We live in an age of seemingly infinite information. If you suffer from depression you might question which treatment will work best for you. As depression rates continue to soar, many are oscillating between different forms of treatments (including both TMS and antidepressants). One size does not in fact fit all when it comes to depression. Or any other mental health condition for that matter. Our goal is to give you insights on TMS vs Antidepressants. So, let’s discuss the different types of antidepressants and how they function, the side effects of both TMS and medications, and the successes and effectiveness of each.
TMS vs Antidepressants
Psychopharmacology has been a preferred method in treating depression for quite some time. The antidepressant families are made up of SSRIs (selective serotonin reuptake inhibitors), SNRIs (serotonin-norepinephrine reuptake inhibitors), and TCAs (tricyclic antidepressants). SSRIs have been available since around the mid-80s. They prevent the reabsorption of serotonin into the synaptic cleft. SNRIs, on the other hand, have been around since the mid-90s. These work by keeping both norepinephrine and serotonin active for longer periods of time. And finally, TCAs have been around since the late 50s. TCAs work to block norepinephrine reabsorption and are typically prescribed less frequently due to intolerability.
Transcranial magnetic stimulation operates by regulating brain activity with electromagnetic pulses. Traditional TMS treatment has been available since 1985 and Deep TMS was FDA approved in 2013. Deep TMS differs slightly in that it uses a cushioned helmet instead of a handheld device. This makes for deeper and wider penetration with each magnetic pulse.
Comparing Side Effects
While both treatments offer significant relief for patients, they also each come with different side effects. SSRIs generally come with weight gain, sexual dysfunction, and sleep disturbances. However, these typically tend to subside after the patient gets adjusted during those initial few weeks. On the other hand, SNRI side effects are usually less severe. The more common effects include nausea, dry mouth, and headaches. And finally, as mentioned earlier, TCAs tend to be harsher. Blurry vision, dizziness, and a higher risk for cardiovascular disease are rank as the more prevalent side effects.
Deep TMS and TMS side effects are mild and vary to a certain degree. TMS side effects may include headaches, scalp discomfort, and lightheadedness. The advantage is that these typically only last for a short period after treatment. A short-lived, localized headache is most common in dTMS. Clinically, they have come to the conclusion that neither causes any harmful long term side effects.
Successes of Both
While medication has long been considered the first line of defense when treating depression, studies are proving that its efficacy may increase when combined with TMS. But first, let’s breakdown the individual successes of each treatment.
A 2006 SSRI study concluded that a third of the participants reached remission. Even better, approximately 44% of patients are finding remission with SNRIs. Finally, TCAs sit at about a 49% remission rate, making them the most effective. However, the adverse and severe side effects tend to play a role in how long patients can tolerate them.
Patients are finding long-term symptom relief with TMS across the board. Deep TMS is particularly showing incredible success. A 2015 study found that a third of patients who were treatment-resistant achieved remission after four weeks of dTMS during the acute phase. 80% of patients who did not respond immediately experienced symptom relief during the continuation phase. Furthermore, when dTMS and antidepressant medications were combined, a higher remission rate was attained.
Which option is best?
In short, there really is no universal answer to which treatment option is best when it comes to treatments for depression. This is entirely dependent on each individual. Both antidepressants and TMS come with their own specific advantages and their own side effects. While therapy and medication have and will most likely continue to be a “first-line” treatment (meaning the initial go-to), TMS is proving to be a wonderful addition in achieving long term remission. TMS may also be incredibly beneficial as a stand-alone option for many. With its non-invasive approach, a shortlist of side effects, and proven effectiveness, it has an appeal to those dissatisfied with standard treatment. In order to determine the most valuable option, it is always best to get advice from a mental health professional. Hope is always just around the corner.
TMS Institute of Great Plains Mental Health
Paula Whittle, PMHNP, and Dr. James Sorrell believe that mental health should be considered as a primary driver for one’s overall wellbeing, both physically and mentally. At TMS Institute of GPMH, we want to make sure your connection to the world you live in is addressed – to change the order to … SPIRIT, MIND, and BODY. As a result, we believe when people are treated in this order they feel better, more at peace, and much stronger to face life’s challenges. Transcranial magnetic stimulation (TMS therapy), the most advanced form of depression treatment, offers us the ability to enhance our patient outcomes following our philosophy of a holistic approach to treating mental health conditions. Contact us today to schedule a consultation or to receive more information about TMS vs Antidepressants.