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TMS vs Esketamine: Alternative Depression Treatments

Dec 6, 2021

Still struggling with depression despite trying first-line treatment options like talk therapy and medication? You are not alone. Please don’t give up hope as there are still options available for treatment-resistant depression.

If you or someone you love is among the third of people that have not had success with antidepressant medication and are looking for alternatives, you may have heard of ketamine infusions (esketamine) and transcranial magnetic stimulation (TMS).

Below, we will discuss these two options, esketamine and TMS, that are growing in popularity.

A Brief Look at Esketamine (Spravato)

Esketamine is an intranasal ketamine that may be sold under the brand name Spravato. Its antidepressant effects act nearly instantly and can give a person a relaxing and enjoyable experience during its onset. It has also been shown to have a profound effect against suicidal thoughts.

During an esketamine treatment session, the patient may self-administer the intranasal solution under the supervision of a clinician or doctor. During this time the patient will experience the effects of the esketamine under continued supervision for two hours.

The treatments are typically done a couple of times a week for four weeks.

Like TMS, it is a treatment that is only provided to people with treatment-resistant depression — who have tried multiple antidepressants without success.

Side Effects of esketamine can include dizziness, nausea, and dissociation (as esketamine is a dissociative drug). More people find these side effects mild to what they might experience with typical antidepressant drugs. However, you may feel tired after treatment and it is not uncommon to want to sleep the remainder of the day following treatment.

Other less common side effects of esketamine include anxiety, sedation, vomiting, feeling “drunk,” increased blood pressure, or increased thoughts of suicide or self-harm. Though, esketamine typically does has a profound anti-suicidal thought effect.

A Brief Look at TMS Therapy

Transcranial magnetic stimulation (TMS) is another popular treatment for treatment-resistant depression. It is not to be confused with electroconvulsive therapy (ECT) — another alternative for treatment-resistant depression.

Though it might not act as quickly as intranasal esketamine, its effects have also been reported by patients to have had antidepressant effects from the first day of treatment. For most people, they may begin to feel antidepressant effects from TMS after a few treatment sessions.

Treatment sessions for TMS therapy are short and can last anywhere from 6 to 20 minutes, depending on the protocol being used. And, after a patient has received treatment, they can go on about their day and drive themselves home. This is typically not the case with esketamine, and especially not ECT treatments.

You can learn more about the TMS procedure here.

One benefit TMS has over ECT is the fact that it is non-invasive and doesn’t require anesthesia. And, it also does not require sedation in the likes that esketamine does by nature of the drug. Though, it should be mentioned that all three of these treatments are rather successful and should be consulted with your doctor on which one is right for you.

In short, TMS for Depression works by applying electromagnetic pulses to specific parts of the brain that are underactive in those with depression or other mood disorders. These electromagnetic pulses are painless and may give slight discomfort at most.

As with ECT and esketamine therapy, these treatments follow a regime that lasts a number of weeks with multiple sessions per week. At Brain Therapy TMS, sessions are provided 5 days a week for 4 to 6 weeks. Though, individual accommodations will help each client find a schedule that works for them.

Side effects of TMS therapy are either non-existant or usually mild. Some people may become lightheaded or have a slight headache, but there are no systemic side effects. And, severe side effects like the risk for seizure are less than 0.1% of patients.

Choosing Between Esketamine or TMS Therapy

Deciding which treatment-resistant depression treatment option is right for you is between you and your doctor. It is important to consider all things relevant to your condition and situation before deciding which option you want to go with.

Ketamine therapy can be a helpful option with fast-acting effects and provide more of an experience to those who choose it. And, TMS therapy can also be a rather quick-acting treatment that has more of a subtle and gradual effect as compared to esketamine therapy sessions. However, many insurance companies still do not cover esketamine therapy, while TMS has been broadly accepted by most insurers at this point in time.

Here at Brain Therapy TMS, we offer TMS therapy and not esketamine therapy. We respect your autonomy to make a decision about your own health and decide which option is best for you. We’re in the business of helping others become the best (and happiest) version of themselves, and any reasonable aid to help a person get there is appreciated by us here.

We are strong believers in the advancements made in technology that have made transcranial magnetic stimulation what it is today. And, we have high hopes that TMS therapy will continue to become a popular effective option for a range of psychiatric disorders — especially treatment-resistant depression.

If you would like to learn more about TMS therapy and what it can do for you, feel free to browse around the site. Or, give us a call at 619-419-0901 to talk to a specialist who can answer any questions you might have.

Considering TMS Treatment? Schedule a Consultation!

Tired of the results you’re getting from your standard treatment? Transcranial Magnetic Stimulation may be able to increase your chances of long-term remission, reducing your symptoms and allowing you to live a more joyful life.




(619) 419-0901


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1539 Garnet Ave.

San Diego, CA 92109

Brain Therapy TMS 619-419-0901
The leader in TMS treatment
We will gladly answer all of your questions