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TMS vs. ECT – Part One of Two

Is TMS Becoming the Standard of Care for Treatment Resistant Depression?

“rTMS is also much less expensive than ECT. But is it cheap and effective enough to justify its use as routine treatment for depressed patients resistant to medication?”


I read this quote in a recent news article entitled, “Wise Buy? Repetitive Transcranial Magnetic Stimulation” with the subtitle, “Cheaper and safer than ECT, the other proven therapy for refractory depression”.

I was instantly transfixed. I knew I would read every word of this article. ECT (Electro Convulsive Therapy) is a therapy that has saved many lives and certainly is a good choice for some. My experience with TMS is groundbreaking as it has proven to earn its place among the top choices for treatment resistant depression.

Finally, does this author really get it? I couldn’t wait to find out what he has to say.

My Journey with TMS

I started following TMS about 25 years ago. Most TMS followers I know became aware of it sometime after it was FDA cleared in 2008. But I was lucky enough to have one of my incredible patients bring TMS to my attention way before it commanded any headlines, except in private institutional memos.  It certainly seems that my journey with TMS was meant to be, from the very beginning.

I had hoped for an alternative treatment that effectively and safely offered help for treatment resistant depression. When TMS was in its early research stages back in the late ‘80s and early ‘90s, it made good sense to me. The more I learned about TMS, the more I came to hope and then believe in it. I’ve been an advocate of TMS for about 25 years now.

Mark S. George, MD, a brain imager, psychiatrist, and neurologist at the Medical University of South Carolina, was the first to use rTMS for depression

Dr. Mark George’s early TMS Research

The article goes on to say that “Mark S. George, MD, a brain imager, psychiatrist, and neurologist at the Medical University of South Carolina, was the first to use rTMS for depression, in the early 1990s. Then at the National Institute of Mental Health, he began by exploring the use of TMS as an experimental tool to study neuronal circuits related to mood. Later, he investigated its use as an antidepressant. By 1993, he had found that daily treatment with TMS over several weeks could treat depression that hadn’t responded to medication.”

A visionary, Mark George saw raw potential. But his early treatments yielded only about a 15-20% remission rate. He wanted more, saying “It was kind of disappointing.”

Today after FDA clearance, George says, “If you ask psychiatrists who are informed about depression, they will say it’s a great tool.” Patients are getting upwards of triple the remission rates of George’s initial tests. TMS is changing lives, not only in the US, but in China as well.

ECT vs. TMS Treatment

Psychiatrists have long desired an alternative to ECT, also known as electric shock therapy. ECT has a dark history, causing seizures and memory loss in many patients. That’s because it’s electric currency cannot be confined to the Prefrontal Cortex, the target treatment area of the brain. Instead, ECT’s electric current saturates the human body and has dramatic side effects.

Enter TMS, with is magnetic treatment technology and ability to confine the targeted area to the Prefrontal Cortex. Side effects are minimal to nonexistent, with treatment appointments scheduled on an outpatient basis. Patients drive themselves to and from each treatment, and carry on with seldom a second thought.

Is TMS Cost Effective?

At Nashville TMS, we have very successfully treated patients who suffer from treatment resistant depression for over five years. Our patients’ response and remission rates exceed the published industry averages. Because the effects of depression are not limited to the individual who suffers, we’re not only changing patient lives, but we’re changing entire families.

“Wise Buy, a MedPage Today series, assesses therapies — new and old — to determine if the treatment is not only a wise choice, but also a wise buy.”

That’s a quote from the article that caught my attention. I’m so pleased that this level of discussion is now surfacing, and becoming widely available to mental health practitioners online.  The article goes on to ask,

“rTMS is also much less expensive than ECT. But is it cheap and effective enough to justify its use as routine treatment for depressed patients resistant to medication?”

Our patients overwhelmingly respond, “Yes!” In fact, many choose to undergo treatment even when their insurance company doesn’t cover TMS. But these days, TMS is routinely covered by all the major carriers. Blue Cross Blue Shield, United Healthcare, Optima, and Medicare are but a few of the national insurers that have adopted coverage policies in the last few years. You can view a more comprehensive list on’s Health Insurance Coverage page.

Many of our patients feel that the price to “get my life back” is very reasonable. What is the price of quality of life? If you’ve experienced the depths of severe clinical depression, you may also feel that way.

Cost of TMS vs. Cost of ECT

As with most covered treatments, TMS reimbursement – especially Medicare – varies by state. In the next post, we will explore the cost of TMS and compare it with the cost of ECT. This information has been elusive until just recently. It’s an important consideration for both patients and providers.

In Part Two, we’ll delve into the costs of each treatment and  hear what experts say about the costs of ECT and TMS.

TMS vs. ECT – Part One of Two

Dr. Scott West

About Nashville NeuroCare Therapy: In April of 2010, Dr. West brought the technology of NeuroStar TMS to Nashville, becoming the first physician in Tennessee to offer the option of Transcranial Magnetic Stimulation (TMS) for patients whose severe depression has not responded to a course of antidepressant medication or treatment for depression. The team at Nashville NeuroCare Therapy offers the most experience in the Tennessee-area. We have treated 550+ patients across the U.S. and administered 16,000+ TMS treatments, plus we maintain some of the highest percentages of positive patient responses and remission rates in the industry.

At Nashville NeuroCare Therapy, we deliver personalized therapy, specializing in TMS Therapy and Neurofeedback. We provide safe and well-researched therapies for depression, ADHD and sleep problems—all without the need for medication.

For more information on our therapies for Depression, ADHD and Sleep Problems, please contact us at (615) 465-4875 or or or visit our website

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APA Reference
West, W. (2016). TMS vs. ECT – Part One of Two. Psych Central. Retrieved on October 1, 2020, from


Last updated: 24 Feb 2016
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