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Does TMS Really Work? Examining Key Facts & Evidence

August 29, 2023

8–12 minutes
Illustration of the neurotransmitters in the shape of the brain

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Illustration of the neurotransmitters in the shape of the brain

Living with treatment-resistant depression can be an uphill battle, leaving you searching for alternatives when traditional treatments fall short. Transcranial Magnetic Stimulation (TMS) has emerged as a promising treatment option for individuals who have found little relief elsewhere.

At Geode Health, we understand the struggle of living with treatment-resistant depression. We aim to provide clear, informative insights to support you on your journey toward improved well-being. Keep reading to learn more about the efficacy of TMS, or reach out to a Geode provider today to learn how you can find relief from depression, whether through TMS or other effective treatment options.

The science behind TMS

Transcranial Magnetic Stimulation (TMS) for major depressive disorder is grounded in the principles of neuroscience and the intricate workings of the brain. This non-invasive brain stimulation procedure utilizes magnetic fields to stimulate specific areas of the brain. Most commonly, TMS therapy for depression will target the dorsolateral prefrontal cortex, an area of the brain involved in mood regulation. TMS work is fascinating; an electromagnetic coil is placed against the scalp near the forehead. The TMS coil delivers repeated magnetic pulses that pass through the skull. These magnetic pulses that penetrate the brain produce nerve stimulation, specifically targeting nerve cells in the brain that are underactive in people with depression.

The magnetic pulses of TMS generate electrical currents that activate or inhibit neurons in the targeted brain regions. Through this focused stimulation, TMS helps to restore the balance of neurotransmitters, such as serotonin and norepinephrine, which are known to play vital roles in regulating mood and emotions. TMS may also help to increase neuroplasticity, allowing neuronal networks in the brain to grow and reorganize.

Clinical evidence supporting TMS

Numerous research studies and clinical trials have been conducted to investigate how TMS can help with various health conditions, including depression. Here are some key findings:

  • Response Rates: Clinical trials have shown that TMS is safe and effective for treating depression. The response rate varies across studies, but patients are several times more likely to improve with TMS than with a placebo. While it is primarily known for the treatment of depression, the FDA also cleared its use for OCD. Patients with obsessive-compulsive disorder may find that TMS pulses help reduce OCD symptoms. TMS appears to be effective as an add-on treatment to antidepressant medication, with studies suggesting around 50% of patients may experience a significant reduction in their depressive symptoms with the help of TMS. TMS is less effective than ECT (electroconvulsive therapy) for treatment-resistant depression, but also generally carries fewer risks.
  • Long-Term Durability: Research suggests that the course of treatment’s positive effects can last for months, offering extended relief. Depending on the protocol, such as standard repetitive TMS or theta burst stimulation, studies show that among patients who have responded to TMS, around half continued to improve even a year after their initial treatment. Some individuals may benefit from maintenance TMS sessions after their initial treatment.
  • Clinical Guidelines and Approvals: Regulatory bodies such as the U.S. Food and Drug Administration (FDA) have approved TMS for the treatment ofmajor depressive disorder. Professional societies like the American Psychiatric Association (APA) recognize TMS as a viable option for individuals who have not responded to initial antidepressant medications.
  • Real-Life Stories: Beyond the numbers, we also value the lived experiences of individuals who have pursued TMS. Their personal stories show the potential of TMS to provide relief from depression, even when other treatments have not been effective. Many individuals have benefitted from TMS, and although it may not be right for everyone. Because TMS is a noninvasive treatment that uses magnetic energy, it has the potential to make a significant difference in the lives of those struggling with treatment-resistant depression.

What to Expect During Your Session

Understanding the logistics of a TMS appointment can help ease any “first-day” jitters. During a typical session, you will remain fully awake and alert, seated comfortably in a reclining chair. Because there is no anesthesia or sedation required, you can drive yourself to and from the clinic and resume your normal daily activities immediately.

A standard session lasts between 20 to 40 minutes. You will hear a repetitive clicking sound, often compared to a woodpecker tapping, and feel a slight pulsing on your scalp. Many patients use this time to listen to music, watch television, or simply relax. A full course of treatment generally involves daily sessions (Monday through Friday) for approximately four to six weeks to ensure the brain receives the consistent stimulation needed for lasting change.

Factors influencing TMS efficacy33

While it is difficult to predict who will benefit most from TMS, several factors can influence the effectiveness of treatment:

  • Treatment Protocol: TMS protocols are designed to suit your specific needs. Your provider may adjust factors such as intensity, frequency, and length of treatment sessions to optimize results.
  • Treatment Duration: We understand that healing takes time. The duration of TMS treatment may vary depending on your response. Some individuals experience improvement within a few weeks, while others may require more extended periods of treatment for optimal results. Some people may also benefit from courses of maintenance TMS after initial treatment.
  • Adjunctive Treatments: Studies suggest that TMS is most effective when used in combination with antidepressant medication. By optimizing the use of medication, psychotherapy, and interventions such as TMS, your provider can develop a treatment plan to best meet your needs.
  • Co-occurring Conditions: Depression often occurs together with other conditions. Common co-occurring conditions, such as anxiety disorders or substance use disorders, can impact your response to TMS treatment. A comprehensive assessment by your provider ensures a holistic approach to your care.

When traditional treatments for depression are not effective, Transcranial Magnetic Stimulation (TMS) offers a promising alternative. As a non-invasive procedure that is well-tolerated by most individuals, TMS has the potential to bring significant relief to those experiencing treatment-resistant depression.

By understanding the key aspects of TMS treatment, consulting with healthcare professionals, and exploring the available research, you can make an informed decision about whether TMS is the right path to address your treatment-resistant depression.

By understanding the key aspects ofTMS treatment, consulting with healthcare professionals, and reviewing the available research, you can make an informed decision about whether TMS is the right path for your treatment-resistant depression.

We have locations in Georgia, Texas, North Carolina, Illinois, and Wisconsin. So, if you need a psychiatrist in Fort Worth, a psychiatrist in Milwaukee, or a psychiatrist in Plano…we got you covered and are here to help. Find a Geode psychiatry location near you and schedule your first appointment today. Remember, you are not alone on this journey, and support is available to help you decide on the best treatment option for you.

Frequently Asked Questions About TMS Treatment

The success rate of TMS varies depending on the individual, but research shows that many people with depression experience meaningful improvement. Clinical studies indicate that approximately 50% to 60% of patients with treatment-resistant major depression respond to treatment, and roughly one-third may achieve full remission of symptoms. While results differ from person to person, the effectiveness of TMS has been supported in multiple clinical trials, particularly for patients with treatment-resistant depression who have not responded to medication alone.

Most TMS patients experience treatment as comfortable and manageable. During sessions, a device delivers magnetic pulses to stimulate specific brain regions involved in mood regulation. You remain awake and alert throughout the appointment. Many patients report a tapping sensation on the scalp and clicking sounds during TMS sessions, but they can resume normal daily activities immediately afterward. Improvement in depression symptoms typically develops gradually over several weeks.

TMS is generally well tolerated. Some patients experience mild side effects, such as scalp discomfort, headache, or light facial muscle twitching, during or shortly after treatment. Serious side effects, such as seizures, are rare. Because TMS uses powerful magnetic fields rather than medication, it does not typically cause systemic side effects such as weight gain, sedation, or sexual dysfunction that can occur with some antidepressants.

Repetitive transcranial magnetic stimulation works by delivering carefully calibrated magnetic pulses to stimulate underactive areas of the brain associated with mood regulation. TMS targets neural circuits in the prefrontal cortex and other parts of the brain that are involved in major depression. By activating these pathways, TMS helps regulate brain activity patterns linked to depression symptoms. The effect of transcranial magnetic stimulation builds over time with consistent sessions.

Yes. While TMS is most commonly used for treating major depressive disorder, it is also FDA-cleared for obsessive-compulsive disorder. Researchers continue to study its role in other mental health conditions, including certain forms of stress disorder and anxiety-related disorders. If you are considering TMS, your provider can help determine whether it is an appropriate option for patients based on your specific diagnosis and mental health needs.

Before starting TMS, your provider will complete a comprehensive psychiatric evaluation to determine whether it is appropriate for you. This includes reviewing your history of depression, prior mental health treatments, and whether therapies such as cognitive behavioral therapy have been effective. TMS is often recommended for patients with treatment-resistant symptoms who continue struggling with depression despite other interventions. Your provider will develop a treatment plan tailored to your symptoms of depression and overall goals.

Results vary, but many TMS patients experience gradual improvement within several weeks. A standard course of treatment involves daily TMS sessions, typically five days per week for four to six weeks. Some patients achieve noticeable improvement earlier, while others may require the full course. Many patients achieve sustained relief, and some may benefit from maintenance sessions if symptoms return.

TMS is frequently recommended for patients with treatment-resistant major depressive disorder who have not found sufficient relief from antidepressant medications. It offers a non-invasive alternative that directly targets brain activity associated with depression symptoms rather than relying solely on systemic medication effects. For many people with depression, TMS provides an option for patients when other treatments have not been enough.

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