While TMS and electroconvulsive therapy (ECT) are both effective non-invasive treatments for major depression, the two procedures could not be more different.
ECT works by subjecting a patient’s body to electrical shocks—hence the colloquial term, “shock therapy”—by sending a powerful electric current through their brain. This procedure induces a generalized seizure, which is used to manage refractory mental disorders such as major depression, catatonia, severe or prolonged mania, or treatment-resistant schizophrenia.
Because ECT induces seizures, patients must be sedated with general anesthesia and paralyzed with muscle relaxants, and it can take a long time to recover from a single session—with side effects afterward including short-term confusion and memory loss. Patients who undergo ECT may need a significant amount of caregiver support for some time afterward.
On the other hand, TMS therapy involves no sedation, and TMS patients can be awake and alert through the entire procedure. For the patient, it’s as easy as sitting in a chair for a half hour, and while there may be some minor discomfort, TMS is overall a completely pain-free treatment for depression. Unlike ECT, a patient will not need much, if any, caregiver support afterward.