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However, the Food and Drug Administration (FDA) has not yet approved TMS as a treatment option for BD. BD is a mental health disorder associated with periods of mania (extreme highs) and periods of depression or depressed mood. While treatment options exist that can help, they are not always effective, which has led researchers to look for other options. TMS is a therapeutic option that has shown success in treating depression and obsessive-compulsive disorder (OCD). Some studies have also found it to be effective in treating BD. This has led many to believe it could be a viable treatment option in the near future for people living with BD. This article reviews what TMS is, what researchers know about its use and effectiveness in treating BD, potential results, and more. What is TMS Share on PinterestTijana Tosic/EyeEm/Getty ImagesTMS stands for transcranial magnetic stimulation. It is a noninvasive technique that uses magnetic fields to stimulate the brain’s electrical activity in certain areas. In targeting different areas of the brain, a doctor may be able to provide potential benefits to different conditions. Researchers have shown that doctors can use TMS in the treatment of several mental health conditions, such as depression and OCD, and other brain-related conditions, such as migraine. Can TMS treat BD BD is a mental health disorder. It can present differently and may cause unusual changes in:energy levelsmoodconcentrationactivity level and overall ability to complete daily tasks There are three types of BD:bipolar I disorderbipolar II disordercyclothymic disorder While each type of BD has important distinctions, a person living with any of the three types goes through periods of depression or depressed mood and manic episodes. TMS has shown some promising results in the treatment of BD. In a 2019 review of published studies on the use of TMS for BD, researchers noted the following:People living with depressive symptoms saw improvements in their symptoms across multiple studies.People living with mania symptoms had mixed results across multiple studies.Only a few studies have looked at people living with BD during phases outside of manic or depressive states, making a conclusion difficult. In 2021, experts noted that more research is necessary to understand the best frequencies to use and areas to target with TMS for the treatment of BD. Still, as the experts pointed out, in 2020 the FDA gave TMS a “breakthrough device designation” for the treatment of BD. While this is not a formal approval for treatment, it does indicate that sufficient evidence supports its use, and it signals that the organization may expedite the review of TMS treatments for BD. Who is a good candidate for TMS Studies appear to indicate that TMS may benefit people living with bipolar depression. A 2019 review of studies found that studies looking at repetitive TMS for depressive symptoms showed potential, while studies looking at its use in manic episodes were mixed. This suggests that TMS may be most appropriate for people living with depressive symptoms of BD. The researchers also noted that the procedure may work for people who have not responded to psychological or pharmacological intervention for the disorder. In a 2020 study, researchers observed 44 people living with depressive symptoms of BD who underwent TMS. They did not have any subjects who fit the criteria with mania. They noted the following results:77% met their response criteria41% of those who had at least 25 treatments met remission criteria Of those that started the study, four (representing 10% of the study participants) discontinued the use of treatment due to concerns about activating mania. Side effects Experts generally consider TMS safe and noninvasive, but as with other procedures, there are certain risks a person should be aware of. These risks can include:inducing a manic episodebrief headachedizzinesspain (during the procedure)anxietyinsomnia Preparation Currently, the FDA has not approved TMS for the treatment of BD. Information on exactly what a person will need to do for TMS is limited. A person should follow instructions from the researchers in any studies they join. Still, the use of TMS for depression may provide some idea of what a person will need to do to prepare for the procedure. Prior to the procedure, it is likely that a doctor will review certain information with the person by:performing a physical examinationconducting a psychiatric evaluationreviewing personal and family historyreviewing any implanted metal plates or devices, such as pacemakers What to expect TMS is a minimally invasive outpatient procedure. For the procedure, a person will likely sit in a chair with earplugs. Once they are seated, a doctor or researcher will attach a coil-like device near the hairline. The device will then emit magnetic pulses that may feel like a tapping sensation. Each session will likely last from 30–60 minutes. A person may need 25 or more sessions to treat BD, though the exact number of sessions required will vary from person to person. Results Researchers have described TMS as a “promising approach” when used to treat BD. In particular, studies have pointed out its potential use in people living with depressive BD symptoms who have not responded well to other forms of treatment. Other studies have shown that, at least in depression symptoms, TMS can be quite effective in treating BD. All studies have indicated a need for additional research to fully understand TMS’s effectiveness and safety in people living with BD. Costs TMS is currently not available in the United States for the treatment of BD. An older study indicated that each session could cost around $300. Costs will likely change upon approval of TMS for BD treatment. Insurance and Medicare may cover the costs once approval for the procedure occurs. Finding a treatment provider Currently, a person will need to participate in a study to receive TMS for BD. To find an active study, a person can contact their primary care doctor and ask about any recruiting studies they may be aware of. A person can search for TMS treatment for BD studies on ClinicalTrials.gov. This site provides a list of clinical trials that a person may be able to join. Summary TMS may provide an effective form of therapy for BD. Currently, the FDA does not approve TMS as a treatment for BD, but studies have shown that it may provide effective therapy for people with depressive symptoms who have not had success with other treatments. Last medically reviewed on June 13, 2022BipolarMental HealthPsychology / Psychiatry 7 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Bipolar disorder. (2020).https://www.nimh.nih.gov/health/topics/bipolar-disorderBrain stimulation therapies. (2016).https://www.nimh.nih.gov/health/topics/brain-stimulation-therapies/brain-stimulation-therapiesCamprodon, J. A. (2021). Therapeutic neuromodulation for bipolar disorder-The case for biomarker-driven treatment development.https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2777418Gold, A. K., et al. (2019). Clinical applications of transcranial magnetic stimulation in bipolar disorder.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6790310/Goldwaser, E. L., et al. (2020). A retrospective analysis of bipolar depression treated with transcranial magnetic stimulation.https://onlinelibrary.wiley.com/doi/full/10.1002/brb3.1805Mann, S. K., et al. (2022). Repetitive transcranial magnetic stimulation. https://www.ncbi.nlm.nih.gov/books/NBK568715/Simpson, K. N., et al. (2013). Cost-effectiveness of transcranial magnetic stimulation in the treatment of major depression: a health economics analysis. [Abstract].https://pubmed.ncbi.nlm.nih.gov/19330495/FEEDBACK:Medically reviewed by Yalda Safai, MD, MPH — By Jenna Fletcher on June 13, 2022 Latest newsWhat sets 'SuperAgers' apart? 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