TMS vs ECT: Pros and Cons of Both

Apr 18, 2021

We have got to stimulate our brain to stay youthful and sharp they tell us. Read a book, exercise, complete a puzzle, meditation — these are all common things we are told to do to keep our minds healthy.

But, not all of us are quite disciplined and mentally healthy enough to engage in these activities to begin with. Conditions like depression can zap our energy and mental capacity, making it tough to stimulate our brains enough to truly make a difference.

In the medical world, we have been embracing technology to stimulate the brains of people with mental conditions, providing relief from symptoms of depression, fatigue and much more.

The two most prominent methods of brain stimulation today are Electro-convulsive therapy (ECT) and Transcranial Magnetic Stimulation (TMS). They work in entirely different ways but share a similar concept.

In essence, both methods stimulate and heal certain regions of the brain weakened by mental illnesses. However, ECT uses direct electric currents and TMS leverages magnetic frequencies.

In this article, we will cover everything you need to know about TMS vs ECT. So that you can make an educated decision when it comes to choosing which is best for you.

What Is TMS vs ECT?

ECT can be used as a front-line approach in rapid depressions with very aggressive psychotic symptoms. The risks and invasive nature of this treatment require patients to take a break from life affairs. Caregivers, psychotherapy, and hospitalization are all recommended.

ECT is a procedure in which a doctor applies an electric current directly to regions of a patient’s brain. In this process, the specialist will induce a brief therapeutic seizure to increase brain activity. The patient is given muscle relaxers and general anesthesia, making them unaware of the 60 second seizure they experience.

Potential side effects of ECT include:

  • Muscle aches
  • Headaches
  • Nausea
  • Blood pressure
  • Heart rate
  • Transient arrhythmia changes

Although rare, long-term memory deficits can sometimes occur as a complication. Because of this, ECT is rarely considered as the first line of defense against most mental conditions.

On the other hand, TMS has no direct electrical application to the head of the patient. TMS activates regions of the brain by magnetizing neural pathways. Patients find TMS much less physically and mentally exhaustive than ECT. And, the patient does not need to be sedated during TMS therapy. In fact, the patient might be encouraged to read to engage in some other leisurely activity during the procedure.

TMS does have some side effects, but there are few and much rarer than seen in ECT. The most common side effect of TMS is slight tingly discomfort where the magnetic coil is placed. Magnetic stimulation enables individuals to work daily, participate in exercise and psychotherapy as well live independently. 

These regular affairs are very difficult to pursue with ECT. Many individuals find that ECT by its very nature is a bit overwhelming for their levels of depression or other conditions.

The Pros & Cons Of TMS

Pros of TMS include:

  • Completely non-invasive therapy
  • Well-tolerated and safe for most people
  • Non-sedative procedure
  • Non-drug therapy, free of pharmaceutical side effects
  • FDA cleared for Depression and OCD
  • Serious side effects are extremely rare
  • Long-lasting results
  • Can work alongside medication and therapy

Cons of TMS include:

  • Works best when supplemented with therapy
  • Getting insurance to cover TMS can be challenging at times
  • Treatment requires 3 to 5 sessions a week for an average of 6 weeks
  • Discomfort, though widely perceived as tolerable

Who Can Be Treated?

TMS has benefits in a variety of cases for various people. Through the ability to alleviate mental health condition symptoms, it’s a very attractive treatment option. 

TMS is proven efficient in individuals who started battling a mental health condition recently. But also patients who have treatment-resistant conditions. It can also be useful for patients who are undergoing other forms of treatment, such as medication or psychotherapy.

TMS is an effective and safe choice for individuals who cannot bear the side effects of other treatments, such as ECT. However, another important factor in TMS treatment is age. Adults and children can go through regular TMS, whereas deep TMS is specific to patients older than 18.

Even though TMS is a gentle treatment form, deep TMS should not be advanced to patients who suffer from the following conditions:

  • Metal in cranium
  • Psychotic symptoms
  • Suicidal ideation
  • Nursing
  • Pregnant
  • Substance abuse
  • Neurological conditions 

This is not an inclusive list, so you should communicate with a medical specialist before considering any type of stimulating treatment for the brain.

The Pros & Cons Of ECT

The efficacy of ECT is well-established, especially in the treatment of depression. In fact, ECT is considered one, if not the most effective treatment for this condition.

However, ECT does have several disadvantages. First and foremost, the treatment requires sedation, making recovery complex and much longer. Second, ECT has a higher chance to cause serious side effects for some individuals, including memory loss, which can deter potential patients.

Pros of ECT:

  • Safer today than previous ECT treatments
  • No medication side effects
  • Works slightly quicker than TMS

Cons of ECT:

  • May not be able to return to work or drive for up to 2 weeks after treatment
  • Treatment sessions are done 2 to 3 times a week for up to 4 weeks
  • Requires sedation through anesthesia and muscle relaxers
  • Confusion post-treatment
  • Typically not well tolerated in the elderly population
  • Memory loss (retrograde amnesia) which usually improves within a couple months of the procedure
  • Physical side effects related to tension (nausea, headache, jaw aches, and muscle aches
  • Not tolerated well in people with heart problems

Who Can Be Treated?

Because of the true level of efficiency that ECT possesses for treating depression, it is often advised for individuals with severe depression or those with severe mania.

Due to its significant level of efficacy in treating depressive symptoms, ECT is often recommended in cases of severe depression. ECT is also used in treatment-resistance conditions, where first-line treatments like psychodynamic therapy or selective serotonin reuptake inhibitors are ineffective in alleviating the conditions.

TMS for You

Now that you understand the differences between TMS vs ECT, you may have an idea of what’s best for you. In most cases, people seem to gravitate towards TMS as it has advantages of ECT in a number of ways. But this isn’t always the case.

Interested in TMS? Our staff can give you more information on your specific condition to see if it is the right option for you.

Call us for a free consultation and we will happily walk you through every step of our assessments and procedures.

Considering TMS Treatment? Schedule a Consultation!

Tired of the results you’re getting from your standard treatment? Transcranial Magnetic Stimulation may be able to increase your chances of long-term remission, reducing your symptoms and allowing you to live a more joyful life.

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