Many people in society today struggle with depression, or as we all know it, a mental condition called `Depression`. Some people find relief when they take the medicine prescribed by the doctor or go to counseling. However, some people do not feel a significant difference or improvement no matter what they do. If you are one of them, do not give up hope. Today we are talking about a special treatment method that can help those who do not get relief from normal treatment methods. This is called rTMS .
How does this rTMS treatment work?
Simply put, rTMS is a painless treatment that uses magnetic pulses to reduce your symptoms of depression. It doesn't require a hospital stay or anesthesia.
Imagine you are having an MRI scan. The strength of the magnetic field used in this treatment is the same as that of an MRI scan. These magnetic waves stimulate the nerve cells in the parts of your brain that control your mood. It's like talking to a part of your brain that has gone a little sleepy and waking it up again. When those cells are reactivated, the symptoms of depression gradually begin to subside.
What happens during an rTMS treatment?
This treatment usually lasts about four to six weeks. You will have to go to the doctor's office or clinic about five days a week.
Before the treatment begins, you will need to remove anything that may be sensitive to magnets, such as metal jewelry and credit cards. During the treatment, the machine will make a loud "click" "click" sound, so you will be given earplugs to protect your ears.
You will be seated in a comfortable chair throughout the treatment session.
What happens on the first day?
The first session alone takes about an hour. During this time, the doctor or technician will take some measurements of your head to determine the best place to place the electromagnetic coil that emits the magnetic pulses. The coil is then placed against your head.
Next, to find the right dose of treatment, that is, the amount of magnetic energy, for you, the doctor will first target your brain's motor cortex. This is the part that controls our muscle movement. He will deliver several magnetic pulses until you feel a slight twitch in your hand or fingers. This is called your motor threshold . It's like tuning a radio to the right channel.
After this test, the doctor moves the coil a little further and targets another part of the brain. That is the area called the `dorsolateral prefrontal cortex`. This is the area that has been found to be directly related to depression. But these measurements and tests to find the range of motion are not done every day, only on the first day.
How does this feel?
The treatment lasts about 30 to 40 minutes. During this time, you will feel a gentle tapping sensation under the skin of your head, where the coil is. You will also hear a loud "click" sound, similar to that of an MRI scan. This is the sound made when the magnetic coil turns on and off and emits pulses.
Are there any side effects of rTMS treatment?
Most people do not experience any major side effects from rTMS. However, some people may experience some minor and temporary side effects. These usually gradually decrease as the treatment continues.
The most important thing is to tell your doctor right away if you feel any discomfort. He or she can adjust the position of the coil or the strength of the magnet to provide you with relief.
| Side Effect | Description & Management |
|---|---|
| Headache | About 50% of people may experience headaches during or after the first few sessions. These are usually minor, and painkillers can be taken as directed by your doctor. These headaches will gradually subside as the treatment continues. |
| Facial discomfort | Rarely, some people may experience a tingling or numbness in their facial muscles. Others report pain in their skull and under their jaw. These also disappear as treatment continues. |
| Lightheadedness | Some people may feel faint during or after treatment. This usually subsides quickly and decreases as the number of sessions increases. |
What are the risks of this treatment?
rTMS is considered a very safe and effective treatment, with a very low risk of serious side effects. However, there are some risks to be aware of.
| Risk | Important Points |
|---|---|
| Hearing problems | Even if earplugs are worn, a small number of people may experience temporary hearing loss after treatment. However, if earplugs are not worn, there is a risk of long-term hearing loss. Therefore, wearing earplugs is mandatory . |
| Exacerbation of bipolar disorder symptoms | It has been reported that rTMS treatment can induce a manic episode in someone who already has bipolar disorder. This is characterized by hyperactivity, risky behavior, rapid thinking, and decreased sleep and appetite. |
| Seizures | This is a very rare occurrence. However, if you have epilepsy or a history of seizures , you should definitely tell your doctor . If you have such a risk, your doctor may not recommend rTMS. |
Who is suitable for rTMS treatment and who is not?
If you have depression, your doctor will first try things like antidepressants and talk therapy. Many people find relief from these treatments.
But some people don't get any relief from these treatments. We call this condition treatment-resistant depression . That's why rTMS therapy is mainly used to help such people.
However, some people cannot undergo this treatment because they have metal parts in their head that cannot be removed. Braces and fillings are not a problem. However, if you have any of the following conditions, rTMS treatment may not be suitable:
| rTMS treatment is not suitable for you if you have any of these: |
|---|
| - Aneurysm clips or coils |
| - Stents in your neck or brain |
| - Deep brain stimulators |
| - Electrodes |
| - Bullet fragments in the head or neck area |
| - Tattoos with metallic ink on the scalp or face |
How successful is rTMS treatment?
In studies of people with treatment-resistant depression, rTMS treatment has been shown to be beneficial in 50% to 60% of cases . Of these, about 30% have achieved full remission, meaning that symptoms have completely disappeared.
Like many treatments for depression, the effects of rTMS are not permanent. Symptoms can recur after about a year, usually at which point some people choose to have another course of rTMS.
Take-Home Message
- rTMS is a safe, non-surgical treatment for depression, especially for those who have not responded to other treatments.
- This does not use anesthesia or surgery, but magnetic pulses.
- Side effects are usually minor, like headaches, and are temporary.
- This is not suitable for everyone, especially those with metal parts in the head area.
- Always discuss this treatment with your doctor to determine if it is right for you.
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