In case you’re beginning transcranial magnetic stimulation (TMS) for despair and questioning, “Does TMS trigger complications or migraines?” you’re not alone. Complications and scalp tenderness are among the many commonest TMS uncomfortable side effects, and for folks like me who’re already migraine-prone, therapies can mild up ache pathways you actually don’t need lit. On this piece, I share precisely what TMS appears like session-to-session, the place the ache reveals up, how lengthy it lasts, and what triggers it (coil place, stimulation depth, and timing). Extra importantly, I’ll stroll by way of what truly helps: easy TMS headache reduction steps, small changes your technician could make, and sensible migraine-prevention tweaks that permit me maintain going. In case you’re trying to find real-world solutions on TMS complications, TMS migraine danger, and how one can scale back ache with out ending therapy, that is the information I want I’d had on day one.
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What Is TMS? TMS Fundamentals You Have to Perceive
Transcranial magnetic stimulation (TMS) is a remedy, typically for treatment-resistant despair, that makes use of sturdy magnetic pulses to stimulate mind neurons. It’s thought-about noninvasive as no chopping of the pores and skin is required. Basically, an electromagnetic coil is positioned on a selected spot (or spots) in your head. Based on the Mayo Clinic:
This coil delivers magnetic pulses that stimulate nerve cells within the area of your mind concerned in temper management and despair. It’s thought to activate areas of the mind which have decreased exercise throughout despair.
There are only a few uncomfortable side effects aside from ache, together with headache and migraine ache, and lightheadedness. See right here for extra.
TMS Headache vs. Migraine: Methods to Inform the Distinction
- TMS headache: localized scalp/temple soreness or strain that tracks with the coil website; normally fades hours after a session.
- Migraine: throbbing, typically one-sided, could embrace mild/sound sensitivity, nausea, aura, and different signs, and might outlast the therapy day.
Drugs and TMS
Understand that some medicines can influence the effectiveness of TMS, and you will have to withdraw from them to provide the therapy the perfect likelihood of working. There are a couple of contraindications, too. Extra on TMS security could be discovered right here. Be sure that to debate all your medicines and dietary supplements with the TMS-prescribing doctor, and don’t modify something by yourself.
TMS ‘Dosing’
When receiving TMS, you’ll have a goal “dose” (coil power). That is decided by measuring your motor threshold (how a lot energy it takes in a selected spot to make your hand twitch). This quantity is then multiplied by your “prescription” to determine your goal.
For instance, your motor threshold is likely to be 40% of full energy. Your prescription is likely to be 120%. This implies your goal is 48% of full energy.
Whenever you start every TMS therapy, they’ll begin you at a decrease dosage (say, 30% of full energy) and work as much as your goal, every time elevating the dosage at which you begin.
I’m receiving theta-burst TMS, a more recent sort of TMS, which can be more practical. It takes simply over three minutes for a TMS despair therapy. (They’re additionally doing TMS for nervousness on the opposite facet of my head. That takes solely 40 seconds per therapy because the pulses are steady.) I will probably be receiving 30 therapies, one a day, Monday by way of Friday.
What TMS Feels Like for Me
All I’ve ever seen mentioned about TMS is that “gentle discomfort” could also be felt. This isn’t what I’ve discovered. I’ve discovered “discomfort” is doctor-speak for ache — the one query is how a lot.
I undergo from persistent migraine, and with out entering into medical specifics, let’s simply say that I expertise head ache each day proper now. And, sadly, TMS therapies make my head ache worse.
For me, that is what occurs:
- I sit within the TMS chair, and so they place the coil appropriately utilizing marks made on a decent cap on my head.
- The stimulation begins, and the pulses and ache produce a startle response. This ramps up my nervousness.
- The pulses really feel like being hit within the head with a protracted, skinny blade. The ache goes by way of my scalp, into my mind, eye, and jaw.
- The ache is simply, simply bearable.
- There’s a break within the pulses. After they resume, I expertise one other startle response, and the ache is worse (as a result of the dosage has been elevated).
And so it goes for simply over three minutes. And whereas three minutes sounds very brief, it feels very lengthy because of that quantity of ache. On the finish of the therapy, I’ve full-blown migraine and I expertise fatigue and nausea. Medical doctors say complications are short-lasting after therapy, however that isn’t my expertise. I’ve one for the remainder of the day.
Please perceive, none of that is to scare you. That is simply my expertise, and yours could differ dramatically. I think about myself fortunate to have entry to this therapy and have hope for its success. I believe it may assist a fantastic many individuals who’ve few choices. Unquestionably, if it really works, the ache will probably be value it.
What Makes TMS Ache Worse?
The primary TMS therapy was horrible, possible due to the excessive diploma of tension going into the therapy. The second therapy was considerably easier.
Moreover, in my expertise, I’ve discovered a couple of issues that make TMS ache worse. They embrace:
- Beginning out with head ache (this is likely to be a full-blown migraine or only a headache)
- Being migraine- or headache-prone
- Getting into with excessive nervousness
- Clenching your muscle tissues
- Sickness (I had COVID, and it dramatically elevated the ache; I used to be advised this occurs due to the irritation attributable to sickness)
- Lack of sleep
A few of these elements are modifiable, and a few aren’t.
What Helps TMS Ache for Me
Counteracting the pain-worsening elements, the place potential, might help reduce TMS ache. For instance:
- Taking headache treatment earlier than therapy to attempt to reduce the ache stepping into. (Be sure that to examine together with your clinician that any treatment you select to take gained’t influence the efficacy of the TMS therapy.)
- Specializing in remaining calm throughout therapy.
- Getting as a lot sleep as potential.
Particular strategies I exploit throughout therapies embrace:
- Rubbing the spot on my head the place the stimulation goes to be to attempt to calm down the muscle tissues as a lot as potential.
- Making chit-chat with the technicians beforehand to assist alleviate nervousness.
- Specializing in one thing optimistic as a substitute of the upcoming ache.
- Utilizing a mantra. (Mine is, “I’m a skydiver. I can do something.“)
- Specializing in deep, sluggish breaths through the therapy.
- Focusing very particularly on enjoyable all my head muscle tissues throughout therapy (together with between pulses).
In case you’re experiencing ache throughout TMS, you may speak to the technicians, and they are able to barely transfer the coil or alter the dosage or ramp as much as alleviate it. Additionally, remember that it’s possible you’ll discover the ache extra bearable with repeated therapies.
Lastly, the technicians have a tendency to supply suggestions through the therapy, comparable to after I’ve reached my goal dose, how lengthy there’s to go, and many others. I discover this very useful and would recommend asking for it if it’s not already being freely given.
However, Does TMS Actually Assist with Despair?
I’ve treatment-resistant (often known as “hard-to-treat”) despair. And “arduous to deal with” is an understatement. I’ve tried each mixture of each drug you may think about, years of remedy, modified life-style elements, plus vagus nerve stimulation (VNS) and electroconvulsive remedy (ECT). I’m the poster baby for therapy resistance.
That being mentioned, I’ve excessive hopes. Most individuals who get TMS have a point of therapy resistance, and the success charge they’ve been seeing on the clinic has been outstanding. The huge, overwhelming majority of individuals expertise enchancment. It’s not assured to work for anybody, however it’s promising.
For me, I’m solely 11 TMS therapies in, so it’s slightly early to say. I do have hope, nevertheless.
FAQs About TMS Complications and Migraines
Widespread; many report mild-to-moderate scalp ache early on that will enhance over time.
It’s mentioned they need to final “a short time,” however I’ve discovered they final the remainder of the day or perhaps even into the subsequent day.
Typically sure, however ask your prescriber (e.g., timing for triptans, over-the-counter analgesics, anti-nausea medicines, and many others.).
Having TMS Complications and Migraines With out Derailing Therapy
The underside line is that TMS complications and scalp ache are widespread, and in case you’re migraine-prone like me, therapy days can set off greater signs. The excellent news is that most individuals discover the ache manageable and sometimes bettering over time, particularly with a plan. What might help is a mixture of clinic changes (comparable to a delicate ramp-up to focus on dose, small coil repositioning) and patient-side methods (like correct sleep, calm respiration, mantra utilization, and clinician-approved medicines). In case you’re beginning TMS for despair and questioning whether or not TMS uncomfortable side effects like headache or migraine imply you need to cease, speak to your crew first: small tweaks could make a giant distinction, and plenty of sufferers proceed efficiently with the proper TMS headache reduction strategy.
