Since it’s the newcomer to the psychiatric treatment toolbox, many myths and misinformation are circulating about transcranial magnetic stimulation (TMS), which causes some patients to overlook TMS as the great treatment option it is. Let’s dispel the confusion. The top misconceptions include the following:
1. Daily Therapy Takes All Day
Many people think TMS treatment takes all day, similar to a day treatment program. However, you can complete your treatment in as little as 15 minutes after your initial consultation and staging appointment. It’s so quick that patients have popped in on their lunch break to get their daily therapy before heading back to finish their work shift.
There is also a newer regimen called accelerated TMS or SAINT TMS for depression, where treatments last all day. Essentially, you condense a standard TMS treatment plan from six to eight weeks into as little as five days. It is easy to misunderstand the differences in daily and overall treatment lengths between traditional and accelerated treatment.
Your provider can talk to you about both types of treatment and which they recommend for you and will fit your schedule.
2. Only Adults Can Have TMS for MDD
TMS is only FDA-approved for patients between 18 and 70, but it’s been effective in studies with patients as young as nine years old. Insurance companies will only cover it for children once the FDA lowers the approved minimum age. However, some doctors have opted to use TMS off-label for adolescents as a last resort. Many researchers are working to prove its effectiveness for children, like Wall et al., which demonstrated that TMS doesn’t adversely impact neurocognitive functions and may even subtly enhance verbal memory.
3. It’s Just Like ECT
Both electroconvulsive therapy (ECT) and TMS are treatments applied to the brain to alter your brain’s chemistry to help regulate your mood and behavior. While they are both effective methods to treat depression, that’s as far as the similarities go. ECT must be performed in a hospital surgical suite under general anesthesia. Electrical currents are directed through your brain to interrupt cell signals, inducing seizures and allowing your brain to “reset” and get the upper hand with depression. It may come with short and long-term side effects like memory loss.
TMS is administered in a relaxing, outpatient setting while you are awake and can watch TV, listen to music, or scroll on your phone. TMS uses magnetic fields, like an MRI, to stimulate your brain cells via an electromagnetic coil on your scalp. These pulses help regenerate and strengthen nerve cell signaling abilities that regulate your brain’s behavior and mood centers.
4. TMS is Unsafe
TMS is one of the few approved treatments for depression without any systemic side effects. It is not invasive and doesn’t come with a warning of increasing suicidal tendencies. The worst side effects reported include a temporary headache during treatment and scalp irritation from where the probe sat. No one has reported any long-term problems, and TMS has been FDA-approved for nearly 15 years.
5. Results Aren’t Real
The placebo effect is a studied psychological phenomenon where patients receiving “fake” treatment report positive results. To rule it out, researchers must verify patient benefits are the result of treatment and not the belief that they got treatment. They do this by randomly assigning people to either a placebo group or the TMS treatment group, ensuring neither the researchers nor the participants know which group the study has placed them in.
If the results are just a placebo effect, there will be no statistically significant difference between the two groups. O’Reardon et al. published one of many studies in 2007 showing statistically different results between those that received placebo treatment and TMS, with the latter having more significant improvements in their depression ratings.
The FDA has approved TMS as an effective treatment for depression, among other disorders, based on verified and replicated studies showing accurate results. TMS has successfully treated depression and other mental health problems for years.
6. Insurance Won’t Cover Treatments
If you decide you would like TMS and do not follow your insurance’s required qualifications, this misconception will be true; your insurance company will not cover TMS. Suppose you have a psychiatric or neurological condition that has been unresponsive to other conventional treatments or medications. In that case, your insurance will likely deem TMS necessary and cover the eligible expenses.
Most major insurance companies, including Medicare and Medicaid, cover TMS. Check with your insurance company to see how much they will cover and what steps you need to take to get TMS covered before you start treatment. Double-check how they will cover it as well. You may need to pay upfront and submit the bill for reimbursement, which is a surprise you don’t want the day you start your therapy.
7. The Treatment Won’t Last
Because we are accustomed to long-term antidepressant and therapy treatments, having a couple of weeks of TMS therapy doesn’t seem like it should keep depression at bay long-term. Dunner et al. researched this in 2014, studying patients with medication-resistant depression treated with TMS. They found that the positive responses persisted for a year when the study concluded.
For over two decades, researchers have studied TMS therapy’s safety, efficacy, and risks for depression. It is safer and less invasive, with lasting results and fewer side effects than any other effective depression treatment. If you are struggling with depression and haven’t explored TMS as a treatment option because of one or more of these misconceptions, speak with your provider about your options today.