Many people confuse Electroconvulsive Therapy (ECT) with Transcranial Magnetic Stimulation TMS) therapy. This confusion is valid, as both are cranial therapies used to treat mental illnesses like clinical depression. But this is where the primary similarities end between the two treatments. While ECT uses electric current to bring about results, TMS uses electromagnetic waves to stimulate areas of the brain associated with mood regulation. While various side effects are associated with ECT treatment, the side effects of the non-invasive TMS therapy are virtually non-existent, according to Karl Lanocha, MD, Psychiatrist and Director of TMS Education at TMS Health Solutions. Below is a little information about ECT and TMS treatments.
What are ECT and TMS
Electroconvulsive therapy or ECT is one of the more intense methods of treatment that is generally reserved for patients with life-threatening clinical depression. Patients undergoing ECT therapy have electric currents passed through the brain through electrodes attached to the scalp, a process which intentionally triggers numerous generalized seizures. Modern ECT practices have improved, as the methods of delivery and pain management have come a long way in the last 30 years. It’s estimated that roughly 100,000 patients undergo ECT treatment in the United States every year. TMS or Transcranial Magnetic Stimulation is an FDA approved therapy that utilizes the power of electromagnets. Irregularities in brain circuit functions have been found in patients with depression. Specifically, the prefrontal cortex, which regulates mood, is underactive in people suffering from depression. TMS therapy targets these irregularities by electromagnetically stimulating nerves and depolarizing superficial cortical neurons in the brain. One of the major benefits of TMS is that it requires no surgery or sedation of any kind, and patients can resume regular activity immediately after each treatment session.
Course of Treatment and Efficacy of the Two Treatments
ECT therapy usually consists of six to 15 initial treatment sessions spaced at least a day apart. Patients usually don’t experience relief from symptoms until they’ve undergone six or more sessions. Roughly 70 percent of patients experience significant relief of symptoms through ECT therapy, but the benefits of ECT don’t last for most patients. Approximately half of all patients receiving ECT treatment relapse after six months to a year. For this reason, doctors usually recommend maintenance ECT or the continuation of antidepressant drug therapy. Patients receiving TMS therapy usually do so over a four to six-week period that includes 30 to 36 sessions. Sessions last from 30 to 60 minutes and patients report feeling a slight tapping on their scalps during administration. Roughly 50 to 60 percent of people with depression who haven’t benefited from medications experience a clinically meaningful response with TMS. About one-third of these individuals experience full remission, meaning that their symptoms go away completely.
Side Effects of ECT and TMS
Patients often experience headaches, nausea, muscle aches, confusion, or memory loss – both short-term and long-term – following ECT treatment. When a patient experiences short-term memory loss, they have trouble remembering things that occurred recently. Short-term memory loss as a result of ECT usually subsides within weeks or months. Long-term memory loss is a more common result of ECT and makes it difficult for patients to recall events that happened two or more weeks earlier. Because of the array of possible side effects, patients usually are held and observed at the hospital after treatment before being released. As previously mentioned, the primary side effect for TMS patients can sometimes be a slight discomfort where the magnet meets the head. Often, the clinician administering the treatment can adjust the intensity of the TMS machine to counter this side effect. It’s also possible that TMS could cause an unintended seizure, but there are very few documented incidents. Two large-scale studies about the safety of TMS stated that most side effects, such as scalp discomfort or headaches, were moderate or mild, and no seizures occurred.