November 23

Who is Esketamine for? Who is TMS for? Understand the Differences Between These Two Depression Treatments

 November 23

by Elijah Zoarski

Esketamine and transcranial magnetic stimulation (TMS) are both treatments used in advanced psychiatry, but they target slightly different conditions and work through different mechanisms.

Here’s an overview of each treatment option to help you decide which is right for you:

    1. Esketamine:

      • For Whom: Esketamine is primarily used for the treatment of major depressive disorder (MDD) in adults who have not responded well to other antidepressant treatments. It is often prescribed in conjunction with an oral antidepressant.
      • Mechanism: Esketamine is a form of ketamine, a drug that acts as an N-methyl-D-aspartate (NMDA) receptor antagonist. It is thought to have a rapid antidepressant effect, which can be crucial for individuals with severe depression.
    1. Transcranial Magnetic Stimulation (TMS):

      • For Whom: TMS is used for the treatment of depression, especially for individuals who have not responded well to antidepressant medications. It is also used in the treatment of certain other psychiatric and neurological conditions.
      • Mechanism: TMS involves the use of a electromagnetic coil placed against the scalp. It produces magnetic fields that stimulate nerve cells in the brain. The exact mechanism by which TMS exerts its therapeutic effects is not fully understood, but it is believed to modulate neural activity in specific brain regions associated with mood regulation.

Differences Between Esketamine and TMS:

  • Administration: Esketamine is administered intranasally (through the nose), usually under the supervision of a healthcare professional, while TMS is a non-invasive procedure where an electromagnetic coil is placed on the scalp.
  • Treatment Schedule: Esketamine often requires more frequent administration initially, and the treatment sessions are supervised in a healthcare setting. TMS typically involves daily sessions over several weeks, but the patient can return home immediately after each session.
  • Response Time: Esketamine is known for its relatively rapid onset of action, sometimes providing relief within hours to days. TMS may take a few weeks before patients start experiencing improvements.
  • Side Effects: Both treatments can have side effects. Esketamine may cause dissociation, sedation, and increased blood pressure. TMS is generally well-tolerated, with scalp discomfort or headache being the most common side effects.
  • Indications:
    • What Conditions Can be Treated with Esketamine?
      • Esketamine is a treatment option for Treatment Resistant Depression and has been found to reduce symptoms of Suicidal Ideation and anxiety disorders including OCD.

“Esketamine’s indication is for “treatment of depressive symptoms in adults with major depressive disorder with acute suicidal ideation or behavior” – National Library of Medicine

    • What Conditions Can be Treated with TMS?
      • TMS is primarily approved for the treatment of major depressive disorder (MDD) in certain cases where individuals have not responded adequately to antidepressant medications. However, rTMS has also shown to be effective in reducing unpleasant symptom’s associated with:
        • Treatment-resistant depression
        • Obsessive-compulsive disorder
        • Posttraumatic stress disorder
        • Tourette disorder
        • Chronic pain syndrome
        • Generalized anxiety disorder (GAD)
        • Bipolar disorder
        • Movement disorders such as Parkinson disease, functional tremors, focal epilepsy, cortical myoclonus, spasticity.

It’s important to note that the suitability of these treatments depends on individual factors, and decisions should be made in consultation with a healthcare professional who can assess the specific needs and conditions of the patient.

Still Not Sure Which is Right for You? Take Our Free Depression Quiz, it’s the First Step!

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