TMS vs ECT: Which Is Better for Psychiatric Treatment and Why?

Everyone knows the importance of keeping one’s mind busy and stimulated to maintain cognitive function into old age. However, mental illness might make it hard to motivate themselves to do good things. Electroconvulsive treatment (ECT) is often the first thing that comes to mind when people hear about transcranial magnetic stimulation (TMS).

While transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT) involve stimulating the brain, are commonly used to treat treatment-resistant depression and other mood disorders, and are typically covered by insurance, they are not identical. Now you can learn about TMS vs ECT.

The objective of any form of brain stimulation is to make you feel better and increase your happiness and satisfaction with life. Talk to your doctor about the possibility of brain stimulation if you’re experiencing mental health issues.

TMS vs ECT

Define TMS

Transcranial magnetic stimulation is what everyone uses to describe this method. To treat mental health issues like depression, OCD, and others, TMS uses magnetic pulses to activate the brain’s afflicted regions. Patients who undergo TMS often see a marked improvement in their symptoms and, in some cases, complete resolution. Only one-third of those with treatment-resistant depression have complete remission, according to studies.

TMS therapy lasts six weeks, with three weekly sessions in the final two weeks. TMS involves delivering magnetic pulses to activate nerve cells in specific brain regions involved in mood control while the patient wears a helmet over their head. TMS is commonly described by those who have undergone it as feeling like someone is tapping them on the head.

What Are the Side Effects of TMS?  

A minor headache during and immediately after the TMS session is the most prevalent adverse effect. Patients typically see relief from this type of headache during the first few weeks of treatment. In addition, you can feel a minor tingling on your scalp at the stimulation location or have some face twitching while undergoing therapy.

Seizures are a doubtful adverse effect. However, studies suggest this only happens less than 0.1% of the time. Some studies have found no link between the medication and seizures, and the most common side effects are transient headaches and scalp discomfort.

Who Is Eligible for TMS?  

Most health insurance policies will pay for TMS if it is used to treat major depressive disorder (MDD) or obsessive-compulsive disorder (OCD). Additionally, TMS is successfully used off-label to treat:

• ADHD
• Anxiety
• PTSD
• Addiction
• Autism
• Bipolar disorder
• Chronic pain
• Disorders of eating
• Sclerosis multiple (MS)
• Schizophrenia
• Stroke rehabilitation
• Substance abuse

What Is ECT?

In medical terms, this treatment is known as electroconvulsive therapy or ECT. An electric current is passed through electrodes implanted on the patient’s scalp and into the brain, causing a mild seizure. Rapid improvement from depressive and manic episodes is a common side effect of electroconvulsive therapy (ECT).

ECT treatment requires hospitalization, and the patient is sedated throughout the procedure. After ECT treatments, patients should not drive, work, or make significant decisions for two weeks. They may need 24 hours if they are taking maintenance treatment.

What Are the Side Effects of ECT?

Nausea, headache, jaw discomfort, and muscle aches are all possible side effects of ECT, especially in the first few days after treatment. In addition, patients may have confusion that lasts for a few minutes to several hours. Rarely, and most commonly in older people, disorientation might continue for days.  

Memory loss, commonly known as retrograde amnesia, is another possible side effect of ECT. Recalling recent past events might be particularly challenging for patients with memory loss. Memory loss for events within a few years following therapy has seldom been reported. Treatment for memory problems typically results in improvement between a few months to a few years.  

Elevated heart rate and blood pressure are possible side effects of electroconvulsive therapy. In addition, ECT anesthesia carries the risk of sedation-related problems. Complications from anesthesia are rare and only occur in:

• Senior citizens
• Patients undergoing extensive procedures
• People with medical histories including but not limited to sleep apnea, seizures, heart disease, lung disease, diabetes, obesity, and alcoholism
• Patients using anticoagulants
• Heart attacks, pneumonia, strokes, and even death might occur due to complications.
• Potential adverse effects of anesthesia include:
• Disorientation and short-term memory loss
• Dizziness
• Urinary tract infection
• Constant nausea and vomiting
• Cold and shivering

These negative effects, however, usually disappear swiftly.

Who Is Eligible for ECT?

Patients who either cannot take medicine or would rather undergo ECT are not out of therapeutic options. Pregnant women who cannot take medication may also be candidates for ECT.

ECT’s rapid symptom relief makes it a viable alternative for the following as well:  

• When a patient refuses to eat, it might cause malnutrition.
• When other medical conditions preclude the use of antidepressants.
• In the case of a catatonic state
• When psychotic symptoms coexist with depression.
• Patient acts or thoughts of suicide
• When a patient has manic episodes that are quite severe
• In Schizophrenia Therapy

Now you have to know the difference between TMS vs ECT:

How Does TMS Differ From ECT?

1. Although TMS and ECT share certain similarities, their differences are much more pronounced. TMS uses magnetic pulses to stimulate the brain non-invasively, whereas ECT uses electric currents to create seizures. Also quite diverse are the methods used. TMS is conducted in less than 30 minutes at a doctor’s office as an outpatient procedure while the patient is awake. ECT is performed under general anesthesia in a hospital setting and may require overnight hospitalization.
2. In contrast, TMS can seamlessly integrate into a patient’s regular life without requiring major changes. The average session lasts about 30 minutes, and afterward, the patient can go on with their day as usual. ECT patients must schedule a hospital stay and may not be able to return to their everyday routine for two weeks.
3. Finally, TMS has a lower risk of adverse effects than ECT. In contrast to electroconvulsive therapy (ECT), which necessitates general anesthesia, transcranial magnetic stimulation (TMS) can be administered without first seducing the patient.  

Conclusion

You may still benefit from TMS even if you’ve already done ECT. The efficiency of one method does not depend on the other. Discussing your options with your doctor is important, as everyone responds differently to these interventions.

In some cases, one may be preferable to the other for treating serious depression and other treatment-resistant mental health problems. Discuss TMS vs ECT with a qualified psychiatrist before beginning any treatment.