Does Transcranial Magnetic Stimulation work for Postpartum Depression?

Yes. TMS can be helpful in postpartum depression. There is no contraindication for TMS in the postpartum phase or with breastfeeding mothers. That being said, there is no specific FDA clearance for TMS for the indication of postpartum depression.

Does Transcranial Magnetic Stimulation work for depression during pregnancy?

Depression could happen during pregnancy not only postpartum. That’s why we are using a new terminology now for depression related to pregnancy as peripartum depression. It is very common that we get asked if TMS can help depressed pregnant women. The answer is; Yes. TMS can be used during pregnancy. The initial clinical trials for TMS excluded pregnant women, later trials looked into the safety and efficacy of TMS during pregnancy and no absolute contraindication was reported. The magnetic coil is far enough not to cause any harm to the fetus. That being said, there is no specific FDA clearance for TMS for the indication of peripartum depression.

Does Transcranial Magnetic Stimulation work for PTSD?

Yes. There are many studies that investigated the use of TMS to treat PTSD . Most showed good results. Some used the same depression protocol of high frequency Left DL-PFC stimulation and others used a different protocol with low-frequency TMS to the right DL-PFC (commonly used for anxiety). That being said, TMS is not FDA-cleared for PTSD for the lack of a large enough randomized controlled trial. The use of TMS for PTSD is considered off-label.

Does Transcranial Magnetic Stimulation work for Autism?

Possibly. We have some data for the use of low frequency transcranial magnetic stimulation for the treatment of mild cases of Autism.

Does Transcranial Magnetic Stimulation work for Tinnitus?

Possibly. There was a study that was done at the VA that showed some promise in TMS for tinnitus. That being said, all patients should use earplugs for hearing protection. Exposure to chronic noise could cause hearing loss or tinnitus. This is different from the use of TMS to treat tinnitus which works on neuromodulation of the hearing centers of the brain.

WHAT CONDITIONS ARE TREATED WITH TMS?

Does TMS Work For Depression, Anxiety, OCD, PTSD, Bipolar?

TMS therapy is known to be helpful in depression, anxiety, OCD and smoking cessation. It can also be helpful in Bipolar Disorder, PTSD, and Autism Spectrum. In this article, I will explain the conditions that TMS therapy can work for.

Click here to learn more about how TMS works.

The Indications For TMS Therapy

Though depression is the main indication for TMS therapy, there are many other uses for TMS therapy. Below I will walk you through most of the current TMS therapy uses, both FDA-cleared and off-label uses.

What is Transcranial Magnetic Stimulation used for?

TMS therapy is indicated for the treatment of Major Depressive Disorder in adult patients who have failed to receive satisfactory improvement from prior antidepressant medication in the current episode. Also, TMS therapy is FDA-cleared for the treatment of OCD in adult patients who have failed to receive satisfactory improvement from prior treatments. Also recently dTMS therapy got FDA-cleared for smoking cessation therapy. TMS is used off label for many other psychiatric disorders like anxiety and PTSD.

When is Transcranial Magnetic Stimulation used?

TMS Therapy is used when talk therapy and antidepressant medications fail to achieve a satisfactory improvement in depressive symptoms. This means that as of 2020 TMS is reserved for severe cases of depression.

Success Rate of TMS Therapy? Click here to learn more.

Does Transcranial Magnetic Stimulation work for depression?

Yes. In fact, It works better than any antidepressant for those suffering from Treatment Resistant Depression or TRD. About two out of three patients respond to TMS therapy. About one third will experience a remission of their depressive symptoms.

Does Transcranial Magnetic Stimulation work for anxiety?

Yes. We have plenty of data to support the effectiveness of TMS for anxiety treatment. That being said, TMS is not FDA-approved for anxiety yet. That is because the anxiety trials were not large enough. Low-frequency right-sided TMS therapy is used for anxiety.

Does TMS work for other psychiatric conditions?

The main ones now are Depression, Anxiety, OCD, and smoking cessation. The current focus is headed towards PTSD, ADHD, Bipolar, and Schizophrenia. Also, TMS there are data supporting the use of TMS for addiction disorders like cocaine use disorder. This is being investigated for other neuropsychiatric disorders like fibromyalgia, chronic pain, insomnia, and dementia.

Does Transcranial Magnetic Stimulation work for OCD?

Yes. A particular type of TMS called Deep Transcranial Magnetic Stimulation is FDA cleared for OCD. It is done using a machine called BrainWay with a particular H7 coil. Recently, in August 2020 another TMS coil made by MagVenture was FDA cleared for the treatment of OCD.

Does TMS Therapy work for Bipolar Disorder?

Bipolar Disorder is, fundamentally, the combination of depression and mania. Many bipolar patients can experience long periods of severe depressive episodes. TMS can be used during severe depressive episodes that don’t respond to medication treatment. That being said, there might be a risk of inducing a manic episode. Close monitoring is very important. The FDA recently in March 2020 granted a TMS device breakthrough designation for TMS for bipolar depression.

Does Transcranial Magnetic Stimulation work for Postpartum Depression?

Yes. TMS can be helpful in postpartum depression. There is no contraindication for TMS in the postpartum phase or with breastfeeding mothers. That being said, there is no specific FDA clearance for TMS for the indication of postpartum depression.
Does Transcranial Magnetic Stimulation work for depression during pregnancy?

Depression could happen during pregnancy not only postpartum. That’s why we are using a new terminology now for depression related to pregnancy as peripartum depression. It is very common that we get asked if TMS can help depressed pregnant women. The answer is; Yes. TMS can be used during pregnancy. The initial clinical trials for TMS excluded pregnant women, later trials looked into the safety and efficacy of TMS during pregnancy and no absolute contraindication was reported. The magnetic coil is far enough not to cause any harm to the fetus. That being said, there is no specific FDA clearance for TMS for the indication of peripartum depression.
Does Transcranial Magnetic Stimulation work for PTSD?

Yes. There are many studies that investigated the use of TMS to treat PTSD. Most showed good results. Some used the same depression protocol of high frequency Left DL-PFC stimulation and others used a different protocol with low-frequency TMS to the right DL-PFC (commonly used for anxiety). That being said, TMS is not FDA-cleared for PTSD for the lack of a large enough randomized controlled trial. The use of TMS for PTSD is considered off-label.
Does Transcranial Magnetic Stimulation work for ADHD?

It is being studied. Some results are promising. It needs further investigation though.
Does Transcranial Magnetic Stimulation work for Autism?

Possibly. We have some data for the use of low frequency transcranial magnetic stimulation for the treatment of mild cases of Autism.
Does Transcranial Magnetic Stimulation work for Tinnitus?

Possibly. There was a study that was done at the VA that showed some promise in TMS for tinnitus. That being said, all patients should use earplugs for hearing protection. Exposure to chronic noise could cause hearing loss or tinnitus. This is different from the use of TMS to treat tinnitus which works on neuromodulation of the hearing centers of the brain.

Does TMS work for Smoking Cessation?

Yes. Preliminary data are currently being revealed proving the effect of TMS for smoking cessation. This will be huge as cigarette smoking is the number one preventable mortality cause in the USA. Helping patients quitting smoking with TMS will open the door wide open for the general public acceptance of majestic therapy or neuromodulation.

August 2020 Update. dTMS is now FDA-cleared for the indication of smoking cessation.

Does TMS Therapy help with Fibromyalgia?

There are some data that support the use of TMS for fibromyalgia and central chronic pain. It is worth noting that Theta Burst Stimulation or iTBS in particular seems to have promising success for fibromyalgia and chronic pain.

Does TMS Therapy help with Migraine Headache?

There is a single pulse TMS device (eNeura) that has FDA-clearance for migraine headaches. It is different from the device we use for depression which is repetitive transcranial magnetic stimulation.

Can repetitive Transcranial Magnetic Stimulation (rTMS) increase IQ?

It is certainly being evaluated for that. There had been a special interest in TMS for reasons of cognitive enhancement. Some trials are looking into performance enhancement with TMS among athletes and surgeons.

Any other indications for TMS?

TMS is evaluated for Insomnia, Chronic Pain, Fibromyalgia, Movement Disorders, Tinnitus. Also, there is a promise in the early stages of dementia.

References

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McGirr A, Karmani S, Arsappa R, Berlim MT, Thirthalli J, Muralidharan K, Yatham LN. Clinical efficacy and safety of repetitive transcranial magnetic stimulation in acute bipolar depression. World Psychiatry. 2016 Feb;15(1):85-6. doi: 10.1002/wps.20300. PMID: 26833619; PMCID: PMC4780310.

Cox EQ, Killenberg S, Frische R, McClure R, Hill M, Jenson J, Pearson B, Meltzer-Brody SE. Repetitive transcranial magnetic stimulation for the treatment of postpartum depression. J Affect Disord. 2020 Mar 1;264:193-200. doi: 10.1016/j.jad.2019.11.069. Epub 2019 Nov 13. PMID: 32056750.

Theodoroff SM, Griest SE, Folmer RL. Transcranial magnetic stimulation for tinnitus: using the Tinnitus Functional Index to predict benefit in a randomized controlled trial. Trials. 2017 Feb 9;18(1):64. doi: 10.1186/s13063-017-1807-9. PMID: 28183355; PMCID: PMC5301432.