Standard transcranial magnetic stimulation (TMS) is a non-invasive technique for stimulating brain activity to treat depression with repetitive magnetic pulses. However, the standard treatment protocol is lengthy for some who receive daily treatments for weeks to months. It can make it challenging to start or adhere to your treatment regimen.
The FDA has cleared accelerated TMS to provide a condensed form of this treatment with the same, if not better, results. If you have a diagnosis of major depressive disorder (MDD) that didn’t improve with medications, accelerated TMS may be a viable option if you can fit daily sessions around your work schedule. Since it is relatively new, you may have some questions about its safety and efficacy. Here are answers to some of the most commonly asked questions about accelerated TMS therapy.
Will It Be Effective?
In short, yes. It’s very effective. Research is still ongoing to determine how much more effective it can be compared to standard TMS protocols, especially for treatment-resistant depression. A 2010 study and a systematic review a decade later compared the efficacy of standard and accelerated TMS, and their results showed them as equally effective. A 2019 meta-analysis determined that accelerated TMS improves overall depressive symptom severity.
Additionally, a targeted review confirmed that accelerated TMS has a similar response rate and trajectory to conventional TMS. Accelerated treatments were trending towards a more substantial antidepressant effect. However, it is difficult to summarize remission rates since studies vary on participants’ antidepressant use, amount of daily treatment sessions, and other variables they need to control.
When specifically looking at treatment-resistant depression, a 2019 literature review concluded it’s as effective and safe as standard TMS treatment, trending towards faster response rates. This is key if you need to travel or take work off for treatment. Faster response times and abbreviated treatment schedules make it more practical and feasible for many patients.
Is It Safe For Me?
The Journal of Affective Disorders published a systematic review of studies conducted to examine the safety of accelerated TMS. They found no safety concerns in administering accelerated instead of standard TMS treatments. Another targeted review in 2022 determined that accelerated TMS does not increase side effects or adverse events compared to standard TMS therapy.
It’s even an effective and safe treatment for older adults with depression, which is very uncommon. A 2019 study examined the safety of accelerated TMS in two groups of adults: those under and above 60 diagnosed with unipolar and bipolar depression. They found both groups tolerated treatment well, statistically significantly improving their depression and anxiety.
What Should I Expect?
Like with standard TMS treatment, you remain awake for the duration of your sessions. You will be in a comfortable medical lounge chair, similar to what dentists have in their offices. You can listen to music, use your phone, watch a movie, or relax quietly during treatment. Both standard and accelerated TMS use the same machine to deliver magnetic pulses to targeted areas of your brain that regulate your mood.
With accelerated TMS, you will have five to ten short treatments. They will last roughly 10 minutes, with 50-minute breaks in between sessions. Treatment courses can be as short as five days or up to two weeks long. You will need to stay close to or at the clinic for the day, so there is a more significant time commitment daily. But the trade-off is that you can complete the course in under two weeks, a standard work vacation, compared to the traditional four to eight-week protocol.
What Are The Potential Side Effects?
Occasionally, you can experience slight transient scalp discomfort either during or after treatment. The worst side effect you could encounter is a mild headache, typically post-treatment. Either aspirin or ibuprofen is safe to take to alleviate these side effects. Some research suggests you can experience some fatigue, especially with accelerated TMS, but nothing to cancel plans over. After treatment, you are safe to immediately return to your normal activities without any driving restrictions or rest needed.
Previously, if you didn’t respond adequately to antidepressant medications or talk therapy and experienced increasing suicidal ideation, your only option was electroconvulsive therapy (ECT). It’s an invasive, inpatient procedure performed under general anesthesia to induce seizures. This treatment has significant risks, and you can suffer permanent memory loss.
Accelerated and standard TMS therapies offer hope and symptom relief if you suffer from MDD and don’t respond adequately to antidepressant medications. Whether you have failed medication trials, cannot tolerate their side effects, are pregnant and cannot take antidepressants, or simply want a non-systemic way to reach remission, speak to your provider about alternative depression treatments like accelerated TMS today.