Learn about how TMS works, and what it could mean for your life.
Major Depressive Disorder is an illness which hurts the person experiencing it, and those who love him or her. Symptoms can include a persistent sad mood, loss of interest in normal activities, loss of pleasure, a slowing down of thought and movement. It can affect sleep, appetite, energy, focus, concentration, and relationships. Depression affects at least 20% of the population or 70 million people, and this is before COVID 19, which seriously inflated those numbers. The highest percentage of people depressed are between 18 and 25 and the second largest percentage are people between 26 and 50. Depression affects more women than men.
Many people suffering from depression have tried therapy, and multiple medication treatments without success. Some have tried or considered Electo-Convulsive Therapy (ECT or Shock Therapy) but do not want to experience the loss of time and memory that can accompany it. TMS is an exciting, new treatment which has achieved remission in over 50% of patients and a positive response in 75%. Compare this to the 25% of patients who achieve remission and the 50% of patients who have a positive response to either therapy or their first medication. Of those who do not achieve a positive response on the first medication, 30% will positively respond to the second medication and half will achieve remission. The positive response rate drops to 10% on the third and all subsequent medication treatments. This means that 33% of patients with Major Depressive Disorder are resistant to any medication. And many people who benefit from anti-depressant medication experience unpleasant side effects: weight gain, sexual dysfunction, suicidal thoughts, nausea, insomnia, and anxiety. The statistics for another newer treatment Ketamine are about the same as those for TMS. However, while TMS treatment lasts for four to six weeks, with occasional need for follow up, currently Ketamine patients need to be treated in a doctor’s office every two weeks for life.
BrainsWay is indicated for the treatment of depressive episodes in adult patients suffering from Major Depressive Disorder who failed to achieve satisfactory improvement from previous anti-depressant medication treatment in the current episode. It is also FDA approved for treating Obsessive Compulsive Disorder (OCD) and smoking cessation.
BrainsWay treatment delivers a magnetic field that could cause any metal objects that are near the device to move or to get hot. The treatment should not be used if you have metal implants in or around your head (except for standard amalgam dental fillings). If you have a pacemaker or any other implanted electronic devices in you body you need to check with your physician and/or the manufacturer to see if it is safe to have TMS.c
In real-life clinical settings, the treatment was proven to be effective for 3 out of 4 patients, with a 51% remission rate and 75% response rate.
Absolutely. However, like any treatment option, patients and clinicians should work together to find the most appropriate treatment option for each patient.
No, tests of memory function during treatment showed no change during the clinical trial.
In the 60 clinical trials sponsored by BrainsWay there were no reports of patients feeling more depressed after TMS treatments. Additionally, there were no reports of TMS worsening depression in the clinical studies which have been carried out.
While any new experience can cause some anxiety in anyone, in clinical studies only 5% of patients reported feeling more anxious after beginning TMS treatments.
There were no reports of TMS making patients studied feel tired. Many left treatments and went to work or carried on with their normal activities.
Any treatment for OCD can initially worsen the symptoms. Because patients must face their obsessive thought patterns to overcome them, they can exhibit more compulsive behaviors in the beginning stages of TMS treatment. These will lessen as treatments progress.
There have not been reports of TMS causing tinnitus. TMS treatments produce a tapping sound that can be unpleasant for some patients despite the ear plugs used to lessen them. After a few treatments most patients become accustomed to them and can read, catch up on social media or watch programs during their treatments.
Most patients need five twenty-minute sessions per week over a period of four to six weeks. To put this in perspective that is a total of seven to ten hours of treatment.
For some patients, the effect on major depressive disorder can begin after one session. More commonly patients notice the difference after the first or second week of treatment.
TMS has been studied in England and Europe since 1985. Repetitive TMS was first approved in the United States for Major Depressive Disorder by the FDA in 2008. Deep TMS was approved in 2013. Because of its longer history in other parts of the world, Deep TMS has been tested in over sixty clinical trials.
The initial mapping of the areas of the brain that will most benefit from treatment is done by Dr. Wind in collaboration with CRNP Rosemary Fordjour. Ms. Fordjour oversees all treatments administered by other licensed medical professionals.
In some circumstances Medicaid will cover TMS. However, their criteria are extremely strict, and it can be difficult to get approval.
Medicare does cover TMS as do most major insurance companies.
75% of patients with Major Depressive Disorder have a positive clinical response to TMS treatments. 50% of patients show remission. Those statistics are as good or better than those for any other type of treatment. No one can guarantee how you will respond to the treatments but the chances of feeling better are there for three of four patients who undertake TMS.
TMS is approved for patients between 18 and 68 years old.
The most reported side effects are discomfort with the tapping sound, or scalp discomfort during initial treatments. These usually resolve quickly.
If you have metal plates or devices in your head area or electronic devices implanted in your body, then you cannot have TMS treatments. Amalgam dental fillings pose no problem.