Cleared by the FDA to treat refractory major depression, repetitive TMS has emerged as an effective alternative for many patients who do not benefit from, or tolerate, previous trials of antidepressants. The TMS procedure uses strong, rapidly-alternating magnetic fields to induce a stimulating current in focused areas of the brain. Based on recent studies, the treatment effect of TMS is at least comparable to conventional antidepressants, though typically has fewer side effects.
Unlike electroconvulsive therapy (or ECT), TMS does not require anesthesia or close medical monitoring after the treatment; individuals receiving TMS typically leave treatment sessions on their own and can return directly to their daily routine. Some patients considering ECT wish to try TMS first given the relatively favorable side effect profile.
A typical treatment course of TMS involves 5 treatment sessions per week for 4-6 weeks. Each treatment appointment usually lasts between 45 and 75 minutes. Side effects are generally few, though the most common are temporary headache or lightheadedness. Individuals with a history of seizures or any metal in the head area are generally not able to receive TMS. An initial consultation visit, including a review of medical and surgical history, is necessary prior to beginning TMS treatments.
While other uses for TMS (such as anxiety, bipolar disorder, pain modulation and addiction) are under active investigation, unipolar major depression is the only currently-approved indication. Many commercial health insurance plans, as well as Medicare, now cover TMS treatments for individuals who meet the eligibility requirements.
Interested patients and providers can e-mail BWH Psychiatry Triage for more information about the referral process. The initial consultation with a physician on the TMS team, and the treatments themselves, occur in the new Building for Transformative Medicine located at 60 Fenwood Road.