. Call us today for a free consultation at (877) 447-6503.