TMS THERAPY
FDA-cleared, non-medication depression treatment
Magnetic Therapy for Depression: Separating Fact from Fiction
Tolu Ajiboye
Antidepressants and talk therapy are effective depression treatments, but they don't work for everyone. If you're still searching for the right treatment, you've probably heard about many techniques and therapies that promise to provide relief from your symptoms. It's important to be able to tell apart viable treatment options from fads.
You may have heard about magnetic therapy for depression. It's easy to think this simply means treating depression with the same magnets you'd put on your refrigerator. Yet in reality, conventional magnets aren't involved at all.
Here's what magnetic therapy really is and what science says about other forms of treatment it could be mistaken for.
TMS Therapy for Depression
Despite what it may sound like, magnetic therapy for depression doesn't involve treatment with refrigerator magnets or any other magnets you may find in your daily life. Instead,
Transcranial Magnetic Stimulation (TMS) treats depression by using an MRI strength magnet to give pulses which stimulate areas of the brain responsible for regulating moods and emotions. The magnetic field for TMS is created using powerful electrical currents flowing through specially designed coils at frequencies and pulse widths specifically designed for their chosen indication.
During TMS treatment sessions, a TMS device that's been calibrated to your physiology is positioned on your scalp, and short electromagnetic pulses are delivered through it. The pulses then activate nerve cells in targeted regions of the brain. This reduces depression symptoms by improving your brain's ability to regulate moods.
TMS Therapy vs. Unproven Treatments
While searching for a treatment, it's likely you've heard about different treatment options. Some of these treatments, like TMS therapy, are FDA-cleared and proven to be effective at relieving depression symptoms. Others may not have definitive evidence supporting their efficacy.
Treatments can sometimes sound similar and be difficult to discern the differences between them. TMS therapy is sometimes confused with transcranial electrical stimulation (TES). In contrast with TMS therapy, which uses magnetic pulses,
TES delivers micro-electric currents to the brain via electrodes. TES received "grandfathered" FDA approval when the FDA started regulating devices in the 1970s and did not have to submit clinical trials to prove efficacy. This is unlike TMS therapy, which conducted randomized, blinded, sham controlled trials showing benefit that led to its FDA clearance for treating
depression and
obsessive-compulsive disorder , and to help with
smoking cessation.
Similarly confused with TMS,
magnetic field therapy involves skin contact with a magnet—magnetic jewelry is a common example—and is claimed to help with pain and other symptoms of depression. But again, there's insufficient evidence that wearing a magnetic bracelet can treat any health condition, including depression, and these static magnets are not the same as the medical device generated magnetic fields used in TMS therapy.
In truth, these alternative practices are completely different from TMS. TMS therapy, which is covered by most insurance, delivers magnetic pulses from FDA-cleared TMS devices to gently stimulate areas of the brain under the supervision of a physician.
How Effective Is TMS Therapy?
TMS therapy is a science-based, FDA-cleared treatment for
treatment-resistant depression,
obsessive compulsive disorder , and to help with smoking cessation. Many people choose TMS therapy for depression because antidepressants and talk therapy approaches do not work for them. TMS therapy has a
62% reponse rate in patients with treatment-resistant depression. TMS therapy is non-invasive, has minimal side effects, and consists of six to nine weeks of treatment sessions that last about twenty minutes each.
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Starting any medical treatment for the first time can leave you with questions, especially if you’re looking forward to the benefits it may bring. It’s no different when you’re preparing for your nasal esketamine treatment. Your previous mental health treatments may have consisted solely of taking antidepressants at home or visiting a therapist’s office for cognitive behavioral therapy (CBT), so nasal esketamine is probably a new treatment experience for you. If you're wondering what it's like to start nasal esketamine and get ready for your first session, keep reading. Getting Started with the Nasal Esketamine Treatment As with any new treatment, you’ll first talk to your primary care provider or psychiatrist about whether nasal esketamine is a good fit for you. Alternatively, you can schedule your esketamine nasal spray consultation with a treatment center (such as Greenbrook) that has certification by the FDA’s Risk Evaluation and Mitigation Strategy (REMS). At Greenbrook's REMS-certified nasal esketamine treatment centers, our Greenbrook-affiliated psychiatrists and psychiatric nurse practitioners will review your medical history and also conduct our own assessment to help determine whether nasal esketamine treatment is right for you. Certain conditions, including blood vessel disease and a history of psychosis, may make treatment a risk for you. Make sure you discuss all previous and present conditions with your doctor or nasal esketamine provider before beginning treatment. If the medication is deemed a good fit, you’ll receive your prescription from the Greenbrook-affiliated provider. Your Greenbrook Care Team will put together a personalized care plan for the weeks and months to follow. Keep in mind that you will need to take a standard (oral) antidepressant along with your nasal esketamine treatment. There are two important regulations to note when it comes to preparing for treatment: Each treatment is followed by a mandatory two-hour observation period. This means you will need to plan to stay at the center for at least two hours following your self-administration of the esketamine nasal spray. You cannot drive during the rest of the day after treatment and must arrange for transportation. These regulations are mandatory. It may be helpful to sit down and plan out several weeks’ worth of transportation once you know your treatment schedule. In addition, if you’re wondering what to bring for the treatment, we recommend entertainment such as an audiobook or playlist of favorite songs and a pair of headphones. You may want them during the two-hour observation period. What to Expect During Nasal Esketamine Treatment On the day of treatment, you’ll need to stop eating any food two hours before your appointment and stop drinking all fluids 30 minutes before you come in. Your Greenbrook Care Team will confirm that you are prepared for the two-hour observation period and that you have a ride home. You’ll get the opportunity to practice using a “trainer sprayer” that mimics the real nasal esketamine sprayer but does not release any medication. The Care Team will encourage you to use the restroom and set up your preferred environment in your private treatment bay or room. Some patients like reduced lighting, for example, while others don’t request light adjustments. You’ll complete a depression scale before each treatment session. Your Greenbrook provider will confirm that the dose kit is yours, show you how to administer it, and then hand it to you. Each sprayer contained 28mg of Spravato esketamine nasal spray. Patients usually start with two sprayers (56mg) and soon increase to 84mg (three sprayers) per treatment. But, your dosage maybe vary. Should you be left with a metallic taste by the spray, the Care Team will offer suckers to help make the flavor dissipate. After your dose, you’ll be encouraged to lie back in your comfortable recliner. While most patients enjoy a quiet setting, Greenbrook is prepared to accommodate patients with a more animated reaction to the medication. You may feel sleepy, dizzy, mildly dissociated, and/or nauseated during treatment. Greenbrook's Care Team is readily available if you need assistance. How to Prepare for after your Nasal Esketamine Treatment Most side effects begin to wane in the second hour of observation, but if you’re wondering, “Is it safe to drive immediately after nasal esketamine treatment?” the answer is a resounding no. In addition to the mandatory ride home, you will need to block off time to rest and let side effects fully dissipate. This extended rest period is especially important in the first weeks of treatment when you’ll have treatment twice a week. Do not drive or operate machinery of any kind until the day after treatment. Just take it easy, relax, and take care of yourself. If you’re unsure what activities you can do or should avoid during this time, talk to your Care Team for more information. While side effects tend to dissipate completely after a good night’s sleep, many nasal esketamine patients begin feeling relief from depression symptoms within hours of their treatment. Other Tips in Preparing for Your Nasal Esketamine Treatment At Greenbrook, we make every effort to schedule your treatment in the afternoons or whenever it is most convenient for you. We encourage you to see each treatment session as an opportunity to relax and take care of your mental health. If you have any questions or concerns, talk to your doctor or the Greenbrook Care Team. At Greenbrook, we’ll help you feel at ease when preparing for each treatment session. Schedule A Free Consultation To get started with nasal esketamine, schedule your free consultation today.
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