Ect Treatment for Depression: Tms vs. Ect

Electroconvulsive therapy (ECT) and (TMS) are two types of procedures use to treat depression. While both have proven to be effective in their treatment, there are significant differences in how these two procedures function.

Electroconvulsive Therapy

Originally introduced in the 1930s, ECT has come a long way in terms of effectiveness and safety as a medical procedure. Mental conditions in which ECT has been successful in treating include catatonia as well as severe and treatment-resistant mood disorders. ECT has also been used as a last resort for treating obsessive compulsive disorder, Parkinson’s disease and Tourette syndrome among others.

ECT treatment is administered in a controlled setting using electric currents which pass through a patient’s brain, deliberately triggering a seizure in the process. The seizure provokes changes in the brain physiology that appear to be successful in reversing the symptoms of mental illness in some patients. Researchers have yet to come to an agreeable conclusion on how the chemical changes evoked by ECT Therapy are able to successfully reduce these symptoms.

ECT sessions run between 20 to 30 minutes, and are typically given two or three times weekly over a two to four week period. Patients tend to see results after two or three ECT treatments.

Risks associated with ECT treatment have decreased significantly from the time in which the procedure was practiced without a strict protocol in place. However, the danger of side effects is still present. Potential risks include:

A state of confusion ranging from a few minutes to several hours.
Memory loss; tends to improve within a couple months but could last longer.
Physical side effects on the days following ECT treatment. These include nausea, vomiting and muscle spasms.
Health problems during treatment triggered from the use of anesthesia, a drug used for medical procedures. Common side effects include increased heart rate and blood pressure.

Transcranial Magnetic Stimulation

TMS therapy is conducted through the use of a treatment coil placed lightly against the scalp of patients sitting in a reclining chair. The coil emits magnetic fields that stimulate nerve cell activity in a brain area implicated regulating mood.

TMS Patients typically receive five weekly treatments over a six week period. Patients remain fully awake during a TMS therapy session, which last roughly 40 minutes.

Unlike ECT treatment, TMS therapy doesn’t require anesthesia or possible hospital recovery time. While scalp pain is the most common side effect, rare incidences of seizures have also been reported during TMS treatment.

Previous studies report as much as a 50 percent drop in depression symptoms among patients using TMS therapy. Compared to medication and ECT treatment, research additionally suggests major depression sufferers are less likely to experience relapse following TMS therapy.

Since its introduction, TMS therapy has seen significant success in alleviating symptoms of depression among patients. However, due to the relatively newness of the treatment, the Federal Drug Administration (FDA) currently limits the use of TMS therapy to adults who have failed to achieve results from antidepressant medication.

The Conclusion

Support for TMS therapy is steadily gaining ground, in part due to the lack of side effects associated with the procedure. However, ECT remains a popular treatment despite the potential risk of side effects due its considerable success in alleviating symptoms associated with mental illnesses.

John M. Hawkins, MD of the Lindner Center of HOPE is the author of this article on TMS treatment and electroconvulsive therapy. John is the Chief of Psychiatry, Deputy Chief Research Officer, Director of Outpatient Clinic, and Medical Director of Brain Imaging Center at the Lindner Center of HOPE, located in Cincinnati, Ohio.

 


 

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Deborah J. Pomroy, RN, BSN, a Distinguished ECT Coordinator and Patient
Deborah works as ECT (electroconvulsive therapy) Coordinator and Patient Education Nurse on the Behavioral Health and Addictions Services Unit of the Methodist Richardson Medical Center. She assists the psychiatrist in performing ECT, a procedure to … Read more on Busbyway


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