As a relatively new therapy for Major Depression and associated anxiety and other mental health disorders, many prospective patients will naturally want to weigh the pros and cons of TMS (Transcranial Magnetic Stimulation) and its success rate. 

Read More: Pros & Cons of TMS →

Approved for the treatment of Major Depressive Disorder in 2008, TMS is still finding its foothold amongst traditional treatments, and the wider medical community often remains largely unaware of TMS and its benefits compared to typical treatments. To get a better picture of the efficacy of TMS, it helps to compare it to the success rates of more conventional treatments for depression and to consider the number of individuals that suffer from depression.

Antidepressant success rate

Standard initial treatment for Depressive and Anxiety Disorders typically includes medication management with antidepressants. Between 2015-2018, over 13% of US adults had used antidepressants in the last 30 days, and usage amongst women was double that of men. In total, approximately 25+ million American adults are taking antidepressants.³ With this many people taking antidepressants at any one time, we would hope for strong success rates with the use of medications. Unfortunately for many suffering from depression, this is not the case.

The most frequently quoted study regarding this is the STAR*D trial - Sequenced Treatment Alternatives to Relieve Depression.⁴ This study looked at remission rates from depression for adults receiving antidepressant treatment across the United States. Patients received four stages of treatment with different medication(s) at each ‘step’ in treatment. This large study showed that each step of treatment led to a decreasing chance of success for remission and a corresponding increased likelihood of stopping medication secondary to side effects. The table below depicts this.

In addition, at the end of the study, nearly one-third of all patients still had not achieved remission from depression. Even those that did experience remission initially, often relapsed back into depression. Relapse rates varied from 40-71% across all the steps of treatment, and increasing frequency of relapse with more medication trials. 

Therapy success rate

What can the STAR*D trial tell us about therapy success? Step 2 of the study involved the option of adding cognitive behavioral therapy (CBT) to the 2nd medication trial. The remission rate for these individuals was still only 31%, however, and it took an average of 55 days to reach this remission. There are many other studies that point to therapy as an effective treatment for mild to moderate depression, but there is less convincing evidence for response to therapy in severe major depression.⁵ Patients can also attest to the fact that the quality and success rate of therapy can vary widely between counselors. There is also a considerable time commitment needed for therapy, often entailing months or even years, and each session typically takes an hour or longer. 

Read more: TMS For Postpartum depression →

Electroconvulsive Therapy Success Rate

ECT also requires inpatient monitoring and anesthesia to induce a seizure safely with a period of recovery following. There can also be substantial cognitive risks such as memory loss. Unfortunately, its historic, and often intimidating reputation renders it unpopular despite huge modern improvements. With that said, there are valid reasons to not pursue ECT and even this strategy doesn't always work.

TMS success rate

This finally brings us to the success rate for Transcranial Magnetic Stimulation. 

In one of the most frequently quoted and large studies using TMS for treatment of depression, 58% of patients experienced significant response and 37% of patients experienced full remission after 30 treatment sessions.¹⁰ Another study that extended treatment up to one year and included patients that received additional TMS treatment as necessary (about ⅓ of patients), showed an increased response rate of 67% and remission rate of 45%.¹¹ Drop-out rates consistently are only around 5% across many studies to date with no systemic side effects. These aforementioned studies date back to 2012 and 2014 and many TMS centers are reporting even higher rates of remission today. The largest current TMS patient registry of 10,000+ patients is getting similar results depending on which rating scale is utilized.¹²

Read more: TMS Myths vs Facts →

TMS registry data of 10,000+ patients

Success rate in comparison

Most insurance companies will require at least two antidepressant failures to pursue TMS treatment. Using a third medication trial as a benchmark, we see that medications only resulted in a 16.2% remission rate in the pivotal STAR*D trial. The response rate was not much better at less than 20%. Therapy might increase this to 31% remission, but this was in a highly structured setting with frequent and standardized counseling. If needing a fourth medication trial, the results are even poorer with just 7% of individuals experiencing remission. ECT success rates are much higher, but ECT involves a number of barriers to routine use and potential side effects as referenced. 

TMS therapy at Inspire TMS Denver

As a patient of Inspire TMS Denver, all TMS treatment options will be discussed with you before embarking on a course of treatment. We always take into account additional medication and non-medication treatments that may improve your chance for success. We coordinate with your established treatment providers to ensure the right combination of therapies are being utilized.¹²

We also help you to incorporate additional tools to fight depression, anxiety, and other mental health symptoms. We ensure you understand the chance for success with TMS therapy and how this is influenced by other therapies. Our treatments are tailored to your individual needs to achieve optimal response.

Whatever TMS treatment you choose, rest assured that Inspire TMS Denver will tailor treatment protocols to your individual symptoms and situation. We promise to keep you informed and comfortable with your individual care plan. More questions about TMS Therapy Success Rate, how it compares to other standard treatments, or other information on this page? Please contact us to see about a free consultation.