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TMS Therapy vs. Medications

Nancy MacGregor MA, ATR-BC, LPC, ACS, Clinical Director

What is TMS Therapy?

Transcranial magnetic stimulation (TMS) is a safe and effective non-invasive treatment to treat depression. With TMS therapy, magnetic fields stimulate the brain’s nerve cells via repetitive magnetic pulses. It can be used when medications just aren’t enough or can be used in combination with antidepressants. A TMS treatment program consists of a series of sessions between 10-20 minutes, 5 days per week for 6 weeks.

What are antidepressant medications?

Antidepressants are medications prescribed by a healthcare professional to relieve symptoms of depression and anxiety disorders. They are intended to correct chemical imbalances of neurotransmitters in the brain that control changes in behavior and mood. There are five main types of antidepressants: serotonin and noradrenaline reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), and noradrenaline and specific serotonergic antidepressants (NASSAs).

Side effects of antidepressants vs side effects of TMS therapy

Antidepressants come with a range of potential side effects including nausea, increased appetite and weight gain, dry mouth, insomnia, fatigue, drowsiness, loss of sexual desire, constipation, blurred vision, dizziness, agitation, irritability, and anxiety. Some side effects will be mild and will go away after a week or two. If you are still experiencing side effects after two weeks, you should consult with your doctor. It’s worth noting that decreased sexual desire may last longer than the two-week period. Not everyone will react to antidepressants the same way as some people may not experience any side effects while other people may experience a few or more. Either way, it’s important to keep track of any changes you notice.

TMS therapy is considered to be a safe and effective alternative to antidepressants, however, it still may come with some side effects. Mild to moderate side effects may include headache, lightheadedness, scalp discomfort, and tingling, spasms, or twitching of facial muscles. These symptoms typically do not last very long after a TMS session. If you experience any side effects, you should inform your doctor and they will be able to adjust the levels of stimulation to reduce symptoms or recommend over-the-counter pain medication.

Selective serotonin reuptake inhibitors (SSRIs) – Prozac, Zoloft, Lexapro, Celexa

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants to treat moderate to severe depression as well as anxiety disorders. They are referred to as selective because they mainly affect serotonin, which is a neurotransmitter, or chemical messenger, that carries signals between brain nerve cells. SSRIs increase levels of serotonin in the brain and also block the reabsorption, or reuptake, of serotonin into the brain nerve cells.

Examples of SSRIs approved by the Food and Drug Administration (FDA):

  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac)
  • Sertraline (Zoloft)

It is important to consult with a doctor before stopping use of SSRIs because while they are not addictive, you may experience withdrawal symptoms if stopped abruptly.

Serotonin and norepinephrine reuptake inhibitors (SNRIs) – Cymbalta, Effexor, Pristiq

Serotonin and norepinephrine reuptake inhibitors (SNRIs) can be used to treat depression, anxiety disorders, and chronic nerve pain. They affect the neurotransmitters that communicate between brain cells by changing the brain chemistry in brain nerve cells that are in charge of regulating mood. They also block the reuptake of serotonin and norepinephrine, another neurotransmitter in the brain.

Examples of SNRIs approved by the Food and Drug Administration (FDA):

  • Duloxetine (Cymbalta)
  • Venlafaxine (Effexor XR)
  • Desvenlafaxine (Pristiq)

It is important to consult with a doctor before stopping the use of SNRIs because while they are not addictive, you may experience withdrawal symptoms if stopped abruptly.

Atypical antidepressants – Wellbutrin, Trazodone, Remeron

Atypical antidepressants work similarly to other antidepressants in that they affect neurotransmitters and change brain chemistry and communication in brain cell nerves that regulate mood and relieve depression. However, these types of medications change one or more neurotransmitters, such as serotonin, norepinephrine, or dopamine.

Examples of atypical antidepressants approved by the Food and Drug Administration (FDA):

  • Bupropion (Wellbutrin SR, Wellbutrin XL, others)
  • Mirtazapine (Remeron)
  • Trazodone

Consult with your doctor to determine if this is the best type of antidepressant medication for you.

Tricyclic antidepressants – Tofranil, Norpramin

Tricyclic antidepressants, also known as cyclic antidepressants, were one of the first antidepressants developed and are still effective today in relieving depression symptoms. This type of medication affects neurotransmitters and blocks the reuptake of serotonin and norepinephrine, which increases the levels of the two in the brain.

Examples of atypical antidepressants approved by the Food and Drug Administration (FDA):

  • Desipramine (Norpramin)
  • Imipramine (Tofranil)

Tricyclic antidepressants can also be used to treat anxiety disorders, obsessive-compulsive disorder, and some nerve-related pain.

Monoamine oxidase inhibitors (MAOIs) – Marplan, Parnate, Nardil

Monoamine oxidase inhibitors (MAOIs) were the first antidepressants developed to treat depression. While they are effective, they are typically overlooked due to newer medications that provide relief with fewer side effects. They work by preventing an enzyme called monoamine oxidase from removing serotonin and dopamine from the brain.

Examples of MAOIs approved by the Food and Drug Administration (FDA):

  • Isocarboxazid (Marplan)
  • Phenelzine (Nardil)
  • Tranylcypromine (Parnate)

MAOIs can still be a good option for some people depending on their level of depression and other medications they are taking. Consult with your doctor as there are certain foods and beverages that MAOIs cannot interact with.

Effectiveness of TMS vs effectiveness of antidepressant medications

According to Harvard Medical School, 50% to 60% of people with depression who have tried and failed to benefit from antidepressant medications experience a positive response with TMS therapy.

Antidepressants can help individuals with moderate, severe, and chronic depression. However, the exact level of effectiveness is up for debate. Everyone’s body responds to different antidepressant medications differently. Sometimes it can take trying two or more medications to find the right one. For those that haven’t had luck with antidepressants, TMS therapy can replace medications or be added to a depression treatment plan along with psychotherapy.

Benefits of combining medication and TMS therapy

When combined with the right antidepressant medication, TMS therapy can help decrease depression symptoms even more. If an individual has previously seen positive results from medications but then stops, TMS therapy might be added as it can actually increase the effects of medications.

If you or someone you love is having a hard time finding relief from depression with antidepressants, it might be time to talk to a psychiatrist in South Jersey. If you are interested in learning more about TMS therapy, take a look at our TMS FAQs and contact Harmony Bay Wellness today at 855.857.6050.

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Harmony Bay is an outpatient behavioral health service that offers primary mental health treatment for a variety of mental health disorders. Our mission is to make mental health care convenient and affordable while providing an unmatched experience to our clients. contact us today by calling 855.765.6399.