TMS Vs. ECT Treatment – What You Need To Know

TMS Vs. ECT treatment

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When people mention electroshock therapy, it is often met with shock. Especially if people find out that it is still used today. Brain stimulation therapies are widely used for severe mental health disorders when medication management has failed. For patients seeking relief that appears to be unattainable, choosing between the two most popular options is hard. What are they? What do I need to know about them? Whether you seek new treatment or want to know more about brain stimulation therapies, keep reading!

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What Is Transcranial Magnetic Stimulation (TMS)

Transcranial magnetic stimulation, also referred to as TMS, uses magnetic fields to stabilize moods. A large electromagnetic coil is placed on the patient’s forehead, and magnetic pulses are pushed into the head. These pulses stimulate nerve cells in the brain to improve moods and other symptoms of depression.

A patient is awake for the non-invasive treatment, which lasts around 40 minutes. Several sessions are required over weeks to months. It is a great treatment option for those with a major depressive disorder with no psychotic component. This treatment is FDA-approved for treating major depression, obsessive-compulsive disorder, and pain associated with migraines.

what is TMS Therapy

What Is Electroconvulsive Therapy

Electroconvulsive therapy (ECT) is most commonly known as electroshock therapy. In the 1940s, ECT was used generously and inappropriately by medical professionals. This resulted in negative associations with the treatment. Many assume that the patient is under duress during the procedure. The reality is, no one is forced to do the treatment, and they are asleep under anesthesia while the treatment is performed. Rest assured, it is not the same procedure as it was before.

A patient is put under general anesthesia, and electrodes are attached to various places on the head. Electrical currents are sent through the head as the patient sleeps and induces a mild seizure. These affect chemicals and neurons in the brain to treat severe depression and other disorders.

About 5-10 min after the treatment, the patient wakes up. Within an hour, they can go through their day normally. Unfortunately, most patients require four to six treatments to see any significant improvement. After that, there are supporting treatments that can be monthly or annually. It depends on the severity of the diagnosis and how well the patient is reacting to the treatment.

This is an effective treatment for treatment-resistant depression with psychotic episodes. It is also effective for some types of treatment-resistant bipolar disorder. However, as with all treatments, there are some side effects to expect. Let’s explore those for TMS and ECT.

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Side Effects of TMS

Transcranial magnetic stimulation (TMS) affects the nerve cells and will come with some side effects after TMS treatment or over a period of treatment. Potential side effects include:

  • Spasms, tingling, or twitching of the face.
  • Headache or light-headedness
  • Scalp discomfort at the stimulation site
  • Seizures, if a person has a history of seizures
  • Mania, if a person has bipolar disorder
  • Hearing loss, if ears are not appropriately protected during treatment
  • Weight gain
  • Fatigue
  • Insomnia
  • Sexual dysfunction
  • Apathy

Side Effects Of ECT

Electroconvulsive therapy is a bit more invasive than TMS. This means that the side effects of ECT are quite a bit different. Possible side effects include:

  • Headaches
  • Muscle aches
  • Nausea
  • Confusion following treatment, which may last a few minutes or hours
  • Memory loss – forgetting conversations or events right before and after treatment, things from weeks or months before treatment, and less commonly, from years before
  • Difficulty learning
  • Increased blood pressure
  • Change in heart rate
  • Altered arrhythmias

Pros And Cons Of TMS

TMS Therapy Testimonials

As with any treatment or procedure, there are pros and cons to weigh when making the decision. Here is a list of pros and cons when utilizing transcranial magnetic stimulation for your mental health care.

Pros:

  • It has a high success rate – medications barely have a 35% success rate, but the success rate for TMS is over 65%.
  • When considering TMS vs. ECT, TMS has a “better” list of side effects.
  • Insurance will usually cover the treatment.
  • Long-term outcomes – 90% of patients have lasting benefits of TMS for at least 12 months.
  • It has had high success rates for PTSD and Depression amongst veterans.
  • Does not require ongoing medication.

Cons:

  • Daily office visits – 5 days a week for 6 weeks. Week 7 is 3 days, week 8 is 2 days, and week 9 is one day.
  • It’s uncomfortable – with TMS, you are likely to feel a tapping at the stimulation site or hear clicking as the magnetic pulses travel through your head. If you are angled a certain way, you may feel uncontrollable movement in your eyebrows or jaws. While some people fall asleep, others do not. It depends on your response to the anesthesia.
  • You cannot have any implanted medical devices in your body! Pacemakers, stents, and even cochlear implants can be ruined by the magnetic fields used during the treatment.
  • Although covered by insurance, it can be difficult to get your insurance to do so.

Pros And Cons Of ECT

Electroconvulsive therapy provides some great benefits to a patient with severe depression. But, at the same time, there are some serious disadvantages to the procedure. Here are the pros and cons of using electric currents for treatment.

Pros:

  • It is far safer than when it was used in the 1940s.
  • Effectiveness can occur slightly faster than TMS.
  • Time commitment is slightly shorter, often 2-3 times a week for around 4 weeks. After that, there may be maintenance sessions annually or monthly.

Cons:

  • Very expensive and not covered by insurance.
  • Unable to return to work for 2 weeks after treatment.
  • Requires muscle relaxers and sedation for each treatment; these come with their own physical side effects.
  • Not a good option for those with heart problems and the elderly.
  • Confusion post-treatment can be frightening.

The Bottom Line With Non Medication Assisted Depression Treatment

When it comes down to it, TMS is often considered the better of the two treatments. The side effects tend to be more manageable, medication is still used to support the success of the treatment, and the cost is significantly less. Electroconvulsive Therapy is best used for severe cases where medication, talk therapy, and other forms of treatment have not worked.

As always, it’s best to speak with your psychiatric professional regarding these options. Everyone has differences in their diagnoses and treatment options that should be addressed. The information here is to provide you with information to get the conversation started.

Sources:

https://www.nami.org/About-Mental-Illness/Treatments/ECT,-TMS-and-Other-Brain-Stimulation-Therapies

https://www.healio.com/news/psychiatry/20200318/fda-grants-breakthrough-designation-to-transcranial-magnetic-stimulation-device-for-bipolar-depression

https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625

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