Die transkranielle Magnetstimulation (TMS) kann eine kostengünstige Behandlungsoption bei der Behandlung mittelschwerer und schwerer Formen von Depressionen sein, die auf andere Behandlungen nicht angesprochen haben

>Mr Cox said: “Our economic analysis was informed via feedback from TMS experts across six mental health care services, and from the experiences of 442 participants suffering with difficult-to-treat forms of depression enrolled within two clinical trials. The study found that a proportion of patients receiving TMS therapies can expect to achieve faster and more sustained improvements in depressive symptoms compared to usual care, and that these gains represent a cost-effective allocation of scarce NHS resources.
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>“It’s important to recognise that the cost-effectiveness of TMS is dependent specifically on how it is going to be delivered in wider practice. Our study findings demonstrate that services that can achieve a streamlined high throughput model of care can expect to deliver a highly cost-effective treatment. Our findings should provide much needed evidence for policymakers to rationalise and establish cost-effective models for implementing TMS within the NHS.”

[Is it time for mental health services to invest in neurostimulation? An economic evaluation of transcranial magnetic stimulation therapies for the treatment of moderate to severe treatment-resistant depression in the UK | BMJ Mental Health](https://mentalhealth.bmj.com/content/29/1/e302237)

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I have treated over 100 patients as a TMS technician and while some patients did not show improvement in their symptoms, the vast majority, around 70%, saw at least a 50% decrease in symptoms and severity which remained for 9 months or longer.

I have also been treated by TMS, and while the treatment itself is not super comfortable, it was 100% worth it and gave my life back to me.

It is also covered by nearly all insurance payors in the US and is FDA approved as a first line treatment for adolescents when using a specific TMS device. This is not as widely covered by payors yet, as the FDA approval is relatively new, but Optum just announced it will be covered by their plans moving forward.

If you are struggling with treatment resistant depression – speak to a psychiatrist or ask your PCP for a referral! It may not be the right choice for you, but it is absolutely worth looking into.

I was supposed to be in a trial for this that got cancelled due to the Covid stuff,

from what I read in general about it, I’m sort of glad that happened.

I’ve seen this procedure performed in many different cases and I’m becoming increasingly convinced that while the idea behind the technology is most likely viable, we are likely in the infancy of understanding how we can use electromagnetic fields to encourage synapse bond strengthening and I look at TMS like trying to fix a problem that requires a surgical solution by smacking it with a hammer.

It helped my partner with her depression.

She says the spot is still tender two years later. She said it also affected her memory from around that time.

I don’t know if the place I did this at was incompetent, but I saw absolutely no results from it. It didn’t improve any of my symptoms, and I still struggle with depression, suicidal ideation, etc. I’m undergoing Esketamine therapy every week, and that does seem to be helping a little. But I’m still frustrated at the slow speed of progress. It does feel hopeless sometimes, like I will never escape this mental prison.

And they have MeRT now that is basically a customized version of this for each individual. It alters the magnet placement and frequency based on results of scans like a QEEG.

Personal experience as a depressed creative – one session helped immediately with mood. However, I could no longer feel creative. Complete writers block, no mental imagery happening. I felt like along with my depression, my personality was just gone. This lasted for weeks. I have never felt so hollow and robotic.

Anecdotally have read some similar accounts on r/TMS, after my experience.

As someone with other health issues, something that stood out for this session (possibly just a provider issue) was how “med spa” like it felt. A “technician” performs the procedure, not a neuro or doctor.

Just my experience. I’m glad it has worked for many.

I’m currently in rTMS treatment, I’m on my second round. I’ve been through a lot of different meds, none were really helpful. rTMS has greatly reduced my panic attacks, depression, and anxiety. It’s basically feels like tapping on your skull, it’s not painful, and there’s few side effects for most people (YMMV and dependent on your health).

Caveat that this is my clinic and my experience, but here’s the process:
They are 6 week treatments, 5 days a week, 15 minutes a day. Other than scheduling, it’s an extremely easy treatment to do. You go in for an initial appointment for them to make sure you’re a good candidate. You get a cap, they do a bunch of measuring and marking on the cap so they can get the coil in the right place for each treatment. They test to make sure they’re in the right place and the pulse isn’t too strong (everyone has different maximums for the pulse strength).

For the actual treatments, you sit in a chair, they put the cap on, you get into the right position and comfortable, they put the coil on your head (it presses against your head so it feels heavy) and they turn it up to a comfortable level. The nurses have stressed to me, at just about every treatment, that it shouldn’t hurt or be overly uncomfortable. They’ve also stressed that your state of mind is very important during, so they have calming music or guided meditation (or whatever makes you feel calm, it’s your choice) during the treatment. I usually get close to falling asleep during. I’ve had no side effects other than an occasional headache (fixed by being properly hydrated).

ETA: They also warned me that if you’re actively having suicidal thoughts, you should not be getting treatment. It can exacerbate suicidal ideation, because treatment basically intensifies what ever you’re feeling. My medical staff asks before every treatment if you’re having suicidal thoughts. They ask about your state of mind and will stop treatment if they think it’s making anything worse. Due diligence on your practitioner’s part is very important.

Where I live, it’s free treatment, so all I pay is parking at the hospital ($2.50 CAD, so $75 total over 6 weeks).

TMS is, to date, the most effective treatment for moderate to severe depression (along with PTSD, OCD, anxiety…) we have ever seen. It’s bit particularly compelling because you have to go into an office for a few minutes a day for 2 months (although this is changing rapidly as accelerated TMS motions are becoming adopted more often). However, as you can see from the other comments in this thread, there are unfortunately a ton of TMS practices that have absolutely no idea what there doing. If you do TMS, make sure your provider knows what they’re talking about. They should be able to give you a detailed understanding as to what’s going on in the brain and explain how they’ll modify treatment if you respond poorly to the first protocol. If they’re certified by organizations like Solstice Training Institute, you know they are legit.

I don’t need to hear cranial, depression and cost effective in the same sentence.