How Effective Is TMS? Exploring This Treatment's Success Rate

TMS, or Transcranial Magnetic Stimulation, can be an effective treatment for depression in some people. This type of treatment generally involves the stimulation of different areas of the brain using a magnet for 20 to 40 minutes. Sessions are typically scheduled five times per week for four to six weeks, and the effects can last for six months to one year depending on the individual’s health and the severity of the disorder, among other factors. Another depression treatment option may be therapy, which can be finished in person or online.

Addressing treatment-resistant depression

Depression can be a serious mental health concern that tends to affect everyone differently and look dramatically different in every personality it touches. Depression encompasses several depressive disorders, including major depressive disorder, seasonal affective disorder, and persistent depressive disorder. Additionally, other mental health conditions can be comorbid with depression or feature depressive symptoms, such as bipolar disorder, anxiety disorders, and substance use disorder. 

For this reason, depression often goes undetected, which can exacerbate symptoms. Despite more than 300 million people living with depression worldwide, many aspects of depression may not be entirely understood, and treating depression can be difficult. 

Depression treatments—which typically consist of antidepressant medication, psychotherapy, or a combination of both—are thought to be effective for up to 90% of individuals. Sometimes, however, those who attempt to treat depression through traditional methods struggle to reduce symptoms for various reasons (e.g., adverse effects of antidepressant medications). For these individuals, symptom relief may be possible through brain stimulation therapies, which are treatment methods that stimulate nerve cells through medical devices.

Common brain stimulation therapies include electroconvulsive therapy and vagus nerve stimulation (which active the brain and vagus nerve, respectively, through electric currents) and transcranial magnetic stimulation, or TMS (which activates the brain through magnetic pulses). TMS is a non-invasive brain stimulation treatment that can be used when individuals with depression are not responding to other treatments.  

Transcranial magnetic stimulation (TMS) therapy

Transcranial Magnetic Stimulation, or repetitive Transcranial Magnetic Stimulation (rTMS), can be a depression treatment that generally uses a magnetic force to alter the patterns of your brain to decrease the symptoms of depression.

To engage in brain stimulation, a professional may begin by placing a magnetic coil against the side of a patient's head. Practitioners may then apply a series of pulses within the magnet to stimulate the nerve cells of the brain involved in mood control.

Because this procedure is non-invasive (meaning there is no direct reach to the brain via surgery), TMS is normally considered a safe treatment for depression without any dramatic or alarming risks.

That being said, there can be some mild side effects brought on by magnetic stimulation (TMS) sessions, which can include headaches, lightheadedness, facial tingling or numbness, and discomfort during the procedure. 

Qualifications necessary to administer treatments

Only a qualified TMS therapist should administer transcranial magnetic stimulation (TMS). This is because, while generally considered safe, repetitive transcranial magnetic stimulation may still pose some risks and should be monitored by a professional for the safety of the patient.

This treatment type is not usually taught as a regular part of earning a psychology certification and is typically considered a specialty. 

Session overview

There can be some variation within the practice of TMS, but the basic mechanism is generally the same: a magnet is placed against the scalp—traditionally, near the forehead—and magnetic pulses are delivered.

Initially, a practitioner may administer TMS therapy to determine a patient's pain tolerance and comfort level, and then move on to "mind mapping" to make sure each session is targeting the correct area of the brain. Once a treatment plan has been established, appointments typically last between 20-40 minutes.

During a treatment session, a patient is usually placed in a comfortable chair and given earplugs to deaden some of the sound emitted by the magnetic machine. The magnet is typically activated for a few seconds. When activated, patients may hear a clicking or tapping sound and feel a similar sensation against the skin.

How often do sessions have to occur?

Most practitioners recommend regular treatment with TMS, which usually means five sessions per week for a four- to six-week period. Treatment can veer outside of this standard but usually requires at least this great a time commitment. Improvement in symptoms can take several weeks, but some patients report feeling changes as early as the first treatment.

Once treatment has concluded, patients typically go on to use traditional treatment methods, such as talk counseling or medication, to maintain TMS results.

The cost of TMS can be difficult to discern, as it is still considered somewhat experimental by some insurance companies. For this reason, many patients are only able to undergo insurance-covered treatment after traditional methods have not worked; Transcranial Magnetic Stimulation is often not covered as a primary treatment option.

Does insurance cover TMS treatment costs?

If insurance is not able or willing to cover Transcranial Magnetic Stimulation treatment costs, patients can expect rates between $400 and $500 per session. Fortunately, many insurance companies allow doctors and clients to lobby for declined treatment options.

How effective is TMS for depression?

TMS generally has a 30% success rate, which can place it just below traditional antidepressants, which typically see a 50% success rate. Individuals who seek TMS treatment and experience improved symptoms are usually instructed to continue seeking regular "maintenance" counseling.

Although the exact efficacy of TMS is not known, as it is still viewed as a fledgling practice, some studies have shown that it can demonstrate consistency in treating patients with depression. Additionally, as discussed below, TMS can be used to treat certain other mental health conditions.

TMS is thought to be an efficacious treatment for people experiencing various types of mental illness. If you’re seeking care for depression or another mental health condition, a qualified healthcare professional can determine the best course of treatment. 

Clinical trials suggest that repetitive TMS can effectively reduce symptoms in those experiencing treatment-resistant depression. Additionally, there is evidence that this form of deep brain stimulation can lead to improvements in obsessive-compulsive disorder. Researchers have also found that transcranial magnetic stimulation can help individuals quit smoking. 

One of the reasons TMS is gaining popularity may be its nature as a non-invasive treatment. Though this might be great for some patients, others can be considered poor candidates for TMS. These can include individuals with pacemakers, stents, aneurysm coils, metallic implants in the upper body, monitoring tools inserted in the head or neck, bullets or shrapnel in the upper body, or tattoos using metallic ink.

Tourette syndrome, schizophrenia, and more

TMS is generally not an ideal match for patients seeking to treat Tourette syndrome, schizophrenia, post-traumatic stress disorder, or obsessive-compulsive disorder. Instead, TMS can improve depression and major depression disorders specifically.

Lack of insurance coverage

Due to the likelihood of insurance companies turning down Transcranial Magnetic Stimulation treatment as a first option, TMS may not be an ideal solution for people who have not tried other options.

Online counseling for depression

Fortunately, research shows that online therapy can play a significant role in reducing depression and anxiety symptoms. For example, one study found that online therapy could be even more effective than traditional in-person sessions, with 100 percent of participants in the online group showing continued symptom reduction three months after treatment.