Curious about this as well. Been considering TMS or Ketamine recently so would love to hear feedback from hackers.
- ~30 minute sessions, 5x a week
- rTMS device stimulates the prefrontal cortex (located through an MRI, and located each session with a pre-measured cap that you wear during the session)
- rTMS is non-intrusive, and seems to have virtually no side effects (unless you have a history of epilepsy, which would have precluded you from the study)
I would describe the sessions as pain-free, with a sense of mild annoyance (the magnetic pulse feels like someone flicking you on the head with a finger). Some other people experienced headaches the first two weeks during treatment, but I didn't experience that.
In terms of effectiveness, I would say that it helped greatly reduce the symptoms of depression for me. I've struggled with depression for ~10 years, and antidepressants would sometimes help, but the side-effects were just not maintainable. With rTMS, I feel like it reduced my symptoms by about 60% (not completely gone, but man can I ever function in life again!).
It's been about 3 months since I participated in the trial, and I am now participating in their maintenance program (2 sessions a month, ~10 minutes per session). At this point, I'm recommending rTMS for those who haven't been able to find anything that works for them yet.
I had rTMS done for a few months, and a couple of different protocols of ketamine infusions.
rTMS was mostly just killing time after I got used to the noise and sensation - the doctor I saw had a TV mounted with Netflix and other services available for you while you sat there.
Ketamine (IV; I haven't tried the esketamine nasal spray that got approved) is an intense experience each time - many doctors advise people sit in dark rooms with headphones playing music while the treatment goes on. I usually describe it as removing a lot of the ability to ignore things - that is, you experience a cognitive burden for all the things you're seeing/hearing/etc in the room, and sufficiently much cognitive burden is draining. It also affects your flow of thought a lot so you don't necessarily track well in conversations with people until you're more experienced. (I also found that it made my emotions very directly influencible by the music or conversation or w/e was going on during the treatment.)
It often makes people nauseous or vomit, so every clinic I've been to stocks an anti-emetic and a bucket.
Some doctors also give you a benzo with the ketamine because it makes it a less intense experience. There's inconclusive research on whether this dulls the antidepressant effect last I looked - I requested during my most recent treatments (mid-late 2018) that they not use it, and they were happy to comply, but it definitely makes the experience less visceral.
rTMS I saw no personal benefit from even after extending the treatment interval past the usual number of weeks. Ketamine I saw massive improvement a month or so after doing an initial treatment of 6 infusions in 2 weeks, but after a few weeks the effect lapsed (though I'd been having "maintenance treatments" periodically), with no recurrence regardless of the protocol we tried.
Please feel free to ask if there's some specific questions that'd be useful to have answered.