Transcranial Magnetic Stimulation

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    Why TMS?

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NON INVASIVE

TMS therapy is non-invasive and does not use any medication.

NEW HOPE

New FDA-approved therapy for treatment-resistant depression.

NO SIDE-EFFECTS

TMS therapy is non-invasive and does not use any medication.

RESTORE BALANCE

Restore and Reclaim your old self again

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. 

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What to expect from TMS

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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 doctor will answer any questions you may have. 

The Consultation:

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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 are 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 attend the full course of therapy to get the most benefit from treatment.

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. 

Results

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Depression and Transcranial Magnetic Stimulation

Many of our patients are referred to our clinic after receiving a depressive disorder diagnosis that is not improving with routine treatment. Our clinic’s specialization in Transcranial Magnetic Stimulation (TMS) provides a practical alternative Acute treatment for depression when medication, such as antidepressants, proves ineffective or harmful. TMS can be considered in the special population who want to avoid taking medications(e.g. pregnancy) or in elderly or medically ill who may not tolerate multiple medication trials.

Symptoms of depression cover a wide range of warnings. Low energy, fatigue, lack of motivation or concentration, irritability, sadness, inability to enjoy activities, guilt, isolation, difficulty sleeping, increase or decrease in eating, decreased sociability, worry, suicidal ideas or intentions, and thoughts of hurting yourself or others are all very common symptoms of depressive disorders.

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Treating Depression with TMS

To qualify for insurance to authorize TMS treatment, the patient must generally have “difficult to treat Depression” or Treatment-resistant Depression. After approval, the patient will undergo an average of 36 total sessions. Our patients generally notice positive changes after the first 1-3 weeks, improving consistently over the process of 4-6 weeks, when the treatment concludes. After the course of 36 sessions has ended, most people will remain well for a year or few years as the benefit of TMS is more enduring than medication. TMS therapy results in long term potentiation of Neuroplasticity and many have remained on minimal medications or none. But, there will be some “tough cases” who may relapse into depression and may need a booster round of TMS therapy within 12 months. Patients with history of frequent recurrence of severe depression may prefer a “maintenance” regimen of regular TMS therapy to prevent going back into the ‘Dark zone’: e.g., weekly once or once every 2 –4 weeks. There are no definitive guidelines on maintenance treatment.

Frequently asked questions

How often is TMS done?


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




Is TMS uncomfortable or painful?


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.




Is TMS like ECT (shock therapy)?


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.




Does TMS therapy cause memory loss?


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




Are there side effects of 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.




Is TMS covered by insurance?


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




Who cannot get TMS therapy?


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




Do I need to be hospitalized for TMS?


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




Who administers TMS?


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.