TMS Therapy vs Electroconvulsive (ECT) Therapy: What's the Difference?

What Is the Difference between TMS and ECT?

Finding the best depression treatment for you requires a clear understanding of your options. At first glance, electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) may seem similar because they both target areas of the brain. However, there are notable differences between the two treatments you should know about, which will allow you to make more informed choices for your mental health and overall well-being.

TMS Therapy vs. ECT

Depression occurs when there are chemical or structural changes to the brain. The brain contains neurotransmitters, which are the chemical messengers that form a communication network between brain cells. If that system isn’t functioning properly, it can contribute to depression. While there are many different types of neurotransmitters, there are some specific ones that are thought to be linked to depression, such as serotonin, dopamine, glutamate and norepinephrine.

Structural variations in the brain may also play a role in depression, though scientists are uncertain if these alterations are the cause of depression or an effect. These changes to the brain’s structure and chemistry are particularly crucial in the limbic system, which governs mood and behavior, among other functions. Parts of the brain that make up the limbic system include the hippocampus and the amygdala.

Both TMS and ECT treat depression by stimulating areas of the brain. The main difference between TMS therapy vs. ECT is the methodology used in these treatments.

What Is TMS?

This treatment uses gentle magnetic pulses to stimulate targeted areas of the brain. The pulses create painless electrical currents that activate nerves in the brain. As a result, new connections between nerve cells are formed to restore brain function and ease depression symptoms.

Many people find TMS easy to integrate into their schedules. This is a non-invasive, outpatient treatment, and it is performed without the use of medication or anesthesia.

A typical treatment session lasts between 18 and 45 minutes. An electromagnetic coil is placed on the patient’s scalp, near the left temple. The placement is determined by mapping the patient’s brain, which is done prior to the start of treatment. This ensures that the magnetic pulses hit their target areas in the brain for the greatest effectiveness. Patients stay seated and comfortable during the TMS session, only feeling a slight tapping on their scalp. Patients can return to their normal routines after the session is over.

There are minimal side effects associated with TMS. The most common are mild headaches or some discomfort at the stimulation site on the scalp. These issues can be resolved with over-the-counter pain relievers, which can be taken as needed. 

TMS treatments are typically every weekday for a few weeks, and then roughly twice per week near the end of the treatment course. More than 62% of TMS patients experience a significant reduction in symptoms, with 42% of those patients achieving complete remission, according to a study in the Journal of Clinical Psychiatry. Treatment can be repeated if symptoms recur at a later date. TMS can be used on its own or in tandem with an existing medication plan. This decision is made by each individual patient and is based on the recommendations of their primary health care professional and the TMS provider.

What Is ECT?

There are key differences between TMS treatment vs. ECT. ECT sends low-level electrical currents to the brain that cause a grand mal seizure that typically lasts around 20 to 60 seconds. This seizure is purposely induced because it is thought to improve depression. Patients must go under general anesthesia for ECT treatment and also receive a muscle relaxant to prevent injury from the induced seizure. Unlike TMS, which targets specific areas of the brain involved with depression, ECT seizures affect the entire brain. TMS also doesn’t trigger seizures.

To begin ECT treatment, electrodes are placed on the patient’s head to transmit the electrical current to the brain. Patients are also attached to monitors to check their vital signs during the treatment session. Plus, an electroencephalogram (EEG) tracks brain activity during ECT. The treatment itself takes five to 10 minutes to complete, not including the prep work that must be done before the procedure.

ECT also takes more time post-treatment. Patients must stay for an observation period after ECT, and it can take a few hours (or longer, for some patients) before normal activities are resumed. Patients cannot drive themselves to treatment; with TMS, however, patients aren’t sedated and therefore don’t need to rely on someone else for transportation.

A typical course of ECT treatment includes two to three sessions per week, over three to four weeks. Once completed, ECT can be used with reduced frequency, or patients can employ standard forms of treatment, such as medication or talk therapy, to prevent symptom recurrence.

There are several potential side effects of ECT. These include temporary memory impairment, confusion, headache or muscle pain, and nausea. Physical symptoms can be alleviated with medication. But ECT side effects related to brain function may persist, in some cases for weeks or even months. Memory loss, in particular, can take the form of a temporary amnesia, where patients draw a blank on events before or during treatment. In addition, ECT may not be recommended for people with cardiac conditions because the treatment raises blood pressure and heart rate. The general anesthesia used during ECT can also increase the risk of complications during treatment.

Learn More about How TMS Therapy Can Help You

Now that you know how TMS is different from ECT, you can make a more informed choice. Depression treatment is a personal decision influenced by several factors, such as your age, current health condition, and scheduling availability, as well as the severity of the depression you’re experiencing. We can help you determine if TMS will be the best fit for you. Our patient consultants will discuss each step of TMS therapy with you, as well as insurance coverage, and you’ll get a treatment plan after meeting with our team of experts.

Find out if TMS therapy is right for you or a loved one. Schedule your free consultation with us today.