Transcranial Magnetic Stimulation (TMS)

Transcranial Magnetic Stimulation (TMS) is an FDA-approved treatment [since 2008] for adults with treatment-resistant depression, i.e. those who suffer from major depressive disorder and who have failed to find relief from anti-depressants or have side effects. It is an office procedure where magnetic pulses target the prefrontal cortex of the brain.

Studies have shown that almost a third of patients do not respond to traditional antidepressants and in this difficult to treat population, almost two-thirds achieve a response with TMS.

What to expect from TMS?

The Consultation:

Your doctor and you, in collaboration, will decide if TMS may be right for you. You will then meet one of our therapists who will take a full history and conduct an evaluation, which will include objective tests and scales for depression, fatigue, etc. This will be done regularly during your treatment as well to monitor your progress. We will then attempt to obtain prior authorization from your insurance. Our TMS specialist and the doctor will answer any questions you may have. 

Treatments:

A doctor and TMS specialist will measure the location of treatment and determine the amount of electromagnetic pulse that will be most beneficial to you. It is done by placing the coil on your head and producing one magnetic pulse while watching for movements in the hand and fingers.

 

During subsequent treatments, a coil will be placed on your head.  The TMS machine will be set to your specific treatment measurements. You will hear a clicking noise and feel tapping on your head.

In the first few treatments, patients may feel a mild headache and goes away fairly quickly.

Treatment lasts 20 minutes and is conducted daily, 5 days a week for 4-6 weeks (20-30 sessions). Some patients may benefit from maintenance therapy after their initial treatment course. Please make sure you are attending the full course of therapy to get the most benefit from treatment.

 

Results:

While TMS does not work for everyone, it does work for the majority of people. Results are not instantaneous and it may take 2 or more weeks to begin to notice improvement. 

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FAQ

Most frequent questions and answers

TMS treatment is administered 5 times a week for 4-6 weeks (20-30 sessions). Each treatment time is around 20 minutes

TMS therapy is delivered as a low-intensity procedure that lightly penetrates the skull and brain but without using invasive measures to alter the structure of the brain.
 
Headaches are the most common side effect, but these are usually temporary.

No, TMS is not like ECT.

There are several key differences between these two treatments; For one, ECT relies on a heavy usage of electricity because most of it encircles the skull since electricity doesn’t want to penetrate the solid surface. The amount of electricity applied induces intentional seizures, whereas TMS therapy is not invasive and doesn’t run the risk of damaging the brain.

Patients undergoing ECT are given anesthesia so the seizures aren’t very visible.

However, in TMS therapy, no such seizures are necessary; magnetic pulses easily penetrate the skull without going very deep.

No, there is no memory loss known to correspond with TMS therapy.

About 1 in 10,000 patients may experience a seizure during Transcranial Magnetic Stimulation therapy. It is important to tell your doctor if you have a history of seizures.
 
The most common side effect is mild headaches after the first two or three treatments.

Most insurances cover TMS. We obtain prior authorization from insurance before treatment.

For the most part, just about any type of patient is capable of getting TMS therapy. There are a few exceptions, however. The following types of individuals may not qualify for TMS therapy:
 
  • Patients who have undergone brain surgery and still have magnetic metals in the brain.
  • Patients who have never responded to other depression treatments.
  • Very elderly patients
  • Patients who have seizures

No, TMS is an outpatient procedure. You can drive after the treatment session.

The initial dose finding treatment is always done by a physician.
 
The daily treatments are administered by our trained technicians under the supervision of a physician.