TMS Therapy vs. ECT


About The Treatments...

TMS Therapy

Transcranial Magnetic Stimulation, or TMS, uses short pulses of a magnetic field (similar to an MRI) to modulate or stimulate nerve cells in the area of the brain thought to control mood. The pulsed magnetic field has been shown to possibly have a positive effect on the brain’s neurotransmitter levels.



 

  • A round of TMS Therapy is typically six weeks long, five days a week, during an office visit.

  • While it takes about an hour per session, the actual treatment with the device is about 37 minutes.

  • 1 of 3 patients gain full remission, while 50% of patients achieve at least partial remission.

  • TMS Therapy is a non-systemic process (meaning nothing is circulating in your bloodstream throughout your body). 

  • Because there is no anesthesia or other medication necessary, you can drive yourself to and from your appointment and return immediately to your regular activities.

  • TMS Therapy is a noninvasive form (meaning it doesn't involve surgery) of neuromodulation, which stimulates nerve cells in an area of the brain that is linked to depression. Some patients experience discomfort of the scalp during the first week, but that is about it for side effects.

  • As shown in the picture below, the TMS device is administered locally, on the forehead. Some people read a book or magazine during the treatment.




 



Neurostar-vs-ECT

ECT Treatment

Electroconvulsive Therapy or ECT, was formerly known as Electroshock Therapy and was often referred to as shock treatment, according to Wikipedia. It is, and has been a standard psychiatric treatment in which seizures are electrically induced in patients to provide relief from psychiatric illnesses.[1]



 

  • A usual course of ECT involves multiple administrations, typically ten sessions given two or three times per week until the patient is no longer suffering symptoms. 

  • A round of ECT is effective for about 50% of people with "treatment-resistant major depressive disorder", whether it is unipolar or bipolar.[4] Follow-up treatment is still poorly studied, but about half of people who respond to the treatment relapse within twelve months.[5]

  • ECT is administered under anesthetic with a muscle relaxant.[9]

  • Electroconvulsive therapy can differ in its application in three ways: electrode placement, frequency of treatments, and the electrical waveform of the stimulus. These three forms of application have significant differences in both adverse side effects and symptom remission. After treatment drug therapy is usually continued; some patients receive maintenance ECT.[3] 


  • Aside from effects in the brain, the general physical risks of ECT are similar to those of brief general anesthesia.[6]:259 Immediately following treatment, the most common adverse effects are confusion and memory loss.[3][7] ECT is considered one of the least harmful treatment options available for severely depressed pregnant women.[8]

 

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Treatment Considerations...

Treatment Considerations


1. What is the treatment?



2. How many sessions?


3. What is the Indication or risk level of depression?

 


4. How convenient is the treatment?

 
 


5. What are the out-of-pocket costs if you pay yourself?



6. Does insurance cover treatment?
 


7. Are there side effects? 




8. What is the efficacy of treatment?



9. Is there post treatment necessary?
 
 
 
 

TMS Therapy


1. TMS uses magnetic coils to create electrical currents that stimulate the brain.


2. Thirty sessions over a five week period.
 
 
3. When previous attempts at treating depression have produced unsatisfactory results. Psychiatrist prescribed. Possibly first level of treatment. 


4. Very convenient; it's minimally invasive, there is no anesthesia. Treatment is at a doctor's office and you can drive yourself to and from treatment.


 
5. $250-500 per session, or $7600 - $13,000 for the full procedure.



6. A growing number of insurers are covering treatment. We provide patient advocacy on your behalf.

7. Scalp irritation, possibly headaches for the first week. Rare (very rare) cases of seizure.



8. 1 out of 3 gain full remission of their depression, while half gain a partial remission.


9. Patients may need an occasional maintenance afterwards.  May be able to reduce or discontinue medication upon Psychiatrist's approval. 

 

ECT Therapy


1. ECT uses an electrical current to create a therapeutic seizure, which causes a dramatic reset of the brain. Formerly known as "shock therapy".
 
2. Ten sessions over a four week period. The first three sessions require hospitalization.
 
3. When previous attempts at treating depression have produced unsatisfactory results, or the depression is serious, possibly suicidal, or when nothing else works. Psychiatrist prescribed.
 
4. Treatment requires anesthesia & muscle relaxants (hospitalization for the first three treatments). Transportation has to be arranged to and from each session; treatments are short, but patients require 2-3 hours to recover and re-orient themselves.
 
5. $2,500/session or $25,000 for treatment, plus one week of hospital care, which is not included. (Answers.com estimates $50,000 for a week in the hospital).
 
6. Most insurers cover the treatment.
 
 

7. Headaches, muscle aches, cognition issues, short-term memory issues, possible long-term loss, possible improvement in memory in some cases.
 

8. 50-80% initial efficacy, however, about 64-84% of people who respond relapse within six months.
 

9.  After treatment, drug therapy/medication is usually continued, and some patients receive maintenance ECT.
 
 

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