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Comparing ECT and Transcranial Magnetic Stimulation

Risks
Who Qualifies for ECT?
How it Works
Fewer Risks
What to Expect

Electroconvulsive Therapy or ECT is a treatment procedure which uses small electric currents emitted directly through the brain. Usually done under general anesthesia, it involves triggering a quick and rapid seizure.

The procedure intentionally causes alterations in the brain chemistry in which can reduce symptoms of certain mental disorders. Medical practitioners often result using ECT when other treatments failed to treat a particular mental disorder. However, ECT may not work for everyone as involves painful sensations and medication like anesthesia. A huge number of patients suffered from memory loss, fractured bones, and other adverse side effects.

 

Risks

Some clinics may claim to administer ECT but side effects vary from severe to worse:

Patients may suffer confusion almost immediately after treatment. This can last from few minutes to several hours, some reported to have confusion for several days longer. Confusion tends to be more noticeable in older patients.

Memory loss is one of the most common side effects of ECT and patients have trouble remembering events that occurred months or weeks before treatment. Doctors characterized this condition as retrograde amnesia. Some patients may claim to have trouble calling events weeks prior to treatment.

Aside from these adverse effects, there are other physical side effects of ECT. Some people suffer from a headache, nausea, muscle pain, or jaw pain. Because ECT is an invasive and systemic procedure, there is some medical complication involve due to the use of anesthesia. Increase heart rate and blood pressure are amongst the most common problems during ECT procedure. Unfortunately, these problems can cause serious heart complications. Medical professional advise against ECT if patient experience or have a history of heart disorders.

 

Who Qualifies for ECT?

Before ECT procedure can commence, patients undergo an intense full evaluation which usually includes the following:

  • A complete physical exam
  • A medical history
  • A psychiatric assessment
  • An electrocardiogram (ECG) to check patient’s heart health
  • Anesthesiologist review to go over the risks of anesthesia
  • Several basic blood tests

Most patients suffering from mental disorders failed to respond positively to conventional treatments. But instead of falling into despair, medical science offers a relatively new, safe and efficient alternative treatment, the Transcranial Magnetic Stimulation or TMS. It’s a noninvasive, non-systemic procedure that uses magnetic pulses to stimulate nerve cells in the brain to improve symptoms of certain mental disorders. Medical professionals usually use TMS as the last option when no other treatments fail.

 

How it Works

During TMS treatment session, medical professional place an electromagnetic coil near the prefrontal cortex of the patient. This coil emits painless electromagnetic pulses that stimulate brain nerve cells associated with mood control and depression. These regions in the brain often have decreased activity in people suffering from depression. The Food and Drug Administration approved the use of TMS as it can effectively ease depression symptoms and noticeably improve overall mood.

Most people can respond positively to the conventional treatment of depression but these medications are not for everyone. Some standards form of treatments losses their efficacy over time due to drug tolerance and other factors. TMS treatment used is often recommended for patients who do not respond accordingly to conventional treatments like medications and psychotherapy.

 

Fewer Risks

As a non-invasive form of brain stimulation, TMS results to fewer risks or none at all as a brain stimulation procedure used for depression. Like another form of nerve stimulation like vagus or ECT, TMS does not require any surgery or implantation of electrodes in the body. TMS does not require any sedation and does not cause any seizure whether intentional or not.

The FDA and other medical organization considered TMS as a well-tolerated, safe, and efficient alternative treatment to cure depression disorders. However, it may cause some mild side effects which eventually go away in the course of the treatment duration.

Some of the common side effects comprise of mild to moderate and improved shortly after each session. These side effects decrease over time and may include the following:

Side effects are generally mild to moderate and improve shortly after an individual session and decrease over time with additional sessions. They may include:

  • A headache
  • Lightheadedness
  • Scalp discomfort at the site of stimulation
  • Tingling, spasms or twitching of facial muscles

 

What You Can Expect

TMS treatment sessions are done inside the doctor’s office on an outpatient basis. Typically last about few minutes or an hour. Patients can immediately resume their daily activity after each session for a period of five times a week for four to six weeks.

 

According to the World Health Organization, an estimated 350 million people or about 5% of the of the world’s population suffer from depression. The main treatments for patients suffering from this disorder are medicinal antidepressants and psychotherapy. Unfortunately, at least 50% of patients don’t respond positively to conventional treatment.

If these don’t provide any relief, it might be the right time to consider alternative forms of treatment. These alternate treatment methods involve therapy through brain stimulation. To date, the US Food and Drug Administration has approved two types of brain stimulation: TMS and ECT.

Both treatments involve specific areas in the brain which control mood behavior. The two offer hope to people who failed to succeed in antidepressant medication or psychotherapy. But their similarities end there. To better understand their differences, here are descriptions about the two.

 

Definition of TMS and ECT

TMS

Transcranial Magnetic Stimulation or TMS is a non-invasive method of stimulating brain nerve cells. This technique uses a coil that emits high-intensity magnetic pulses. Research has found that TMS can effectively treat medication-resistant depression. The response rates are 40% to 60% higher with remission rates of only 35% to 40%. The average treatment last between 4 and 6 weeks.

 

ECT

Electroconvulsive therapy or ECT is also referred to as shock therapy. It involves sending an electric current into patients via attached electrodes. Health care professionals send out an intentional series of “generalized seizures”.

Doctors may recommend ECT for severe depression and suicidal patients. The procedure involves delivering intense but brief electrical pulses through the patient’s head.

 

Getting the Procedure

TMS

Usually, TMS therapy is done in an outpatient setting inside a doctor’s office. It is a simple procedure that does not require any sedation or anesthesia. Patients are fully awake and able to resume their daily routine as soon as the session ends.

 

ECT

Where TMS is a simple procedure, ECT is a bit more complicated. ECT treatment requires series of generalized seizures. Because patients are exposed to pain, they are given muscle relaxant and generalized anesthesia. Patients are also induced into deep sleep during their therapy sessions.

 

Side Effects

TMS

Patients have reported very little side effects while undergoing TMS therapy. The most common side effects of TMS include:

  • Headache
  • Scalp soreness at the site of stimulation
  • Spasms or twitching of facial muscles
  • Lightheadedness

The patient can immediately go back to their daily routine like driving and work upon session completion. There are no memory losses reported with TMS therapy.

 

ECT

Unfortunately, ECT has more reported side effects. These may require observation before a health care professional can clear a patient for discharge. These side effects include:

  • Headaches
  • Muscle aches
  • Nausea
  • Confusion following therapy
  • Pain in the jaw
  • Muscle soreness
  • Memory loss

Patients often describe their short term memory loss as not remembering past events from previous months. Some reported to forget what they even ate that morning. This memory loss tends to dissipate over time.

Although ECT has been around longer, experts have found a safer and more effective depression treatment in TMS therapy. In any case, it is best to consult your physician on what will best work for your condition.

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