TMS vs. ECT: What You Need to Know
Many people confuse Transcranial Magnetic Stimulation (TMS) Treatment with Electroconvulsive Therapy (ECT). Confusing the two is understandable as both are forms of treatment used to help patients with depression, but this is the only thing that these have in common.
While ECT uses an electrical current to stimulate the entire brain, TMS Treatment uses a magnetic pulse to encourage a specific network within the brain to reconnect and communicate at a healthy level. Below is some information on each to help you understand what each is, and which option would be best.
What is ECT
ECT is a procedure where controlled electric currents are passed through the brain while a person is under general anesthesia. The electrical currents result in a brief, controlled seizure that affects the patient’s communication of its neurotransmitters in the brain. ECT is typically done in a hospital facility and takes about half of a day to a full day to complete one session and recover from the general anesthesia. Most patients will need a friend or loved one to take them home after the appointment. ECT is often reserved for patients with severe, life-threatening depression.
A patient will typically have four to six treatments before improvement is seen. ECT Treatment generally is followed by additional rounds of treatments or maintenance ECT, usually once a month or a few times a year.
Although modern-day ECT has improved and decreased many of its side-effects, there are still risks with treatment. Some side effects include:
- physical effects, such as headaches, muscle pain or nausea,
- confusion following treatment, which can last a few minutes or hour,
- and finally, memory loss, which can range from forgetting conversation or events right before, to forgetting things from weeks, months, and even years back.
How is TMS Treatment Different from ECT?
Transcranial Magnetic Stimulation (TMS) is a non-invasive, out-patient treatment which safely treats the Salience Network area of the brain using MRI strength magnetic pulses. TMS Treatment strengthens your brain’s ability to relay the signals you need to regulate mood and behavior. TMS Treatment is done in an out-patient facility or doctors’ office, and there is no use of general anesthesia. Treatments typically last about 20 minutes, and patients can drive themselves to and from treatment. One big difference from ECT is that most patients can return to work or normal daily activities directly after TMS.
A patient will typically have 36 total sessions of TMS Treatment, over the course of 7 weeks. Some patients will need maintenance TMS, usually completed once a year following their first course.
One of the significant advantages of TMS vs. ECT is the reduced amount of side effects. The most common side effects of TMS Treatment are:
- Scalp discomfort at the site of the magnetic coil. Typically goes away after a few sessions.
- Minor headache or light-headedness
- If a person has a history of seizures, then seizures could be a potential although they are extremely rare.
Which is better for my depression, TMS, or ECT?
This question can only be answered by each patient in consultation with their doctor. Both treatments have been proven effective in relieving depression, but they are very different in terms of their side effect profiles and how they are administered.
While ECT typically takes fewer sessions to see improvement in your depression, its benefits are short-lived. Most patients who do ECT continue to receive ECT periodically to prevent relapse. Long term data following remission produced by ECT in patients with treatment-resistant depression have been disappointing, with only 13% being still in remission a year later. Multiple ECT treatments do increase the patient’s odds of having adverse side effects from ECT.
With TMS Treatment, most patients begin to show improvement after two to three weeks of treatment. With Salience TMS Treatment, around 80% of our patients see improvement in their depression symptoms and close to 60% of patients see full remission. Remission meaning little to no depression symptoms daily.
Maintenance with TMS is still being studied; however, research has shown that TMS treatment will provide remission that lasts six months or longer. In a study in 2013, where 257 patients participated in a TMS Clinical study were observed for a year after treatment with periodic checkpoints, 69% of the patients still reported improvement to their depression, and 45% of patients reported complete remission.
With the high success rate, reduced side effects from treatment, and ease of access to treatment, most patients will select to try TMS Treatment before ECT.
What can I do next?
If you are interested in learning more about TMS Treatment, please visit https://salienceneuro.com/tms-treatment/ or call us at (214) 880-8778. You can speak to one of our patient navigators, and they would be happy to answer all your questions regarding TMS Treatment and its benefits.