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http://www.fda.gov/downloads/advisorycommittees/committeesmeetingmaterials/medicaldevices/medicaldevices
advisorycommittee/neurologicaldevicespanel/ucm290787.pdf
TRANSCRANIAL MAGNETIC STIMULATION (“TMS”) FOR DEPRESSION
SUMMARY
WHAT WE KNOW
Transcranial Magnetic Stimulation (“TMS”) has been FDA-approved for treatment of
depression since 2008 and has been approved for this use in Europe, Canada, Australia, and the
United States. Other promising areas of research include treating the negative symptoms
of schizophrenia. However, TMS is expensive compared to CES, and the Cochrane Collaboration
seriously questions its efficacy. TMS is experimental, not supported by persuasive clinical
evidence or endorsed by any source, and usually not reimbursed by insurance. Moreover,
unlike CES, TMS treatments require a therapist in attendance and are expensive.
SIDE EFFECTS
No drug interactions have been noted. Single pulse TMS stimulation is considered safer than
repetitive TMS (“rTMS”). However, in rare cases, seizures may follow single pulse TMS
stimulation in people with stroke or other disorders involving the central nervous system. RTMS
has been reported to cause seizures in individuals without pre-existing conditions when certain
combinations of stimulation frequency and intensity are used, and guidelines have been
developed to avoid this. Common adverse effects of rTMS are discomfort or pain from the
stimulation of the scalp and associated nerves and muscles on the overlying skin. This is more
common with rTMS than single pulse TMS.
CONCLUSION
Promising, but not yet proven. But given minimal side effects, experimentation with TMS is a
reasonable choice if other treatments prove ineffective or poorly tolerated.