How Long Do the Effects of TMS Treatment Last?

How long do the effects of TMS treatment last? Read on to learn more about what TMS therapy entails, along with any potential side effects.

What Is TMS Treatment?

Transcranial magnetic stimulation (TMS) is a newer, noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain in order to help with symptoms of depression. TMS is also known as repetitive transcranial magnetic stimulation (rTMS), due to the fact that it often involves delivering repeated and multiple magnetic pulses. TMS therapy is often utilized for patients who have tried other treatment options to help with their depression that ultimately was not effective in mitigating symptoms. 1

How long do the effects of TMS treatment last

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How Does TMS Therapy Work?

During sessions for rTMS, the patient will have an electromagnetic coil placed on their scalp near the forehead. Through this coil, magnetic pulses will be delivered into the brain in order to stimulate the nerve cells in the region of the brain that is associated with mood and depression. The magnetic pulses are not painful and often cannot even be felt by patients. The most that patients will feel during sessions is a slight discomfort on the scalp, or potentially a headache that will last for an hour or two after the session has been completed.
TMS therapy works to stimulate the area of the brain that, due to depression, may have started to decrease in overall activity. This, in turn, can exacerbate symptoms of depression further, especially if one has been diagnosed with long-term or persistent depressive disorder.

Transcranial Magnetic Stimulation: an Overview

How Can a Magnet Affect My Brain?

Due to the fact that our brains are magnetically active, repeated stimulation of these areas by a magnet can help to reactivate or re-stimulate regions that may be underutilized due to symptoms relating to depression or other mental disorders. TMS targets these areas specifically, especially those related to pleasure, overall mood, and decision-making.
There have also been proven TMS results for obsessive-compulsive disorder, nicotine addiction, and migraines, although it is primarily used for symptoms relating to depression.2

What Devices Are Used in TMS?

Depending on what type of device is used in TMS therapy, sessions can last anywhere from five to fifty minutes. This amount of time also depends on if the patient is receiving TMS or rTMS as well. TMS treatment for depression has come a long way since the practice first started, meaning there are now better and more streamlined devices available.
The TMS procedure will look different for everyone, and your TMS therapist or doctor will come up with a TMS treatment schedule that is best suited to your needs. The three main types of TMS treatment are surface TMS, deep TMS, and rapid TMS. Some popular devices used for TMS therapy include the NeuroStar, the Brainsway, and CloudTMS.3
tms treatment

Surface TMS

Surface TMS treatments are utilized for only stimulating the outer cortex region of the brain. NeuroStar machines are generally used for surface TMS treatments, and sessions for this type generally last for around forty minutes. This is seen as the most traditional type of TMS therapy and is most often the treatment utilized for patients. 4

Deep TMS

This type of TMS therapy claims to reach deeper into the brain than surface TMS does, although this has not been entirely proven. However, some scientists have seen that deep TMS is more effective for those with more intense or serious symptoms of depression. Brainsway’s machines are most commonly used for deep TMS.
It’s also important to note that many doctors and patients both feel more comfortable utilizing surface TMS due to how the technology works and the potential side effects of deep TMS.

Rapid TMS

Rapid-rate TMS is generally defined as rTMS that uses frequencies greater than 1 Hz. This type of TMS is not as common as surface or deep TMS, but is more often used for patients who need more intensive treatment sessions. Research has found that patients who underwent rapid-rate TMS saw a 60% decrease in their depression symptoms after just five daily sessions.5

How Does TMS Help When Antidepressants Didn’t?

Doctors generally bring up transmagnetic stimulation as a treatment option when patients have used antidepressants before without significant results, or when patients have experienced negative side effects as a result of those antidepressants.6

How does TMS therapy work when antidepressants didn’t? Is there that much of a difference in how they affect the regions of the brain associated with depression and mood? TMS treatment tends to work for some patients because it directly affects the electrically charged areas of the brain, whereas antidepressants only focus on brain chemistry in general. Attempting to figure out what symptoms need to be treated, and then finding the right antidepressant for effective treatment, can be difficult and time-consuming depending on the patient and their needs. TMS therapy works in a more direct way than antidepressants do, often helping with symptoms quicker and with more efficacy.7

Side Effects of Antidepressants

Another reason that TMS therapy may be recommended instead of antidepressants is due to the fact that many antidepressants have varied side effects that can adversely impact an individual. These side effects, coupled with depression symptoms, can be overwhelming, leading to TMS therapy instead.

Potential Impact(s) of Antidepressants

Some of these side effects from antidepressants can include:
  • Sexual dysfunction
  • Weight gain
  • Nausea
  • Headache
  • Irritability 
  • Blurred vision
  • Dry mouth
  • Sleep disturbances or fatigue

TMS Therapy to Mitigate Symptoms of Depression

Benefits of Transcranial Magnetic Stimulation

There are multiple benefits of TMS or rTMS for patients who have symptoms of depression, anxiety, OCD, or other mental conditions. These will be detailed below.

tms therapy results

Non-Invasive

TMS therapy is a non-invasive treatment option and only occurs on the surface area of the scalp. This means that a wide variety of people can receive this sort of treatment unless the patient has metal somewhere in their head or a history of strokes. TMS is non-surgical and only requires electrodes to be placed near the forehead of the patient.

No Extreme Side Effects

As mentioned briefly above, TMS healing therapy does not have as many side effects as traditional antidepressants can have. This is part of the reason why TMS effectiveness is so high. The most common side effects of TMS are headaches and slight scalp discomfort. Some serious, but very rare, side effects can potentially include seizures or hearing loss. However, a physical examination of the patient will be conducted before therapy starts, helping to mitigate these rarer risk factors.

No Sedation or Anesthesia

Unlike certain surgical procedures that are designed to help with mental conditions, TMS or rTMS therapy does not require sedation or anesthesia. Due to the minimal invasiveness and mild side effects of the procedure, patients can remain alert and awake during the entirety of the session.

Not Addictive

While uncommon, certain antidepressants can become addictive for the individual if taken over a long period of time or abused, or at least make the patient dependent on them as a substance. These can include SSRIs such as fluoxetine and sertraline.8

Effective and Has Long-Term Results

Research has shown that approximately 50-60% of people with depression who have tried other avenues of treatment have found some sort of success with TMS therapy. This shows that TMS is effective and has long-term results for the individual in many cases. It’s especially effective for those who have experienced serious or intense risk factors associated with depression.9

Effects of Transcranial Magnetic Stimulation

There are various benefits of transmagnetic stimulation, both short- and long-term. Some patients see fast results for mitigating certain symptoms of depression, whereas others may need more sessions in order to see any noticeable benefits. However, most patients do see some sort of benefit from starting TMS therapy.

Short-Term Effects of TMS Therapy

Most commonly, the short-term effects of TMS therapy may include headaches and scalp discomfort. On the other hand, many patients also often experience many symptoms of depression lessening in scope and severity. These can include experiencing less fatigue, becoming more interested in activities that they enjoyed before depression set in, along with mood swings decreasing in both severity and amount.

Long-Term Effects of TMS Therapy

As TMS is still a relatively new therapeutic approach for severe depression, there are still some unknowns about the long-term effects of TMS therapy. For patients who already have tinnitus, which affects the ears and overall hearing, TMS can make this condition worse with prolonged and repetitive exposure.
Otherwise, most long-term effects of TMS generally include headaches, which generally resolve themselves after treatment has stopped or with the use of migraine medication. The long-term benefits and TMS success rate still both almost overwhelmingly outweigh the negatives, with improved mood and happiness in many patients.10

How Many TMS Sessions Are Needed?

The amount of TMS sessions that may be needed will depend on the individual patient and the specific symptoms associated with their depression or other mental condition. In many cases, TMS is offered in six- or nine-week courses, with patients often receiving five to seven sessions per week.
Studies have shown that twice-daily sessions are generally more effective than once-daily sessions, specifically for those who are using TMS to treat a major depressive disorder. The response rate in patients who received twice-daily sessions was 83%, whereas for once-daily sessions, that number decreased to 53%.11

How Long Does It Take For TMS to Start Working?

How long it takes for patients to see the effects of TMS therapy varies as well, but many patients start to see results within a couple of weeks of starting TMS therapy. Oftentimes, if TMS is administered at least once per day, patients can see results as early as the end of the first week.

How Long Do The Effects of TMS Treatment Last?

TMS treatment’s efficacy over the long term often depends on various factors, including age, early responses to the treatment, and the severity of depression that the patient suffers from. It’s important to note that TMS is a treatment option that usually requires patients to undergo sessions multiple times throughout their life, depending on how long their depression symptoms last and if antidepressants had altered how their brain received serotonin or dopamine. Many individuals receive at least three or four rounds of TMS, especially if they have chronic or long-term depression. However, some individuals only need one round of treatment that works to mitigate symptoms.
A single four- to six-week TMS treatment often shows benefits for patients for anywhere from six months to a year. If their depression symptoms start worsening again after this time period, they will generally be directed to undergo another round of TMS sessions.12
tms treatment for depression

Age

While TMS treatment is generally effective for younger patients, due to the fact that their brains are not as developed as they are in older individuals, there has been research that shows that rTMS can especially be beneficial in geriatric patients who struggle with symptoms of major depressive disorder.13

Early Positive Responses to TMS Treatments

For those who experience earlier positive responses to TMS treatment for depression, it is expected that they will continue to respond this way as opposed to patients who don’t see many, or any, results early on. Since TMS treatment generally shows effects relatively quickly, those who don’t see early responses will not often see positive results later on during the session course either.

Severity of Depression

TMS is a treatment option that is generally only prescribed for patients who have not seen results with regular antidepressant use. Therefore, TMS is usually only used for patients who have more severe depression that antidepressants were not able to help with.
For patients with less severe depression, or who have underlying and untreated anxiety or mood disorders, TMS may actually worsen depression symptoms, meaning it’s important to talk with your doctor before undergoing either surface or deep TMS treatment.

How Many Times Can You Get TMS Treatment?

If a patient’s depression symptoms come back after the six- or twelve-month mark, they can undergo another round of treatments. TMS is not a lifelong treatment option, however, and while patients may choose to undergo more rounds of TMS after symptoms come back, it’s generally recommended to not receive more than four or five total rounds of TMS, due to the fact that it hasn’t been extensively studied beyond that point. Also, it’s recommended that there are, at the most, only two TMS treatments per day, especially if the patient is receiving rapid TMS treatment.

What Outcomes Should Be Expected From TMS Treatment?

For patients who start TMS sessions, symptoms of their depression, such as apathy, anxiety, fatigue, sadness, and mood swings, should begin to lessen. In some cases, these symptoms may disappear entirely after the round of TMS treatment has subsided. As stated previously, TMS treatment is often not permanent, meaning other avenues of treatment eventually may be necessary. However, TMS does help with these more severe symptoms in the short term and can help patients begin to feel back to their normal selves again.

Does Insurance Cover TMS Treatment?

Depending on what insurance provider you have, insurance may cover TMS treatment sessions. Due to the fact that TMS treatment is now FDA-approved and has been utilized as a medically necessary service for those with major or persistent depressive disorder, many insurance providers do cover the service. However, it’s important to check with your insurance provider or doctor before starting treatment, as it is not a cheap therapy option.
tms long-term results