Transcranial Magnetic Stimulation (TMS) is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain. Approved by the U.S. Food and Drug Administration (FDA), it is often used when other depression treatments have not been effective. This technique involves placing an electromagnetic coil against the scalp, delivering magnetic pulses to specific brain regions involved in mood control. Like any medical intervention, TMS therapy can have potential side effects.
Common and Mild Side Effects
Mild headaches are among the most frequently reported side effects of TMS therapy, affecting about one-third of patients. These headaches often occur during or immediately after a session because the magnetic field stimulates scalp muscles. Scalp discomfort or pain at the treatment site, felt as a tingling or slight pressure, is also common. This discomfort typically lessens as treatment progresses and the body adapts.
Patients may also experience lightheadedness, facial muscle twitching, or jaw pain during sessions. These sensations are usually temporary and resolve shortly after the session ends. Mild side effects are generally most noticeable during the first week and often decrease over time, rarely leading to treatment discontinuation.
Rare and Serious Side Effects
While generally considered safe, TMS therapy carries a small risk of more serious side effects. Seizures are the most significant, though extremely rare, potential complication. They are more likely in initial sessions or in individuals with a history of seizure disorders.
Another rare side effect is the induction of emotional highs, known as mania or hypomania, particularly in individuals with bipolar disorder. These episodes are uncommon and typically subside after treatment. Hearing changes, such as increased sensitivity to sound or tinnitus, can occur due to the loud clicking sounds. This is usually temporary, and proper ear protection is provided to mitigate this risk.
Factors That Influence Side Effects
Several factors can influence the likelihood or severity of TMS side effects. Pre-existing medical conditions play a significant role; individuals with a history of seizures, epilepsy, or certain neurological conditions may have a higher risk. The presence of metal implants in the head, such as aneurysm clips, stents, pacemakers, or cochlear implants, can also contraindicate TMS due to strong magnetic fields.
Medications that lower the seizure threshold can also influence risk. The specific TMS protocol used, including the intensity and frequency of magnetic pulses, coil type, and distance from the head, are adjustable parameters that can affect the outcome and potential for side effects. Patient screening and individualized treatment plans are important for minimizing risks.
Addressing Side Effects
For common, mild side effects like headaches or scalp discomfort, over-the-counter pain relievers can often provide relief. Communicating any discomfort to the TMS technician is important, as they can adjust stimulation intensity or coil position. Wearing earplugs during sessions is recommended to protect hearing from the loud clicking sounds.
Patients should ensure adequate sleep, hydration, and balanced meals before sessions to help prevent lightheadedness and fatigue. If side effects persist or worsen, or if any unexpected symptoms arise, patients should promptly inform their healthcare provider. Immediate medical attention is necessary for severe reactions like seizures, marked mood changes, or persistent severe pain.