Is TMS better than ECT?
TMS versus ECT for Depression
TMS versus ECT for Depression. TMS is for patients who failed to respond well to depression medication. ECT is an effective, but invasive treatment that is often a last resort.
Scientists and researchers never stop their search for solutions to mental disorders as they increase throughout the United States. The most common mental disorder, even before the 20th century, is depression. Depression is characterized by a feeling of deep sadness. And decrease or increase in appetite, increase or decrease in sleep, low energy, little interest or pleasure in doing things, trouble concentrating, and often thoughts of hurting oneself. It can categorized as mild or severe depression. Severe depression can be treated with two leading therapies we have today, ECT and TMS.
WHAT IS ECT?
Electroconvulsive Therapy (ECT) also known as Electric Shock Therapy, is an invasive treatment for severe or manic depression that uses controlled seizures in the brain to help treat depression. In the 1940s there was a terrible stigma associated with ECT because it was considered a terrifying method of alleviating the symptoms of manic depression, now referred to as bipolar disorder, due to its misuse and inhuman way of administration.
HISTORY OF ECT.
Early 1940s, ECT was administered to treat patients with severe depression and schizophrenia. Two electrodes were applied to the temporal areas of the head. They would fire 120 volts for a few seconds without anesthesia, intravenous (IV) line, oxygen, or muscle relaxants. Adverse effects followed, which included memory loss for a few minutes or even days. Also, broken bones because of tight restraint during seizures. Death occurred if the body could not compensate.
Decades ago ECT was that severe. Today ECT is less invasive because it begins with a full physical examination, blood tests, and an ECG check. Anesthesia & muscle relaxants are provided via the IV line. Oxygen is given to the patient prior to the initiation of ECT. A blood pressure cuff is applied on one of the ankles to impede the flow of the muscle relaxant to the foot, so the doctor can monitor the slight seizures during the procedure. After the treatment, the patient wakes up and memory loss will end within minutes.
Considered one of the most controversial therapies in the history of psychiatry, it is administered 2 to 3 times a week for 3 to 4 weeks. Each session lasts 5 to 10 minutes. Very effective, and very invasive. There is a risk for side effects like memory loss. Researchers and inventors found a treatment for almost all mental disorders in a milder method, TMS.
WHAT IS TMS?
Transcranial Magnetic Stimulation (TMS) is a non-invasive procedure for depression which can be done in an outpatient clinic. FDA approved for depression in 2008, and researched in treatment for other mental health illnesses and neurological disorders. Such as; alzheimer’s disease, Parkinson’s disease, autism, and epilepsy. Recently, TMS has also been FDA approved in the United States for its aid with obsessive-compulsive disorder. Our highly skilled TMS psychiatrist will apply a magnetic field outside of the left-dorsolateral prefrontal cortex, and administer magnetic pulses which help activate neural connections.
WHEN SHOULD YOU RECEIVE EACH TREATMENT?
For severe depression, antidepressant drugs are given to improve symptoms, such as; concentration, appetite, and sleep. If these drugs are unsuccessful, doctors can prescribe an alternative treatment like TMS.
This is considered a next-step treatment for patients who have failed to respond to medication. Contrasted to ECT, which is an effective, but invasive treatment that is often a last resort when a patient’s depression is very severe.
PROS AND CONS OF ECT
We now see a few advantages of ECT because it is not administrated the same way it was 70 years ago. One of which is a long-term partial to complete disappearance of symptoms after several sessions. Some patients do recover from severe depression. Unlike before, the therapy is more certain and accurate. As a result, it has become one of the most effective treatments for depression. During pregnancy it is safer than taking medications. Medications have a higher chance of affecting the development of the fetus.
Magnetic pulses are delivered only to the brain, not the whole body, during TMS. Therefore, the fetus is safe as claimed by most psychiatrists.
Disadvantages of ECT include frequent hospital visits prior to therapy to monitor the brain’s electrical activity. While receiving the treatment, the patient is not conscious as he is under general anesthesia. Rare cases may experience permanent memory loss or disorientation for weeks or months caused by ECT.
ECT AND TMS SAFETY
Safety is a concern with modern ECT because of possible adverse affects such as, permanent memory loss or disorientation. Under general anesthesia during ECT, the brain is at risk for damage or coma.
Thanks to the 21st-century breakthrough, TMS made all impossible possible. No anesthesia is required because it is non-invasive. Treatment lasts between 15 and 37 minutes. Patients settle into a reclining chair, and can watch television or chat during their treatment. Immediately after treatment, patients can drive and return to normal activities.
