What’s The Difference Between TMS & ECT?

What’s The Difference Between TMS & ECT?

The Albany Clinic • June 2, 2023

Mental health conditions can be challenging to treat, and traditional therapy, medication, or lifestyle changes may not always be enough to provide relief. For patients with treatment-resistant depression, two alternative treatments are TMS and ECT. Many people confuse the two, but they are very different methods of treatment.

In this article, we will explore the differences between TMS and ECT and examine their effectiveness, side effects, and who can benefit from each treatment.

Understanding TMS & ECT

Transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT) are two treatments used to alleviate symptoms of depression and other mental health conditions. While both treatments are effective, they differ in their approach and level of invasiveness.

What Is TMS?

TMS is a non-invasive treatment that uses magnetic fields to stimulate nerve cells in the brain. This stimulation can help alleviate symptoms of depression and other mental health conditions.

During a TMS session, the patient sits in a comfortable chair while a technician holds a coil over their head. The coil sends magnetic pulses to the brain, which stimulates nerve cells and improves mood. TMS treatments are typically performed in an outpatient setting and do not require anesthesia or sedation.

One of the benefits of TMS is that it is a relatively safe and painless procedure. Patients can return to their normal activities immediately after the treatment, and there are typically no side effects. Additionally, TMS can be used in conjunction with other treatments, such as medication and therapy, to enhance their effectiveness.

What Is ECT?

ECT is a more invasive treatment that uses electric currents to trigger a seizure in the brain. The seizure can help alleviate symptoms of depression and other mental health conditions.

During an ECT session, the patient is given an anesthetic and a muscle relaxant to prevent them from convulsing. Then, electrodes are attached to their scalp, and an electrical current is passed through the brain to induce a seizure. ECT treatments are typically done in an outpatient setting, but require sedation or anesthesia.

ECT is generally reserved for patients who have not responded to other treatments, such as medication and therapy. It can be an effective treatment for severe depression, bipolar disorder, and other mental health conditions. However, ECT is more invasive than TMS and can have more side effects, such as memory loss and confusion. Patients may also experience headaches, muscle aches, and nausea after the treatment.

Which Treatment Is Right For You?

If you are struggling with depression or another mental health condition, it is vital to talk to your doctor about your treatment options. TMS and ECT are just two of the many treatments available, and your doctor can help you determine which one is right for you. Factors such as the severity of your symptoms, your medical history, and your personal preferences will all be taken into account when deciding on a treatment plan.

Remember, seeking treatment is an important step towards improving your mental health and overall well-being. With the right treatment and support, it is possible to manage your symptoms and lead a fulfilling life.

The Science Behind TMS & ECT

How TMS Works

When the magnetic pulses from TMS pass through the brain, they stimulate the nerve cells in the prefrontal cortex. This area of the brain is responsible for mood regulation, and by stimulating it, TMS can improve symptoms of depression and other mental health conditions. TMS treatments typically last 20-30 minutes and are performed five days a week for four to six weeks.

During a TMS session, the patient sits in a chair and a magnetic coil is placed on their scalp. The magnetic pulses are painless and do not require anesthesia. Some patients may experience a tapping or knocking sensation on their scalp during the treatment, but this is generally well-tolerated.

TMS is a relatively new treatment, having been approved by the FDA in 2008. It is considered a safe and effective treatment option for patients who have not responded well to other treatments, such as medication and therapy.

How ECT Works

Electroconvulsive therapy (ECT) has been used to treat mental illness for over 80 years. During an ECT session, an electric current is passed through the brain, triggering a seizure. This seizure has been linked to the release of chemicals in the brain that can improve mood. However, the exact mechanism of action is not well understood.

ECT treatments are usually given two to three times per week, for a total of six to twelve treatments, depending on the patient’s response. During the treatment, the patient is given anesthesia and a muscle relaxant to prevent injury during the seizure.

While ECT has a reputation for being a harsh and outdated treatment, it is still used today in cases where other treatments have not been effective. It is generally reserved for patients with severe depression or other mental health conditions who are at risk of harm to themselves or others.

Despite its effectiveness, ECT does have some potential side effects, such as memory loss, confusion, and headaches. However, these side effects are usually temporary and can be managed with medication and therapy.

Comparing TMS & ECT

Effectiveness In Treating Mental Health Conditions

Both TMS and ECT have been shown to be effective in treating depression and other mental health conditions. TMS has been FDA-approved since 2008 and has been shown to be effective in approximately 60% of patients. ECT has been in use since the 1930s and has been shown to be effective in approximately 70% of patients. However, ECT is typically reserved for patients with more severe and treatment-resistant depression.

It is crucial to note that the effectiveness of these treatments may vary depending on the individual patient and their specific mental health condition. Some patients may respond better to TMS, while others may respond better to ECT. It is essential for patients to work closely with their healthcare provider to determine the best treatment option for their individual needs.

Side Effects & Risks

TMS is a non-invasive treatment and does not have many reported side effects. Some patients may experience headaches or mild discomfort at the site of the magnetic pulses. These side effects are typically mild and go away shortly after the treatment is completed.

ECT, on the other hand, is a more invasive treatment and has more associated risks. Patients may experience confusion, memory loss, or headaches after an ECT treatment. These side effects are typically short-term and go away within a few hours to a few days after the treatment is completed. However, in rare cases, patients may experience more serious side effects, such as heart problems or seizures.

It is important for patients to discuss the potential side effects and risks of each treatment option with their healthcare provider before making a decision.

Duration & Frequency Of Treatments

TMS treatments last approximately 20-30 minutes, and patients typically require five treatments per week for four to six weeks. This treatment schedule allows patients to continue with their daily activities and does not require any downtime or recovery time.

ECT treatments last longer, approximately 10-20 minutes, but patients may require more treatments. In total, patients usually receive six to twelve ECT treatments, two to three times per week. This treatment schedule may require patients to take time off from work or other daily activities to recover from the treatment.

It is critical for patients to consider the duration and frequency of treatments when choosing between TMS and ECT. TMS may be a more convenient option for patients who have busy schedules or who do not want to take time off from work or other daily activities. ECT may be a better option for patients who require more intensive treatment or who have not responded well to other treatment options.

Who Can Benefit From TMS & ECT?

Candidates For TMS

TMS is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain. It is typically recommended for patients with treatment-resistant depression or those who cannot tolerate medication. TMS has been shown to be effective in treating depression, anxiety, and other mood disorders.

During a TMS session , the patient sits in a comfortable chair while a magnetic coil is placed on their head. The coil delivers magnetic pulses to specific areas of the brain that are responsible for regulating mood. The treatment is painless and does not require any anesthesia.

Patients with metal implants in the head or neck should not undergo TMS treatments. Additionally, TMS may not be suitable for patients with a history of seizures or other neurological conditions.

Candidates For ECT

Electroconvulsive therapy (ECT) is a more invasive treatment that involves passing electrical currents through the brain to trigger a seizure. ECT is typically recommended for patients with severe, treatment-resistant depression, or those who are suicidal.

ECT has been shown to be effective in treating a variety of mental health conditions, including depression, bipolar disorder, and schizophrenia. However, it is usually considered a last resort treatment due to its potential side effects.

During an ECT session, the patient is given anesthesia and a muscle relaxant to prevent injury during the seizure. The electrical currents are delivered through electrodes placed on the scalp. The treatment usually takes less than 30 minutes.

Patients with a history of heart problems, seizures, or other medical conditions may not be able to undergo ECT treatments. Additionally, ECT can cause side effects such as confusion, memory loss, and headaches.

The Future Of TMS & ECT

Advances In TMS Technology

Currently, researchers are investigating new ways to deliver TMS treatments, such as using multiple coils at once to stimulate multiple areas of the brain. These advances may increase the effectiveness and efficiency of TMS treatments.

Advances In ECT Technology

Newer ECT machines use lower levels of electricity, which may reduce the risk of side effects such as memory loss. There is also research being done to combine ECT with other treatments, such as medication or psychotherapy.

Conclusion

At The Albany Clinic , we understand the importance of finding the right treatment for individuals with treatment-resistant depression and other mental health conditions. TMS and ECT are two valuable options that offer distinct benefits and risks.

If you or someone you know is considering these treatments, we encourage you to schedule a consultation with our experienced team. We will assess your unique needs and help you make an informed decision about the most suitable treatment option for you. Take the next step towards finding relief and improving your mental well-being by reaching out to The Albany Clinic today. Your journey to a better quality of life starts here.

If you are interested in learning more about ketamine for TMS therapy treatment in Carbondale, IL, contact the Albany Clinic and request your consultation today.

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In-Clinic vs. At-Home Ketamine Therapy: What’s Best for Your Mental Health?

By Kimberly Mercille • July 9, 2025
As ketamine therapy becomes increasingly popular for treating mental health conditions like depression and PTSD, more people are exploring their options. At-home ketamine therapy gained traction during the pandemic for its convenience, but without medical supervision, this approach may come with elevated risks. In this article, we’ll explore some of the key differences and pros and cons of in-clinic versus at-home ketamine therapy. What Is In-Clinic Ketamine Therapy? IV Ketamine Treatment In-clinic ketamine therapy involves receiving treatment at a licensed medical facility, such as The Albany Clinic , where professionals monitor and administer the medication under strict protocols. This ensures your safety, especially during your initial sessions. At The Albany Clinic, we specialize in intravenous (IV) ketamine infusion therapy , which has been most well-researched when it comes to treating mental health disorders. IV ketamine bypasses the digestive system, delivering the medication directly into the bloodstream. IV ketamine can help relieve symptoms of various mental health disorders, including depression , anxiety , post-traumatic stress disorder (PTSD) , and more. During an infusion at our clinic, you’ll rest in a calm, controlled environment while ketamine is delivered into a vein through a catheter. Our trained staff will closely monitor your vital signs and mental state throughout the session, adjusting the dose of ketamine if needed. We’ll observe you after treatment to ensure any side effects are managed promptly and effectively. Spravato We also offer Spravato (esketamine) at our clinic, a nasal spray based on ketamine. Unlike other forms of ketamine treatment, Spravato is approved by the FDA and is specifically for adults with treatment-resistant depression or major depressive disorder with suicidal thoughts . Spravato is only approved for in-clinic use under professional supervision and cannot be administered at home, making clinical oversight a legal and medical necessity for this treatment option. During a Spravato session, you’ll self-administer the medication under the supervision of our medical staff. We’ll then closely monitor you for a couple of hours to ensure you’re safe and all side effects have subsided before leaving. What Is At-Home Ketamine Therapy? At-home ketamine therapy allows patients to self-administer the ketamine, typically in the form of lozenges or nasal sprays, delivered via mail. While this option offers flexibility, it usually involves minimal supervision , often limited to virtual check-ins with healthcare providers. Some at-home providers offer optional video support during sessions, but this is not always the case. Patients are largely responsible for monitoring their own physical and emotional reactions, without the benefit of immediate medical intervention if adverse effects occur. At-home treatment often includes supplementary materials , such as guided meditations or journaling tools. However, the lack of real-time clinical oversight makes this option less ideal for those with complex or severe mental health needs. Safety Considerations: In-Clinic vs. At-Home While ketamine therapy is considered safe for most patients, it does come with potential physical and psychological side effects , including: Physical Risks: Elevated blood pressure or heart rate Nausea or vomiting Sedation or dizziness Impaired coordination Rare allergic reactions Psychological Risks: Hallucinations or dissociation Temporary confusion or anxiety Emotional vulnerability during treatment Risk of misuse or dependency The FDA has issued warnings about at-home ketamine use due to its potential for abuse and lack of medical supervision . Without proper monitoring, the risk of addiction and long-term complications, such as bladder damage and cognitive decline, may increase. Key Differences Between In-Clinic and At-Home Ketamine Therapy

A Guide to IV Ketamine

By Matt Rodriguez • July 8, 2025
Intravenous (IV) ketamine has emerged as a promising option for individuals struggling with treatment-resistant depression and other hard-to-treat mental health conditions. Ketamine was originally developed as an anesthetic, but is now being used in controlled medical settings to deliver rapid relief when traditional therapies fall short. This guide explores the history, science, benefits, and practical considerations of IV ketamine therapy and what you can expect from treatment at The Albany Clinic.

Stellate Ganglion Block (SGB) for Depression

By Kimberly Mercille • May 27, 2025
Stellate Ganglion Block (SGB) is an emerging mental health treatment that targets key mechanisms linked to depression. In this article, we’ll discuss the science behind SGB and its potential benefits. If you or someone you know is struggling with depression, this information can help you make an informed decision about whether SGB might be the right option. What is a Stellate Ganglion Block (SGB)? What is the Stellate Ganglion? The stellate ganglion is a cluster of sympathetic nerves located on each side of the neck near the first rib. These nerves are part of the autonomic nervous system, which controls automatic body functions like heart rate, blood pressure, and digestion. The term "stellate" means "star-shaped" because the ganglion often looks like a star under a microscope. It helps regulate the body's stress response by controlling norepinephrine, a chemical that triggers the fight-or-flight reaction. When this system becomes overactive, it can cause various physical and psychological problems, including depression. Stellate ganglion block (SGB) therapy may help by reducing the activity of the stellate ganglion, calming the fight-or-flight response, and lessening the damaging effects of prolonged nervous system stress. How Does Stellate Ganglion Block Work? Stellate Ganglion block (SGB) is when a local anesthetic is injected near the stellate ganglion. These drugs inhibit transmission between nerve cells, dampening activity in the ganglion. They typically include lidocaine, bupivacaine, or mepivacaine, which are sometimes combined with a steroid medication. Patients may also receive another medication to relax them before treatment. SGB is typically performed using ultrasound guidance . The injection process lasts no more than 10 minutes, but patients will motinoted for another 30-45 minutes after treatment to ensure their safety. How Does Stellate Ganglion Block Work for Depression? Chronic stress is a major contributor to depression and is often linked to an overactive sympathetic nervous system. People with depression commonly show high levels of cortisol, a hormone that plays a key role in the body's stress response, in their blood stream. Cortisol is helpful in small doses, but when chronically elevated, it can disrupt neural circuits in the brain. Excessive cortisol can lead to: Neurotoxicity - Cortisol can be toxic to nerve cells, especially in the hippocampus, which is crucial for memory and emotional regulation. Overinflammation - Cortisol increases the activity of the body’s natural defense system, resulting in the system causing damage to nerve cells. Impaired synaptic plasticity - Cortisol inhibits the capacity for the brain to “re-wire” itself. This makes it harder for people to adapt to stressful situations and learn new patterns of behaviour. Disrupted sleep - High cortisol can prevent people from sleeping well. During sleep, restorative biological processes occur in the brain, and excess cortisol can prevent these from happening. SGB decreases sympathetic nervous system activity, which can reduce cortisol levels. This can help restore function in brain areas and pathways associated with positive mood, emotional regulation, and stress resilience. Evidence Supporting SGB for Depression To date, there’s very limited evidence supporting the use of SGB for depression. One pilot study found that SGP significantly reduced depression symptoms in people with treatment-resistant depression (TRD) and was well-tolerated. However, there was no significant difference to the placebo group and the sample size was very small. Nonetheless, multiple lines of research show that SGB can alleviate symptoms of post-traumatic stress disorder (PTSD), which shares similarities with depression. In a trial of SGB for PTSD , participants reported significantly lower scores of depression following treatment. Who May Benefit from SGB for Depression? SGB is primarily utilized for treating PTSD, so individuals with PTSD who also experience depression may find SGB beneficial. Additionally, SGB has shown potential in alleviating anxiety symptoms, suggesting it may be advantageous for those dealing with both depression and anxiety. Because SGB isn’t approved by the FDA, it is typically only used when standard treatments like antidepressants and psychotherapy haven’t worked. SGB is an “off-label” treatment, much like ketamine therapy or brain stimulation therapies. Importantly, SGB may not be suitable for everyone because of medical reasons. Contraindications include: Recent myocardial infarction Coagulopathy or anticoagulant therapy Glaucoma Pre-existing contralateral phrenic nerve palsy Severe emphysema Cardiac conduction block Potential Risks and Side Effects of SGB Common Side Effects Most side effects of SGB are temporary and resolve as the anesthetic wears off. These may include: Hoarseness or Voice Changes: The proximity of the stellate ganglion to nerves controlling the voice box can lead to temporary hoarseness. Drooping Eyelid (Ptosis): Temporary drooping of the eyelid on the side of the injection may occur. Red or Bloodshot Eyes: Some individuals may notice redness in the eyes following the procedure. Watery Eyes and Nasal Congestion: Increased tearing and nasal stuffiness are possible but typically short-lived. Sensation of a Lump in the Throat and Difficulty Swallowing: Some individuals may experience a sensation of a lump in the throat and have difficulty swallowing after the procedure. Warmth or Tingling in the Arm or Hand: A warm or tingling sensation in the affected limb may be experienced temporarily. Although uncommon, some individuals may experience more serious complications, such as nerve damage, seizures, and allergic reactions. Given the potential risks, patients interested in SGB at the Albany Clinic will have an in-depth consultation with one of our qualified healthcare professionals before undergoing treatment. They can assess your medical history, current health status, and the potential benefits and risks of the procedure in your specific case. SGB for Depression in Illinois If you're in the Carbondale area and interested in the potential benefits of SGB for depression, the Albany Clinic is here to help. We specialize in innovative mental health treatments, including SGB, which has been shown to provide rapid relief from mental health symptoms, with effects lasting several weeks. Our experienced team offers personalized support, guiding you through every step—from determining if SGB is the right option for you to exploring alternative treatments and financial considerations. Contact us today to learn more about how we can support your mental health journey.