How does TMS treatment work?
TMS treatment stimulates directly magnetically and indirectly electronically. The pulses only reach 2 to a maximum of 5 centimeters into the brain. But they activate nerve cells, which then better connect other networks – for example, in the crucial regions of the cognitive control networks responsible for thinking and recognizing, remembering, and problem solving. The orbitofrontal brain region (which plays a central role in evaluations and decisions), the amygdala (responsible for processing emotions), and the hippocampus (essential for memory and learning) are also activated. This improves cognitive control. Dysphoria (dissatisfaction, negativity, irritability) and rumination are reduced. Emotional numbness and loss of energy are eliminated. Anxiety symptoms are minimized.
TMS is a scientifically based and professionally recognized method of non-invasive neurostimulation. Its effectiveness has been sufficiently proven in neurological and psychiatric disorders such as depression, anxiety, and obsessive-compulsive disorders.
Who is eligible for this treatment?
The treatment is aimed at people with depressive disorders who have not achieved sufficient improvement by taking antidepressants and/or do not want (or no longer want) psychopharmacological treatment. It can also be very helpful for people with anxiety or obsessive-compulsive disorders.
TMS therapy has been studied in numerous clinical trials and has been described as effective, especially when taken in combination with antidepressants. Taking other psychotropic drugs does not preclude treatment. However, delayed effects have been reported after 4-6 weeks when taken concomitantly with antipsychotics. TMS can be used as an adjunctive treatment for depression when sufficient improvement in depressive symptoms has not been achieved with medication and/or psychotherapy alone.
Indications such as compulsive behaviors, eating disorders, and a number of others are also possible and helpful. Further research is needed on the effect of therapy on post-traumatic disorders.
What are the reasons for exclusion from the therapy?
- Recent CNS infarcts
- Pacemakers
- Epilepsy
- Deep brain stimulation electrodes
- History of brain surgery
- Brain tumor in the DLPFC
- Traumatic brain injury with loss of consciousness less than 3 months ago
- Brain hemorrhage or stroke less than 3 months ago
- Intracranial implants (e.g., clips, cochlear implants, or a metal plate on the DLPFC)
- Alcohol and/or drug addiction
- Drug abuse
- Taking more than 3mg of lorazepam per day
- Taking more than 25mg of diazepam per day
- Lack of capacity to give consent
- Dementia
- Acute suicidal tendencies
- A borderline personality disorder diagnosis
- Pregnancy
* Dental implants do not pose a problem for the therapy.
How long does the therapy take?
An effective treatment plan consists of 30 TMS treatment sessions, three times a day (Monday to Thursday) for 10 minutes each. There is a break of approximately 45 minutes between sessions. The total treatment period is three weeks. An additional 45 minutes should be allowed for the first session, which requires preliminary measurements.
How much does the treatment cost?
A total of €3,000, which must generally be paid privately. However, Unica private insurance, for example, covers the costs. Please check with your health insurance provider in advance. We offer a limited number of appointments for people who cannot afford the therapy. We will be happy to provide you with more detailed information upon request.
What side effects can occur with TMS treatment?
An additional advantage of this form of therapy is that it has few side effects. Mild headaches are possible, but only up to about the fifth session—after that, TMS treatment has a pain-relieving effect. Neck tension or mild dizziness may occur.
How effective is the therapy likely to be?
The effectiveness of TMS has been proven many times in several clinical, placebo-controlled studies for people with depression. This also applies to patients who have not achieved significant improvement with previous treatment methods. For this group, 30-60 percent experience a significant improvement or complete remission of symptoms.
When combined with psychotherapy, the positive effects are usually more pronounced. The therapeutic effect of the treatment occurs relatively quickly, with improvements visible after just 2-4 weeks. After 4-6 weeks, the treatment can be completed or continued in the form of individually tailored maintenance therapy.
* If four or more other therapeutic approaches have already been attempted to treat the current episode of depression, the response will be correspondingly lower.
What happens if one’s depression recurs?
TMS does not guarantee that a patient will never suffer a relapse. But the good news is: if it worked once, it will work again.