Quick facts
- TMS
- Magnetic pulses, awake, in a doctor's office; about 30 to 36 sessions.
- ECT
- Electrical current under general anesthesia, in a hospital; about 12 sessions.
- Driving
- After TMS you can drive yourself. After ECT someone needs to drive you home.
- Main risks
- TMS: mild scalp discomfort, headache. ECT: memory loss, headache, anesthesia risks.
- Decision
- Your psychiatrist helps choose based on your history and symptoms.
- Locations
- Wesley Chapel and Tampa, Florida.
The short version
TMS uses magnetic pulses and ECT delivers electricity directly. Because magnetic stimulation passes through the skull without intentionally causing a seizure, TMS avoids the sedation and memory effects associated with ECT.
| TMS | ECT | |
|---|---|---|
| Stands for | Transcranial Magnetic Stimulation | Electroconvulsive Therapy |
| How it works | Magnetic pulses | Electrical current |
| Setting | Doctor's office | Hospital |
| Sedation | None, you are awake | General anesthesia |
| Sessions | About 30 to 36, daily on weekdays | About 12, 2 to 3 times a week |
| Main risks | Mild scalp discomfort, headache, very rare seizure | Memory loss, headache, anesthesia risks |
Stands for
TMS: Transcranial Magnetic Stimulation
ECT: Electroconvulsive Therapy
How it works
TMS: Magnetic pulses
ECT: Electrical current
Setting
TMS: Doctor's office
ECT: Hospital
Sedation
TMS: None, you are awake
ECT: General anesthesia
Sessions
TMS: About 30 to 36, daily on weekdays
ECT: About 12, 2 to 3 times a week
Main risks
TMS: Mild scalp discomfort, headache, very rare seizure
ECT: Memory loss, headache, anesthesia risks
Who may prefer TMS, and who may need ECT?
The choice depends on your symptoms, history and safety needs. Your psychiatrist weighs these with you.
- TMS may fit if you want an outpatient treatment with no anesthesia, want to keep driving and working, or are concerned about memory effects.
- ECT may be considered for severe illness that needs the strongest option, or for conditions such as psychosis or catatonia, which TMS is not used for.
- Many patients start with the less invasive option; your history and response guide the next step.
How does TMS work?
An electrical current runs in pulses through a coil, producing a targeted magnetic field that gently activates specific brain cells. A seizure is very rare, about 1 in 30,000 treatments.
How does ECT work?
ECT runs an electrical current diffusely through the brain and produces a therapeutic seizure lasting about 1 to 3 minutes, under full sedation. It can cause memory loss, usually short-term and sometimes longer-term.
What are they used for?
TMS is FDA-cleared for depression and OCD, and is also used for anxiety and other conditions. ECT is used for resistant depression, psychosis, bipolar disorder, catatonia and neuroleptic malignant syndrome.
Where and by whom?
TMS is done as an outpatient in a psychiatrist's office without anesthesia, and you can drive yourself before and after. It is ordered and supervised by a psychiatrist and delivered by a trained TMS technician. ECT is done in a hospital, you must be monitored after waking, and someone needs to drive you home.
Number of treatments
TMS is done daily, 5 days a week for 6 weeks (30 sessions), then a taper of 6 sessions over 3 weeks, 36 sessions in all. ECT is done 2 to 3 times a week for a few weeks, about 12 sessions, and maintenance ECT is usually recommended.
Next steps
If you are deciding between TMS and ECT, a psychiatric evaluation with Dr. Bowarshi is the best first step. Call (813) 867-2378 to schedule one in Wesley Chapel or Tampa.
Frequently asked questions
Sources and further reading
- Perera T, et al. The Clinical TMS Society consensus review and treatment recommendations for TMS therapy for major depressive disorder. Brain Stimul. 2016;9(3):336–346. Clinical TMS Society
- Brain Stimulation Therapies. National Institute of Mental Health
Medical information on this page is educational and not a substitute for professional advice. Individual results vary.