Comparing ECT and TMS for Treating Depression

Depression affects nearly 20 percent of the adult population in the United States. Talk therapy and antidepressants are the first-line treatment options. But some may not respond to antidepressants or have adverse effects.

In these cases, brain stimulation therapies such as electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS) may be treatment options to provide relief. Both ECT and TMS increase the activity of your brain cells, stimulating their connectivity and efficiency, which helps regulate your mood and emotions. Both treatment options can positively impact your mental health, but how they achieve these results is very different.

Before deciding which treatment is best for you, it is wise to understand what they are and how they are different.

What is ECT?

Electroconvulsive therapy (ECT), also known as “shock therapy”, was first used in the 1940s. Doctors have made many advances to increase its safety and effectiveness over the years. It is a procedure used to treat psychiatric disorders that have been resistant to gentler treatment options.

Doctors perform ECT at a hospital as an outpatient procedure. You will be under general anesthesia in an operating room. A trained physician will administer a short shock to stimulate your brain with electricity, inducing a small therapeutic seizure. The seizure is used to reset the brain and is minor enough that it does not cause muscle movement.

After ECT treatment, you will feel groggy and have some potential memory loss. However, it should help your brain return to normal function, improving your mental state and mood.

What is TMS?

Transcranial Magnetic Stimulation (TMS) utilizes magnetic fields to stimulate your brain. You will be able to have the treatment at a comfortable outpatient clinic or doctor’s office. You will have an electromagnetic probe placed lightly on your scalp. Magnetic pulses emitted by the probe will locally stimulate specific areas of your brain. The goal is to increase neural activity in your brain in the areas responsible for your emotions and mood.

Differences Between TMS and ECT

1. Comfort Level and Invasiveness

ECT requires you to be put under anesthesia and in a hospital setting. You will need an IV catheter and fluids. You will need some recovery time and a ride to and from your treatment. In some cases, you will not be able to drive for the duration of your treatment course, restricting your independence.

TMS is gentler. You can receive treatment in a more comfortable spa-like environment. You are awake during the procedure but can lay back, relax, and watch tv during the whole treatment. You will be able to resume your regular activity, including driving, immediately following your appointment.

2. Mechanism

ECT uses electrical currents to elicit seizures to reset your brain. TMS uses magnetic pulses to stimulate your brain’s nerve cells and does not create seizure like activity in the brain. Because TMS works with magnets, patients who have pacemakers or any metal objects in or around their heads are not good candidates for TMS.

3. Side Effects

ECT may induce confusion that lasts hours, short-term memory loss, head or jaw aches, muscle pain, and fatigue or nausea. In rare cases, the memory loss can cover events from just weeks to years before treatment. You can have temporary or permanent changes to your heart rate, rhythm, or blood pressure. Seizures can last longer than planned, and deaths are still reported from ECT or resulting complications.

TMS can rarely cause minor scalp pain from the probe placement or a slight headache that resolves quickly. TMS is generally very well tolerated.

4. Cost

Because your ECT treatment will be in a hospital setting, it is more expensive. Even with insurance covering your treatment, which isn’t always the case, your out-of-pocket costs are typically more because your treatment involves an anesthetist, doctors, nurses, and recovery time. On average, TMS is half the cost of ECT, and both private health insurance and Medicare/Medicaid typically cover it.

5. Treatment Length and Frequency

ECT is performed up to three times a week for 12 sessions or six weeks. You may need maintenance ECT if you have more severe depression. TMS treatment plans are also typically six-week courses. However, a single session of TMS is significantly shorter than ECT. To understand your needs, you can discuss your personalized treatment plan with an experienced provider at a TMS treatment center near you.

Both treatments can change your neurotransmitter levels and receptors in the brain, leading to better brain chemistry for regulating your mood and combating depression. TMS is the more affordable proven treatment for depression, especially for those suffering from treatment-resistant depression.

You can complete ECT with fewer sessions overall, but the sessions last longer. ECT is more invasive, has more side effects, and involves more risk. ECT requires general anesthesia, which may not be suitable for everyone. ECT may mean you have to take a temporary leave from work.

With TMS, you can continue your life as usual. You will be able to participate in healing practices like talk therapy and exercise, which are nearly impossible to continue during ECT. TMS is a less-invasive treatment option that helps many people feel better.

If you’re interested in learning more about NeuroStim TMS Therapy, you can download a free copy of our latest brochure below this article. Alternatively, if you’d like to find out whether NeuroStim TMS could be right for you, please take our free 30-second TMS Quiz now to find out if you’re a candidate. Click here to get started.

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