Transcranial Magnetic Stimulation (TMS) therapy is a non-invasive, non-drug, and FDA-cleared treatment with zero downtime that is safe and effective for a range of conditions affecting mental health and cognition. Many people who are not satisfied with the results of their antidepressant medication may consider trying TMS as an alternative or a supplementary treatment. considering a popular high-tech way to treat depression might be scared off by the potential side effects. That’s why it was important for us to directly address the side effects of transcranial magnetic stimulation (TMS) without using rhetoric or a sales pitch.
Understanding Transcranial Magnetic Stimulation – TMS
Even the name sounds a little intimidating, right? So does electromagnet radiation, which is the long name for an X-ray. How about magnet resonance imaging? That’s MRI scans.
TMS therapy works a lot like MRI scans, in fact. It is a non-invasive procedure requiring no sedation or anesthesia.
TMS is nothing like Electroconvulsive Therapy (ECT), better known as Shock Therapy. Hollywood has given us a scary view of ECT, but it does require full sedation and is meant to trigger seizures that can come with harsh side effects. TMS therapy is designed to not be performed on people with a history of seizures.
During repetitive transcranial magnetic stimulation, the patient is taken into a treatment room, and a magnetic coil is placed near the mood control center – the dorsolateral prefrontal cortex – of the patient’s brain. Brain mapping is done to ensure the correct placement of the coil, which looks similar to a large blowdryer.
Magnetic pulses resonate into the underactive portion of the brain and will stimulate nerve cells to reduce depression symptoms or some other mental health disorders. TMS comes in repetitive transcranial magnetic stimulation, deep brain stimulators, and theta-burst simulation *versions.
**Your psychiatrist will discuss which one is appropriate for your needs.
TMS Treatment Guidelines and Warnings
Before you can be considered for repetitive transcranial magnetic stimulation therapy, there are several conditions that must be met, either by the practitioner or your insurance company.
- Diagnosis of major depressive disorder.
- Ongoing treatment-resistant depression, even with several different medication cycles and talk therapy.
- No implants above the neck, like cochlear implants, metal plates, or aneurysm clips.
- No battery-powered, magnetic, or electrically charged devices, like a pacemaker.
- Inability to tolerate or strong dislike of side effects from antidepressant medications.
TMS treatments have other limitations by each provider, so ask for a specific list of conditions and requirements before scheduling treatment sessions.
Safety Factors to Consider for TMS Therapy
Side effects and risks can be directly related to the provider. Unfortunately, there are some places that might just be trying to get your money instead of using the utmost safety standards.
Topics to address ask include:
- Proof of certification or training for repetitive transcranial magnetic stimulation therapy.
- The success rate from each provider.
- References to patients you can contact, not just written statements.
- Name of the doctor who oversees TMS treatments so you can research their medical practice history.
- Most common side effects from that provider.
- Reviewing the forms, disclaimers, and releases you’d have to sign to get the treatments.
A legitimate TMS provider will not simply push one option on you and certainly shouldn’t go for the most expensive option first. Patients suffering from mental health disorders should be treated with compassion, respect, and detailed explanations. A list of options should be presented, and the pros and cons of each should be weighed.
You’ll also want to bring a full medical history, including a list of all medications, surgeries, and genetic risks, with you to the first appointment.
Be Educated: The Most Common TMS Side Effects
Like most treatments, TMS has known side effects that have been consistently reported from transcranial magnetic stimulation research.
When the FDA approves or clears a medication or device, it is never guaranteed to be a risk-free experience. In truth, FDA-approved or FDA-cleared means the risks outweigh the benefits in verified research presented – in full – to the Food and Drug Administration.
Various studies have been done on how TMS pulses and the electromagnetic coil could impact brain activity and if there’s any risk of brain damage. Some studies focus on specifics, like how TMS helps people with PTSD or TMS on a control group with bipolar disorder.
We will review a Stanford University School of Medicine research project from 20211 and other side effects from noted expert entities such as the Centers for Disease Control and Prevention (CDC) and the FDA.
Common side effects of repetitive transcranial magnetic stimulation include:
- Temporary Tinnitus/Ringing of the ears (wear earplugs to reduce this risk)
- Scalp irritation/Scalp discomfort
- Dislike of tapping sensation from magnetic coil
- Mild to moderate headache
- Facial muscle twitching
- Pain in the jaw, face, or neck
- Fatigue
- Dizziness
Let’s address the concern about seizures, as there is widely manipulated information mistakenly connecting transcranial magnetic stimulation therapy and seizure disorders. A study by the Department of Psychiatry and Behavioral Sciences in the Feinberg School of Medicine at Northwestern University in Chicago showed a full course of TMS sessions resulted in a 0.10% chance of a seizure2.
So why would there be so much internet chatter about the risk of seizures?
- Some people are predisposed to seizures based on genetics, other medications raising the risk of seizures, or a lack of transparency with other depression treatments being used.
- Patients can also have other underlying health issues unrelated to mental health or not relayed to the mental health provider during the intensive medical history review.
There is little evidence that when a patient meets all the conditions for transcranial magnetic stimulation treatments, they experienced seizures as a direct result of the magnetic pulses.
Side Effects of Antidepressants
Despite being more effective than antidepressant medication, TMS therapy is considered an alternative treatment for depression. One thing to keep in mind when considering starting TMS therapy instead of medications is the side effects of antidepressants. Antidepressants like SSRIs often bring unwanted systemic side effects including weight gain, sexual dysfunction, gastrointestinal issues, and brain zaps.
Breaking it Down: The Most Serious Concerns of TMS Therapy
Aside from talk therapy or group therapy, there isn’t a treatment for depression symptoms that do come with risks. Medications can have minor or serious risks, plus the potential of “Brain Zaps” if a person quits a drug cold turkey or misses a dose.
No research or clinical trials show any serious long-term effects of TMS treatment as of 2024.
There is a lot of chatter on various reddit threads spreading misinformation about TMS therapy, so let’s address the most serious concerns:
- Brain tumors: There is no evidence whatsoever that TMS therapy causes brain tumors. In fact, the presence of brain tumors will likely disqualify a patient from treatment in many clinical settings. Additionally, studies are now being done about to show how TMS therapy might be able to help in the removal of brain tumors.
- Magnetic coil concerns: A TMS session has much less intense and frequent exposure to magnetic pulses than an MRI. Only a fraction of magnetic energy is expelled during TMS treatments.
- Memory loss: This is usually where patients get transcranial magnetic stimulation confused with electroconvulsive therapy (ECT). Shock therapy is generally used as a last resort due to the purposely triggered seizures and resulting memory loss that happens in the name of healing psychiatric disorders.
- It doesn’t work: There is no guarantee it will work, and if a mental health professional does, you should run from that office. Starting TMS therapy is an option, not a cure-all.
- Hearing loss Prevent this risk by wearing earplugs during the treatment. If they aren’t offered to you, demand them.
- “I did not know that”: The stories of people who claim TMS “ruined my life” list a lot of things “they didn’t know.” You shouldn’t be surprised by muscle twitching, a bad headache, or a tingling sensation. Watch out for providers who emphasize the benefits but severely downplay the risks. The less you know, the more prone you’ll be to anxiety symptoms, too.
- More depression symptoms: Some people will claim the treatments make their mental health condition, like severe depression, worse – even suicidal. There is no direct correlation between TMS therapy and those symptoms, but there are other factors, such as medication, emotional state, and life challenges, that could impact a patient. Staying in touch with your mental health provider is critically important.
TMS Therapy in Los Angeles
As mentioned above, there is no know treatment for depression that is without risk, however the amount of evidence that supports TMS therapy as an effective and more sustainable treatment for treatment-resistant depression far outweighs the arguments against it. It is important to discuss your concerns and potential side effects with a trained psychiatrist who can do a comprehensive assessment of your mental health and prescription history.
The psychiatrists at Neuro Wellness Spa are skilled at providing the highest quality of mental health care and will walk you through all of your treatment options. Neuro Wellness Spa boasts above national average response rates to TMS Therapy at 73%. Contact us today to schedule a no-obligation consultation. We treat:
- Severe depression/Major depression
- Treatment-resistant depression
- Obsessive-compulsive disorder
- Post-traumatic stress disorder (PTSD)
- Anxiety disorders
- Bipolar Disorder
- Attention Deficit Hyperactive Disorder (ADHD)
- Stress
- Grief
- and more
Our team of mental health experts is experienced with brain stimulation therapies, and we also offer a host of complimentary psychiatric and therapeutic services, including talk therapy, MeRT, and medication management.
References
- Experimental depression treatment is nearly 80% effective in controlled study. (n.d.). News Center. https://med.stanford.edu/news/all-news/2021/10/depression-treatment.html
- Janicak, P., & Dokucu, M. E. (2015). Transcranial magnetic stimulation for the treatment of major depression. Neuropsychiatric Disease and Treatment, 1549. https://doi.org/10.2147/ndt.s67477