148 – Transcranial Magnetic Stimulation

The Body of Evidence

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The opening of a new private clinic spurs Chris and Sophie to ask whether Transcranial Magnetic Stimulation (TMS) is real medicine or pseudoscience. How does a magnetic field stimulate the brain and how is this different from electric convulsive therapy (ECT)? Also, a brief digression on One Flew Over the Cuckoo’s Nest and other classic movies Sophie has never seen.

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Editor: Robyn Flynn

Theme music: “Fall of the Ocean Queen“ by Joseph Hackl

Rod of Asclepius designed by Kamil J. Przybos

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Obviously, Chris is not your doctor (probably). This podcast is not medical advice for you; it is what we call information.

References:

1) A study on the efficacy of ECT by Slade et al. http://jamanetwork.com/article.aspx?doi=10.1001/jamapsychiatry.2017.1378

2) The accompany editorial on modern ECT use: Modern Electroconvulsive Therapy Vastly Improved yet Greatly Underused https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2633172 3) A study on the safety of ECT: Lancet Psychiatry study 2021 https://doi.org/10.1016/s2215-0366(21)00168-1 4) Consensus statement on the use of Transcranial Magnetic stimulation (TMS) https://doi.org/10.4088/jcp.16cs10905

5) Network meta-analysis comparing different TMS modalities https://doi.org/10.1001/jamapsychiatry.2016.3644

6) The durability of response after TMS treatment: https://doi.org/10.1016/j.brs.2018.10.001

7) RCT comparing ECT and TMS and showing ECT is more effective: https://pubmed.ncbi.nlm.nih.gov/17202547/

8) The older cochrane review from 2002 suggesting little benefit: https://doi.org/10.1002/14651858.CD003493

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