tms therapy

This article will provide a thorough and informative comparison between TMS and ECT as two distinct approaches to mental health care, with information about critical differences between TMS and ECT and consideration for different treatments.


When it comes to mental health treatment options, many people wonder about TMS therapy vs. ECT.

TMS stands for transcranial magnetic stimulation. It occurs in a clinical setting or a doctor’s office, and you remain fully awake. Instead of relying on electricity, it uses electromagnetic pulses that feel like a tapping sensation against your head. These sessions deeply penetrate the brain to activate nerve cells and stimulate blood flow to regions that might not be functioning correctly. It’s a common treatment for depression, anxiety, and even migraines.

ECT stands for electroconvulsive therapy. It is a unique form of treatment for severe cases of psychosis or schizophrenia that has to be performed under general anesthesia in an operating room. It uses electricity to stimulate the brain around 5-second intervals, inducing a small seizure. It’s a mild seizure that helps reset the brain to return to normal functioning.

Key differences between TMS and ECT

What is the difference between TMS and ECT? While both are used to treat things like depression, there are several key differences.

Treatment approach and mechanism

The biggest difference between TMS and ECT is the mechanism used.

ECT relies on electrical currents that force a seizure. When the brain seizes, it can restart some areas of the brain that might contribute to mental health disorders.

TMS relies on low-intensity magnetic pulses instead, and these stimulate nerve cells within the brain to encourage better blood flow and growth to areas that might be stunted.

Targeted brain regions

ECT targets the whole brain by causing the seizure, whereas TMS can be more localized, penetrating deeper areas of the brain and targeting particular regions based on the outcome desired.

Anesthesia and recovery

TMS and ECT might be used to treat similar conditions, but the methods are different. ECT uses anesthesia, so you are entirely out cold during the process. This increases your risk of anesthesia-related complications, and long-term anesthesia could have potential health ramifications.

Moreover, it takes longer to recover from anesthesia, and the grogginess you feel immediately after the session requires other people to be present to help bring you home. You may not be able to work or go back to regular activities for several hours until the anesthesia wears off.

By comparison, TMS does not require anything and is much gentler; you are awake during the course of your treatment, and you can get yourself home safely with very little recovery time.

Duration and frequency of treatment

With TMS vs. ECT therapy, there are differences in duration and frequency, too.

ECT is typically administered two or three times each week for a total of 10 or 12 sessions. Each session is normally 60 minutes. This means most clients go through treatment over the span of six weeks.

TMS is typically administered up to five times per week for a total of anywhere between 20 and 40 sessions. Each TMS session typically lasts 20 to 30 minutes. This means most clients go through treatment over the same span of time, but they have increased shorter sessions.

Side effects and safety profile

There are significantly more side effects with ECT vs. TMS.

There are not only more ECT side effects, but they are typically more intense. Some of the side effects can occur because of the anesthesia, but others can be a result of the treatment and include the following:

  • Confusion, which can last an hour
  • Short-term memory loss
  • Nausea
  • Headaches
  • Jaw pain
  • Muscle aches
  • Blood pressure changes
  • Adverse anesthesia reactions
  • Changes to heart rhythm
  • Seizures
  • 1 in 50,000 can die from it

Because it uses magnetic impulses instead of electrical currents, typical side effects for TMS are much less severe, and most of them diminish after several sessions. Some examples include the following:

  • Headaches
  • Dizziness
  • Lightheadedness
  • Skin discomfort from the electromagnetic pads
  • Twitching

Applicability to different mental health disorders

ECT is uniquely designed to treat severe psychiatric conditions, particularly schizophrenia and psychosis.

TMS can be used for depression, OCD, substance abuse disorders, anxiety, and even migraines.

tms consulting

Factors to consider when making a decision

If you are deciding between TMS vs. ECT, there are three key factors to consider:

The severity of the condition

ECT is much better suited for severe conditions. If you are struggling with severe psychosis or schizophrenia, this is a viable treatment to consider because it can shock the brain more intensely and reset functions throughout several areas.

If you are struggling with a mild or moderate condition like depression or anxiety disorders, even substance abuse, mild resets can be possible with TMS.

Patient preferences

Your personal preferences should come into play when you consider TMS vs. ECT. If you prefer something safer, with fewer side effects, and can be done in just about any clinical setting and not an operating room, TMS is a better choice.

Medical history and contraindications

With ECT vs. TMS therapy, you have to be aware of any side effects unique to specific conditions. You should review your medical history for any contraindications. You can work with a healthcare provider to look at any medications you are currently taking or any history of conditions that would otherwise influence the effectiveness or increase the risk of side effects for both treatments.


ECT stresses the cardiovascular system and changes blood pressure. As such, it is not recommended for anyone with a diagnosed heart condition or heart disease or who is on medication for blood pressure.

ECT causes mild seizures. If you have a history of seizures or epilepsy or are taking any anticonvulsant medications, this therapy is not recommended for treatment.

Consult with professionals

When making a decision between TMS therapy vs ECT for mental health treatment, it is essential to discuss your needs with a psychiatrist or mental health specialist. Consultations with your primary healthcare provider or another healthcare professional can give you case-specific insight, especially given your history of any medication, personal preferences, and condition.

Summing Up

When comparing TMS vs. ECT therapy for mental health treatment, it is essential to note the key differences and which factors need to be considered when making a decision. You can find personalized treatment when seeking professional guidance through health consultations.