If you are treating with TMS Therapy and it has not brought you relief, we understand your concern. Response times are quite variable and while 3 weeks is an average time to begin to see a response, there are some patients that respond sooner while often many respond later. We have even treated patients that show response at the very end of treatment or after treatment has concluded. The older the patient, the longer it may take to see a response, but regardless of age, about 15% of patients make a subset of late responders and can require TMS Therapy beyond 6 weeks.
At Greenbrook TMS, if a patient has had absolutely no improvement by the end of the fourth week, confirmed with validated rating scales for depression, we may relook at the treatment course and consider adjustments. Often, we assess patients for co-occurring medical conditions that may be inhibiting recovery, such as untreated sleep apnea or low thyroid. We also look at the patient’s medications and confirm that they are not having any drug interactions or side effects. We discuss potential environmental stressors that may be impacting quality of life. Sometimes we recommend genetic testing to look for genetic variations that require very specific treatment interventions (see genomind.com for more on this). We recheck the device settings and confirm the treatment location and treatment parameters. If none of these factors seems likely to be impacting the depression, we do sometimes recommend changing devices or pulse sequences. The coil designs of each specific TMS device have varying magnetic field generations and thus stimulate the brain slightly differently.
Unfortunately, there are some patients that do not respond to TMS Therapy, but there are other potential treatment options that patients should discuss with their providers. There is also a significant research effort looking at subtypes of depression and different stimulation techniques with the goal of improving response rates. So, if you do not respond to a treatment course, it is worth staying in contact with your TMS provider should they acquire new technology that may be worth considering in your treatment plan.
You can learn more about TMS Therapy on the many topics discussed on this Blog, or please feel free to reach out to us at greenbrookTMS.com.
Please be advised that the information presented here is for information purposes only and should not be considered medical advice. All patients are encouraged to discuss any issues or concerns they may have with their behavioral health providers.