Does TMS Trigger Complications or Migraines? My Expertise + What Helped

If you happen to’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 most typical TMS unwanted effects, and for individuals like me who’re already migraine-prone, remedies can mild up ache pathways you actually don’t need lit. On this piece, I share precisely what TMS looks 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 means of what really helps: easy TMS headache reduction steps, small changes your technician could make, and sensible migraine-prevention tweaks that allow me preserve going. If you happen to’re trying to find real-world solutions on TMS complications, TMS migraine threat, and find out how to scale back ache with out ending therapy, that is the information I want I’d had on day one.

Soar to:

What Is TMS? TMS Fundamentals You Must Perceive

Transcranial magnetic stimulation (TMS) is a remedy, usually for treatment-resistant despair, that makes use of robust magnetic pulses to stimulate mind neurons. It’s thought-about noninvasive as no chopping of the pores and skin is required. Primarily, an electromagnetic coil is positioned on a particular spot (or spots) in your head. In accordance with 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 unwanted effects aside from ache, together with headache and migraine ache, and lightheadedness. See right here for extra.

TMS Headache vs. Migraine: The best way to Inform the Distinction

TMS headache: localized scalp/temple soreness or stress that tracks with the coil website; normally fades hours after a session.
Migraine: throbbing, usually one-sided, could embody mild/sound sensitivity, nausea, aura, and different signs, and may outlast the therapy day.

Drugs and TMS

Take into account that some medicines can influence the effectiveness of TMS, and you could have to withdraw from them to offer the therapy one of the best probability of working. There are a number of contraindications, too. Extra on TMS security may be discovered right here. Make 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 particular spot to make your hand twitch). This quantity is then multiplied by your “prescription” to establish your goal.

For instance, your motor threshold may be 40% of full energy. Your prescription may be 120%. This implies your goal is 48% of full energy.

While you start every TMS therapy, they are going to 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 anxiousness on the opposite facet of my head. That takes solely 40 seconds per therapy because the pulses are steady.) I can be receiving 30 remedies, one a day, Monday by means 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 power migraine, and with out stepping into medical specifics, let’s simply say that I expertise head ache daily proper now. And, sadly, TMS remedies 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 anxiousness.
The pulses really feel like being hit within the head with an extended, skinny blade. The ache goes by means 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 quick, 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 an important many individuals who’ve few choices. Certainly, if it really works, the ache can be value it.

What Makes TMS Ache Worse?

The primary TMS therapy was horrible, seemingly due to the excessive diploma of hysteria going into the therapy. The second therapy was considerably more easy.

Moreover, in my expertise, I’ve discovered a number of issues that make TMS ache worse. They embody:

Beginning out with head ache (this may be a full-blown migraine or only a headache)
Being migraine- or headache-prone
Entering into with excessive anxiousness
Clenching your muscular tissues
Sickness (I had COVID, and it dramatically elevated the ache; I used to be informed this occurs due to the irritation brought on by sickness)
Lack of sleep

A few of these components are modifiable, and a few aren’t.

What Helps TMS Ache for Me

Counteracting the pain-worsening components, the place potential, might help reduce TMS ache. For instance:

Taking headache treatment earlier than therapy to attempt to decrease the ache getting in. (Make 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 take advantage of throughout remedies embody:

Rubbing the spot on my head the place the stimulation goes to be to attempt to calm down the muscular tissues as a lot as potential.
Making chit-chat with the technicians beforehand to assist alleviate anxiousness.
Specializing in one thing constructive as an alternative of the upcoming ache.
Utilizing a mantra. (Mine is, “I’m a skydiver. I can do something.“)
Specializing in deep, sluggish breaths in the course of the therapy.
Focusing very particularly on stress-free all my head muscular tissues throughout therapy (together with between pulses).

If you happen to’re experiencing ache throughout TMS, you possibly can discuss to the technicians, and they are able to barely transfer the coil or regulate the dosage or ramp as much as alleviate it. Additionally, take into account that you could discover the ache extra bearable with repeated remedies.

Lastly, the technicians have a tendency to supply suggestions in the course of the therapy, reminiscent of once I’ve reached my goal dose, how lengthy there may be to go, and so forth. 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 (also referred to as “hard-to-treat”) despair. And “arduous to deal with” is an understatement. I’ve tried each mixture of each drug you possibly can think about, years of remedy, modified way of life components, plus vagus nerve stimulation (VNS) and electroconvulsive remedy (ECT). I’m the poster little one for therapy resistance.

That being mentioned, I’ve excessive hopes. Most individuals who get TMS have some extent of therapy resistance, and the success charge they’ve been seeing on the clinic has been exceptional. 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 remedies in, so it’s a bit early to say. I do have hope, nonetheless.

FAQs About TMS Complications and Migraines

How frequent are TMS complications?

Frequent; many report mild-to-moderate scalp ache early on which will enhance over time.

How lengthy do TMS complications final?

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 following day.

Can I take migraine medicines with TMS?

Usually sure, however ask your prescriber (e.g., timing for triptans, over-the-counter analgesics, anti-nausea medicines, and so forth.).

Having TMS Complications and Migraines With out Derailing Remedy

The underside line is that TMS complications and scalp ache are frequent, and when 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 infrequently enhancing over time, particularly with a plan. What might help is a mixture of clinic changes (reminiscent of a delicate ramp-up to focus on dose, small coil repositioning) and patient-side methods (like correct sleep, calm respiratory, mantra utilization, and clinician-approved medicines). If you happen to’re beginning TMS for despair and questioning whether or not TMS unwanted effects like headache or migraine imply you must cease, discuss to your group first: small tweaks could make an enormous distinction, and lots of sufferers proceed efficiently with the correct TMS headache reduction strategy.