So, we decided to write this TMS VS ECT post below.
Over the last decade or so, we have seen the incidence of depression climb exponentially, now the most common mental illness on the planet.
According to the ADAA, 18% of the adult population in the U.S.A. have depression.
With this increase, we have seen an abundance of research looking into new ways that we can help treat depression.
That’s exactly where TMS and ECT enter the discussion.
Dig into these topics below:
– What is ECT?
– What is TMS?
– What are the differences and similarities?
– How effective is ECT vs TMS for depression?
– ECT & TMS treatment duration and frequency
– Cost of ECT and TMS
– Side effects of ECT vs TMS
– Pros & Cons of ECT vs TMS
– Getting help with your depression
What is ECT and What is TMS?
So is TMS, ECT???
No, Transcranial magnetic stimulation (TMS) and Electroconvulsive therapy (ECT) are 2 different depression treatments.
Both are proven to have very positive effects on your mental health.
Over the last few years, they have become increasingly popular in healthcare circles because of their effectiveness.
But what are they? And is one better than the other?
What is ECT?
ECT, or Electroconvulsive therapy, is a very unique procedure.
It has traditionally been used to treat severe psychiatric disorders, such as schizophrenia and psychosis.
However, over the last decade, it has been used more and more often to help cases of depression where traditional treatments have failed.
What to know about ECT:
- Typically performed in an operating room
- Performed under general anesthesia
- Stimulates your brain with electricity, lasts around 5 seconds
- The shock induces a small seizure, lasts about 1 minute
It is important to note that as this seizure is very mild, it will not result in any real muscle movement.
This seizure is thought to almost reset the brain, returning its function to normal in the process.
While immediately after the session (which will last a total of 30 minutes) you might find yourself feeling groggy, ECT has been shown to cause lasting improvements in mood and mental state – which is why it is thought to have some serious benefits for depression.
What is TMS?
TMS, or Transcranial magnetic stimulation, is a pretty futuristic treatment for depression.
It uses magnetic fields to stimulate your brain.
Like I said – futuristic.
The results of TMS are impressive. 68% experienced improvement in their depression, 45% achieved complete remission.
What to know about TMS:
- Typically performed in a doctors office
- Fully awake and aware
- MRI strength electromagnetic pulses (not electric shocks like ECT)
- Pulses feel like a light tapping
- 1 session lasts 18 minutes
Once you’re done your session you’re free to go about your day without feeling residual effects.
During a typical TMS session, a small electromagnetic pad is placed on your head. When turned on, this pad sends MRI strength magnetic pulses into the areas of the brain which cause depression symptoms, activating very important nerve cells.
When the electromagnetic pad is placed in the right spot (just above your forehead), it will start to stimulate the key areas of your brain that are responsible for controlling your emotions and your mood.
This entire process essentially increases the neural activity in your brain, leading to lasting improvements in both your mood and your wellbeing.
4 Main Differences and Similarities?
So, as I have already alluded to, there are some pretty large differences between TMS and ECT.
ECT uses electrical currents to cause the brain to seize, which acts in a similar manner to a reset button.
TMS uses low-intensity magnetic pulses to stimulate the nerve cells of the brain which facilitates growth and healing.
ECT must be completed in an operating room, as it requires the use of a general anesthetic.
TMS is a much simpler procedure. This means that it can be performed in a doctor’s office without the need for any additional equipment.
3) Level of Discomfort
ECT requires you to be out cold. Depending on how much you like spending time at the doctors, this could be viewed as a positive or a negative.
TMS is much gentler, you can be awake during the treatment. You might experience a little discomfort in the region where the magnet is working.
Despite these obvious differences, both treatments do have some similar effects on your brain.
Both TMS and ECT increase the activity of very important cells found within your brain, which leads to their growth and development. They also increase the production of the key brain chemicals that control your mood and wellbeing.
Subsequently, they can both have a positive impact on your mental health – which leads us to our next point quite nicely.
How Effective is ECT vs TMS for Depression
I guess comparing the 2 treatments is what many people would consider being the crux of the discussion.
I mean, do they both work, and does one work better than the other?
First and foremost, both treatments have been shown to be very effective at helping cure depression.
In fact, diving into this in a little more detail, both TMS and ECT have been used successfully to help with treatment-resistant depression – which is a specific type of depression that hasn’t responded to traditional medications (hence the name, being treatment-resistant).
However, this does not necessarily mean that they are created equal.
There is evidence to suggest that of the 2 treatments, ECT has better outcomes. This means that it is generally more effective, causes longer-lasting improvements in mood, and may even result in larger improvements in mental health.
ECT success rate is 75-83% for treating depression.
TMS success rate is at 68% for treating depression.
But there is also a little bit more to this story.
ECT vs TMS – Treatment Duration and Frequency
Before we get into the cost of the two treatments, I wanted to go into a little more detail about what treatment entails.
I have already outlined what a single session looks like, but what about an actual treatment plan?
ECT Duration & Frequency
ECT is normally given 2-3 times per week, for a total commitment of around 10 to 12 sessions being considered normal.
This means that treatment can last up to 6 weeks in total duration.
Because of all that is involved, a single session of ECT can take up to 60 minutes.
TMS Duration & Frequency
When it comes to TMS, most people tend to undertake a 6-week treatment plan, which includes a total of 20 – 30 single sessions of the treatment.
This means that over the 6 weeks, you could have up to 5 sessions per week.
It is also important to note that a single session of TMS will take about 20 – 30 minutes.
Cost of ECT vs TMS
Now this is where things start getting a little interesting.
While ECT is slightly more effective than TMS, most choose TMS because it’s less expensive and far less invasive.
TMS consistently appears to be about half of the cost of ECT. although costs can certainly vary between states, and even between clinics,
Cost of ECT
It is not uncommon for treatment of ECT, lasting roughly 6 weeks, to cost over $12,000 thousand dollars.
As important as this is, try and remember that there is a reason for this.
ECT requires a surgical theatre, a nurse, and a general anesthetic. The equipment is also typically more expensive, which obviously adds to the cost.
Cost of TMS
A typical 6-week bout of TMS (which can be up to 30 sessions) can cost anywhere between $8,000 and $12,000 with the Neurostar system.
Most clinics offer payment plans through financing if needed.
TMS is covered by health insurance and Medicare in most states.
Side effects of ECT vs TMS
As I am sure you can imagine, when applying these sorts of treatments directly to your brain, there can be potential side effects.
These are markedly different between the 2 treatments and vary in severity greatly.
Side Effects of ECT
Side effects occurring with a treatment of ECT tend to be much more common, and also much worse.
Some of these occur as a result of the general anesthetic, while others appear to be a result of the seizure itself.
Common side effects of ECT include:
1) Feeling confused after the treatment (which can last several hours after the treatment)
2) Short term memory loss, that can cause you to forget events that have occurred in the months leading up to the treatment
3) Feeling ill and nauseous after the treatment
5) Jaw aches
6) Muscle aches
It is also important to note that ECT places quite a bit of stress on the cardiovascular system. This can cause changes in blood pressure, meaning that it may not be the best treatment for people with any type of diagnosed heart disease.
Rare side effects of ECT include:
1) adverse reactions to anesthesia
2) increase blood pressure
3) hyper and hypotension
4) changes in heart rhythm
5) ongoing, lifelong heart issues
6) produce seizures that last longer than expected
Yes, you can die from ECT treatment. 1 in 50,000 dies.
Side Effects of TMS
For the most part, TMS treatments are a breeze when compared to ECT.
This is because TMS uses magnetic impulses rather than electrical currents, and acts to stimulate the brain, rather than induce a seizure.
Common side effects of TMS include:
1) The onset of a mild headache
2) Skin discomfort where the electromagnetic pad has been placed
3) Tingling, spasms, or even twitching of the muscles in your face
4) Feeling light-headed or dizzy
I should also note that these side effects during the treatment tend to disappear after a couple of sessions.
Now, with these minor side effects, some people have also experienced rare side effects. While rare, these do occur in a very small percentage of the people who receive treatment and therefore do need to be considered.
Rare side effects include:
1) The onset of seizures
2) Mania (typically in people with a diagnosed bipolar disorder)
3) Hearing loss (only if there is inadequate ear protection during treatment)
Pros and Cons of TMS vs ECT
Taking all the above into consideration, we can summarise the pros and cons of both treatments quite simply.
TMS is more affordable (covered by most insurance and Medicare), and elicits fewer side effects than ECT. It has also been proven to be an effective treatment for depression.
However, it appears to be less effective than ECT and requires more sessions.
Alternatively, ECT is typically more effective than TMS and can be completed in a much smaller number of sessions (10 vs 30).
However, ECT is more expensive, causes more side effects, and requires the use of a general anesthetic – meaning that it may not be suitable for everyone.
Also, you cannot drive at all during the treatment course of ECT. Someone has to drive you to and from all treatments and sometimes it is recommended not to drive in between treatments bc the seizure and anesthesia can affect coordination and response time. So you’re losing independence and relying on someone else for transportation.
Take Home Message
TMS and ECT are two of the most interesting depression treatments on the planet right now.
Sounding like something out of a science fiction movie, they both impact the brain at a cellular level, causing lasting changes in your mental state – which acts as a catalyst for treating depression.
However, they are not without their differences (which is why we wrote this article in the first place!).
Get Help Today
Need help with your depression? TMS can help you.
Have you ever tried either of these treatments? Are you thinking of trying ECT or TMS?
We would love to hear your thoughts – drop us a comment below.