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Question : What is repetitive transcranial magnetic stimulation (rTMS)? Should I consider it to treat my depression?
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The Trusted Source
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Howard LeWine, M.D.

Michael Craig Miller, M.D Michael Craig Miller, M.D., is Senior Editor of Mental Health Publishing at Harvard Health Publications. He is an assistant professor of psychiatry at Harvard Medical School. Dr. Miller is in clinical practice at Beth Israel Deaconess Medical Center, where he has been on staff for more than 25 years.

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June 06, 2013
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Repetitive transcranial magnetic stimulation (rTMS) is a relatively new treatment. It was first approved by the FDA in 2008. Generally, you should only consider it if you haven’t gotten relief from other standard depression treatments.

Patients receive rTMS treatment while sitting in what looks like a dentist’s chair. A technician moves a device that has a magnetic coil directly above one side of the patient’s scalp. The device produces a series of strong magnetic pulses. The pulses are painless.

The magnet creates a weak electrical current. This causes a change in brain activity in the area targeted by the doctor.

You do not need anesthesia to undergo rTMS. Patients are awake. Loud clicking sounds happen as the rTMS device emits its magnetic pulses. People may wear earplugs or earphones during treatment.

The most common side effects are mild to moderate headache or scalp pain on the side closest to the device. Some people experience ringing in the ears from the noise. People do not appear to develop memory problems.

Seizures can happen. But they are quite rare, especially in people without a prior seizure history. Seizures are reported in fewer than 1 patient in 1000.

Sessions are typically 40 minutes, given 5 days a week, for 4 to 6 weeks. It may be necessary to have less frequent maintenance treatment afterward.

Treatment is expensive. The initial course may cost from $6,000 to $10,000. Though it is often not covered by insurance, a center may work with you to make it more affordable.

Experts believe rTMS is most likely to benefit people who have moderate to severe depression that has been relatively resistant to other treatments. It is impossible to predict who will respond only to rTMS (that is, to rTMS alone and no other treatment).

This treatment is still untested relative to other depression treatments. Other obstacles to treatment are its limited availability and expense. But if nothing else has worked for you, rTMS may strike the best balance of cost and benefits.

 

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