There’s no doubt that antidepressants can be a lifesaving treatment. When the right one is found to work, the patient can experience a relief or remission of the symptoms of depression but for many, the road to a life free of depression is a long and difficult one with many turns along the way. What works miracles for one person may do nothing but cause painful side effects for another. Fortunately, there may be another way. TMS (Transcranial Magnetic Stimulation) is an alternative to a life on medication which uses magnetic fields to stimulate the area of the brain associated with depression.

The Differences

Systemic v. Extrinsic

Antidepressants are systemic which means they are taken in through the bloodstream and they affect the whole body. The brain may be receiving the help it needs but the chemicals are reacting with every cell in the body. People who have depression have problems with neurotransmitters that release serotonin, norepinephrine, and dopamine. Antidepressants change how the neurotransmitters work so the messages in your brain can get through easier and these chemicals can be delivered. Neurotransmitters serve other functions as well, so changing how they work produces side effects.

While TMS is not free of side effects, they are generally mild because it affects the targeted area of treatment making it extrinsic. Only the natural function of the brain’s neurotransmitters is activated using a magnetic field.

The Side Effects

Side effects can be a real problem with antidepressants. Their side effects may include:

  • Headaches
  • Nausea
  • Drowsiness
  • Sleeplessness
  • Reduced sex drive
  • Weight gain
  • Dry mouth

Some side effects may only last for a few days or weeks but for others, these side effects can be long-lasting and severe. Even if the drugs work well for you, there’s concern with the long-term effect of antidepressant use as some studies suggest a link between long-term antidepressant use and weight gain and Type 2 Diabetes.

Because it usually takes weeks to determine whether or not a drug is working, a patient may have to go through 3 or 4 medications before finding one that works and doesn’t have intolerable side effects.

Side effects for TMS are localized to the treatment area which includes the head and neck. There may be discomfort around the area during the treatment and there can be neck pain and headaches. In rare cases, seizures can happen which is why the treatment is not recommended for anyone who has a history of seizures.

Effectiveness

Antidepressants are not one-size-fits-all. Some medications have an overall better rate of success and others vary in success from one individual to the next and some patients need to take a combination of several at one time to achieve effectiveness. About half of the people using them find relief.

It’s also common for antidepressants to lose their efficacy after a while, sometimes without the patient even knowing that it’s happening. Someone taking antidepressants can expect to need an adjustment of dosage or maybe even to need to find a different medication somewhere down the road.

TMS shows a higher rate of success. A 2014 study of 257 patients found that after a full year, 67.7% had a response to the treatment and 45.1% had reached remission and there’s also a key difference between TMS and antidepressants. With TMS, there’s no lengthy trial period to see if it works as there typically is with medications which means that you’ll know by the time the 4-6 week treatment is done if TMS works for you. You won’t need to endure long-lasting side effects.

TMS is not a permanent treatment but the effects of the initial treatment could last up to a year. When its relief begins to lessen, follow up treatments are necessary.

Response
36%
Antidepressants
67%
TMS
Remission
17%
Antidepressants
45%
TMS
Withdrawal

People coming off of antidepressants can experience difficult symptoms of withdrawal, just like with any other drug. Antidepressants need to be taken regularly, every day, and stopping not only stops the treatment, but it can be dangerous to stop taking them without the supervision of a doctor.
With TMS, there is no withdrawal when your treatment is over. The treatment consists of a 20-40 minute session, 5 times a week for 4–6 weeks. There’s no downtime after individual sessions or when the entire treatment is over.

Working Together

People who suffer from depression don’t want to feel that way. They want to get back to normal and get their lives back on track. They just can’t do it alone. They need a little help. That help is typically in the form of psychotherapy and antidepressants but that isn’t always enough.

This is where TMS can help: it works where medications have failed.

Doctors prescribe antidepressants first, in hopes that one will be found that will work with minimal side effects and when those fail, they can prescribe TMS which often works quickly to relieve symptoms of depression. TMS is typically used alone but some patients have found success with both therapies simultaneously. As always, it’s vital to work closely with your physician to determine what’s best.