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Alternative to Antidepressants

Learning About TMS Therapy
Suzanne Jessee Oct 23, 2019
The lifestyle trends are clear. More and more people are looking fir healthier, more natural options in just about every realm of life. This includes much closer scrutiny to the foods we eat, reading labels on personal hygiene products and household cleaning solutions—even changing lifelong habits.
Hand in hand with these new perspectives about what we put into our bodies and what we expose ourselves to, the trend has also reached physical and mental healthcare. No longer do we accept a singular pathway to wellness via western-based medicine.
On the contrary, an increasing backlash to the overmedication of the American population is shifting treatment options towards a more balanced approach that blends holistic and conventional treatments.
While there is a legitimate need for many that battle depression to rely on antidepressants for symptom relief, the efficacy of these drugs has been shown in recent studies to be rather disappointing. Only about half of those who try antidepressants for the treatment of depression actually experience statistically significant response and remission rates.
In essence, half the patients with depression continue to struggle with life-impairing symptoms because antidepressants simply didn’t work for them.
Antidepressants, even if they are helpful in reducing symptoms, often leave patients riddled with unpleasant side effects. Many who try these drugs simply discontinue the medication due to weight gain, nausea, fatigue, loss of sex drive, blurred vision, constipation, and insomnia.
When considering antidepressant drug therapy, balance between symptom relief and adverse effects must be addressed. Patients with major depressive disorder that did not experience symptom relief with antidepressants, or had to discontinue due to drug’s side effects, an excellent alternative treatment option available: Transcranial Magnetic Stimulation (TMS).

What is TMS?

TMS is a brain stimulation technique that uses magnetic fields to help reset brain chemistry. While brain stimulation therapies are not new, TMS offers a unique advantage to other, older methods in that it does not require any sedation, no surgical procedures, and no recovery time.
TMS was FDA-cleared in 2008 for treating those individuals with major depressive disorder who had not had success with antidepressant drug therapy. In fact, many of the patients had tried up to three different antidepressants unsuccessfully.
TMS therapy offers renewed hope for treatment-resistant individuals, providing a safe and effective alternative to drug therapy.
TMS therapy is provided in an office setting while the patient is completely alert. Following the treatment, the patient is free to drive back to work to continue with their usual activities. Generally, TMS therapy is prescribed for 4-6 weeks, with five sessions per week for best results.

How Does TMS Therapy Help Depression?

TMS therapy has been shown to help patients struggling with depression by going at the treatment process from a different angle. Antidepressants work systematically to alter the brain’s structure by increasing levels of the neurotransmitter serotonin.
TMS also impacts the neurotransmitters, but does so by directly stimulating the brain cells that are underactive. Over the course of treatment, brain chemistry becomes rebalanced while depression symptoms gradually improve. Where antidepressant drug therapy may last for a year, five years, or a lifetime, TMS is a short-term, drug-free solution.
During a TMS therapy treatment session, the patient is seated comfortably for about 40 minutes. A coil is placed over the scalp so the magnetic pulses will be delivered to the left prefrontal cortex. This is the limbic region of the brain, also referred to as the “Mood Center.”
As the therapy sessions proceed, the patient begins to notice subtle positive changes. As early as the 10th session, a patient may realise he/she is sleeping much better. As the TMS sessions continue, other improvements begin to surface, such as feeling more energy and being able to concentrate better. And the individual notices that the mood has improved.

Where is the Evidence That TMS Works? Is It Safe?

A myriad of clinical trials and studies have been successfully completed worldwide that demonstrate TMS to be both safe and effective in treating major depressive disorder.
In sham-controlled (placebo) trials, participants who received the TMS had response and remission rates demonstrably higher than those who had received sham therapy. A meta-analysis of multiple TMS studies can be reviewed here
In addition, TMS studies have determined that it is well tolerated by patients. A large study with 325 patients from 23 clinical sites was conducted to evaluate TMS safety after acute exposure to the TMS therapy, extended exposure, and follow-up exposure.
Adverse treatment effects were recorded at each benchmark with resulting data showing that TMS had a low incidence of adverse effects, that was mild to moderate in nature. These effects were scalp irritation and headaches that were transitory, resolving as treatment continued. The study concluded TMS is well tolerated and safe for major depressive disorder.

Can TMS Therapy Be Combined with Antidepressants?

Some patients have experienced a degree of relief from depression symptoms through antidepressant therapy, but may have seen the results plateau. Depending on the type of antidepressant, individuals may be candidates for adding TMS therapy to their treatment plan.
TMS therapy can be an excellent complementary therapy that can augment the overall symptom relief achieved.
When the psychiatrist determines that augmentative TMS is a safe treatment option, the individual will be closely monitored and evaluated to prevent any adverse reactions. Certain drugs, such as tricyclic antidepressants, would not be considered for this combined therapy, as seizures could result.
In most cases, TMS therapy is administered as a stand-alone treatment, or in conjunction with psychotherapy. As the trend continues toward exploring drug-free treatment alternatives for treating both mental health and medical conditions, TMS therapy will experience ongoing success in treating major depressive disorder.