TMS (transcranial magnetic stimulation) and ECT (electroconvulsive therapy) are two types of treatment for depression that do not use medications, but they do not have much else in common.
When you are trying to decide which treatment you would like to use for your medication-resistant depression, it is important to know the differences. At The TMS Center of New Jersey, we will discuss all the possible treatments available to you and answer any questions you have.
ECT is used to treat major depression when other treatments like medications or talk therapy do not work. It is used when depression symptoms are severe, and the patient needs a quick response from treatment. Most patients receiving ECT must take time off work, or even a leave of absence for an extended time. You could find yourself needing a long time for your ability to function at work to return.
Patients who have ECT treatments routinely require care immediately after the session. You might need to be hospitalized during your ECT treatments or require a dedicated caregiver while undergoing ECT therapy. This means you will be unable to care for yourself and other family members.
Every ECT treatment must be performed with the patient under general anesthesia for their safety and comfort. ECT uses a small amount of electrical current to trigger a controlled seizure. Ideally, the seizure will reset or restart your brain function and relieve depression. Once the seizure is over, anesthesia is stopped, and you wake up. However, some patients do not tolerate the medications used for anesthesia very well. You may have significant side effects such as nausea, vomiting, or dizziness.
Because the seizure produced during ECT affects your entire brain, you can have significant side effects because the therapy disturbs parts of your brain other than those that control mood. Many patients report side effects, such as memory loss and difficulty concentrating. The expectation is that these problems will decrease over time, but this varies from one person to another.
Many patients find that their first ECT treatment is only the start, and they must have more ECT sessions to reach a point where other therapies can take over. Each ECT treatment can mean at least a repeat of any problems you have from the session. You could develop more issues as the number of treatments increases.
NeuroStar TMS treatments at The TMS Center of New Jersey require no medications or anesthesia. You are awake during treatment and can resume your usual activities immediately after a TMS therapy session. Most patients do not take time off or a leave of absence from work to complete their therapy because they can work during their treatment cycle. You may choose to have a trusted friend or family member with you throughout TMS therapy, but you will not need to have a caregiver.
TMS therapy is more specific to the affected areas of your brain vs. ECT. The tiny electrical currents created by the magnetic waves of TMS are concentrated on the areas of your brain thought to control mood. The rest of your brain remains untouched, so regular brain function is maintained. Significant side effects such as memory loss or difficulty concentrating do not occur.
Some people feel that TMS therapy is disadvantageous because it does not deliver results as fast as ECT. However, with the newest FDA-approved treatment protocols, TMS can work quickly, so this is becoming a moot point.
There is an extremely low risk (0.03%) of having a seizure due to TMS therapy, which is significantly lower than the risk of having a seizure while taking most antidepressant medications. You will be screened for seizure risk before beginning your TMS treatments. If Dr. Sikowitz feels that your risk is increased, he will discuss this with you so you can decide whether you wish to have TMS treatments.
NeuroStar TMS therapy at The TMS Center of New Jersey involves multiple treatment sessions, but side effects are minimal and quickly improve. With ECT, the side effects stay the same or worsen. For most patients, the lack of significant side effects and the ability to continue working and caring for family during TMS therapy make it a better choice vs. ECT therapy.
When deciding on TMS therapy vs. ECT for their depression, most patients will consider TMS first due to its side effect profile. Patients who do not have success with ECT often turn to TMS therapy.
Consider the differences between TMS and ECT when making your treatment decision. If you have questions about either treatment, contact the staff at The TMS Center of New Jersey. We want you to feel confident that you have chosen the right therapy.
