Ongoing Depression Treatment After TMS Therapy

Transcranial magnetic stimulation (TMS) has been proven to be an effective therapy for depression. Read on to learn more about this type of treatment. However, even if an introductory course of TMS therapy is effective, therapeutic care of a patient with depression usually does not end after the first acute treatment. Depression is a chronic disorder, so it typically needs ongoing therapy after alleviating an episode to prevent reoccurrence.

Ongoing depression treatment with TMS

Like continuous psychotherapy or long-term antidepressant medication, TMS maintenance may successfully avert the return of depressive symptoms and maintain a patient's wellness. TMS maintenance entails scheduling TMS treatments on a weekly, bimonthly, or monthly basis.

The duration of the effect of TMS treatment

According to a study by the Center for Anxiety and Depression focusing on the long-term efficacy of TMS, the number of patients who achieved remission after acute TMS therapy was identical to the number of patients who achieved remission by the last follow-up evaluation after 12 months. 36.2% of individuals underwent reintroduction of TMS after an acute index course of TMS therapy, with an average of 16 booster TMS treatment sessions. The long-term efficacy of TMS was proven in this trial in circumstances that allowed for continued TMS maintenance to treat recurrent depression symptoms.

TMS maintenance’s effectiveness

Every month, clustered TMS maintenance may consist of five TMS sessions spread out over two days. Other TMS maintenance procedures include one weekly session for two weeks, one session every two weeks for two months, and one session per month. All of these methods of TMS maintenance have been demonstrated in studies to be more successful in averting a relapse than undertaking no preventive maintenance at all.

In a randomized pilot study of TMS maintenance in patients with severe depressive disorder, individuals who got TMS maintenance once a month had improved chances of better results. Despite its small sample size, this research found evidence to support TMS as an independent maintenance method without the need for medication.

TMS maintenance

Transcranial magnetic stimulation, unlike electroconvulsive treatment, is typically well-tolerated and is linked with very minor, short-term adverse effects, if any. One peer-reviewed clinical case series compared the effectiveness of TMS maintenance with ECT maintenance in avoiding depressive symptoms return. TMS was shown to be safe and effective when used as a maintenance alternative for ECT to sustain remission from depressive symptoms.

Recommendations for TMS maintenance

According to the Clinical TMS Society's consensus evaluation and treatment guidelines for utilizing TMS as a treatment for major depressive disorder, TMS should be used as a follow-up option in patients who have previously benefitted from an acute treatment course but have relapses of depression symptoms.

Also, when other recognized modalities of ongoing antidepressant treatment, such as medication and psychotherapy, fail to offer a sufficient persistent pattern of clinical response, particularly in patients who have a history of repeated relapse (two or more episodes in one year), maintenance TMS therapy should be explored.