Frequently Asked Questions About TMS Therapy

FAQs about Treating Depression with TMS 

Will TMS work for me?

 -Rachel N. (Lakewood)

I believe that TMS is an extremely powerful tool that can be utilized to achieve a certain mental stability. It’s not a magic pill-there are no guarantees in medical treatment-and it won’t work on its own. What TMS Solutions offers people is a research-based treatment cutting-edge treating for depression. TMS therapy increases your chances of getting better after having failed multiple antidepressants.

I think there are practices that every patient can and should adopt while undergoing treatment. 

  1. Sleep is crucial—try to develop a healthy sleep regimen. A good sleep regimen, although extremely difficult for some, is the goal.
  2. Watch your diet—try to eat a well-balanced diet, staying away from highly processed foods, sugars, and alcohol.  
  3. Exercise! Work those muscles, get the blood pumping and the endorphins flowing.
Continuing these three key practices after TMS therapy will help patients cope when treatment ends.

 

Will TMS Work For Me?

What can I do during TMS Treatment?

Am I allowed to watch TV, read a book, listen to music, meditate, etc. during treatment?

Holly B. (Cherry Creek) 

Of course! Because TMS Therapy is non-invasive, you are awake and alert throughout your sessions. You are free to do whatever you would like with your treatment time-except sleep! Studies show that if a patient is not alert during treatments, efficacy of TMS Therapy is reduced as brain wave patterns change during sleep. (Sorry)

If you choose to listen to music, please make sure your headphones or earbuds are rated to 30 dB of hearing protection. At TMS Solutions, we like to get to know our patients and build a professional relationship during our time together, so be sure to save a few minutes for us to talk with you during your treatment.

 

What Can I Do?

What happens if I miss a session?

All TMS Solutions clinics are open for treatments from 9am-5pm. Our technicians do an incredible job of balancing current patient load with after-hours requests. They will be as flexible as possible, within reason, to help a patient fulfill their commitment to TMS treatments. Improving a patient's quality of life is our #1 goal!

 

How much does the treatment cost?

Insurance and self-pay options are available for those who are interested in TMS Therapy. If insurance does not cover treatment, we offer a sliding fee scale for self-pay patients. This scale factors in household size and annual income, and may greatly reduce the out-of-pocket cost for patients who qualify for assistance. At TMS Solutions, we make every effort to ensure treatment is affordable for everyone.

 

Cost of TMS Therapy

Would you like to speak with a Patient Advocate?

If you think TMS Therapy is right for you, let's talk about the next step.
Contact us using one of the links below to talk about treating your depression.

More questions about TMS Therapy

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What Is TMS Therapy?

What is TMS?

TMS is a process that uses short pulses of a magnetic field (like an MRI) to stimulate/modulate nerve cells in the area of the brain thought to control mood. The pulsed magnetic field may have a positive effect on the brain’s neurotransmitter levels by targeting the regions of the brain thought to be responsible for mood regulation.

What is TMS

>>Learn more about TMS Therapy

How does TMS Therapy work?

Once the TMS device is positioned, it creates a deep magnetic pulse that targets and stimulates neurons in the left prefrontal cortex to restore normal function in these under-performing areas of the brain. This pulse comes in rapid succession and is thought to stimulate regions of the brain that are linked to emotion. In depressed patients, these emotion-baring regions are shown to be very non-responsive compared to healthy patients.

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How is TMS administered?
Transcranial Magnetic Stimulation is administered by placing a device on the top front portion of the head. The device sends a magnetic pulse to the brain. The device is positioned by a technician and the patient sits or reclines comfortably in a chair. The actual portion of the treatment takes approximately 37 minutes.How is TMS administered
Who should receive TMS Therapy?

NeuroStar TMS Therapy® is indicated for the treatment of Major Depressive Disorder (MDD) in adult patients who have failed to receive satisfactory improvement from prior antidepressant medication in the current episode.

The NeuroStar TMS Therapy System is available upon prescription by a licensed physician. It can be used in both inpatient and outpatient settings including physicians’ offices, clinics, and hospitals.

Is TMS suitable for everyone?

While TMS Therapy is considered to be a well-tolerated treatment, there are some patients it is not suitable for:

  • Patients with a history of seizures
  • Patients who have any type of non-removable metal implant in or near their heads (with the exception of braces or dental fillings)
  • Patients with any type of non-removable metal within twelve inches of where the coil is placed

Failure to follow this rule could cause the object to heat up, move, or malfunction, and result in serious injury or death.

The following is a list of metal implants that can prevent a patient from receiving TMS:

  • Aneurysm clips or coils
  • Stents in the neck or brain
  • Implanted stimulators
  • Cardiac pacemakers or implantable cardioverter defibrillator (ICD)
  • Electrodes to monitor brain activity
  • Metallic implants in your ears and eyes
  • Shrapnel or bullet fragments in or near the head
  • Facial tattoos with metallic or magnetic-sensitive ink
  • Other metal devices or object implanted in or near the head

To determine if TMS Therapy is suitable for you, your doctor or psychiatrist will carefully screen you for the presence of medical conditions or metal objects which may make TMS either unsuitable or harmful.

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What Benefits Can I Expect From TMS?

How long before I feel differently or better?

Patients typically need between 20 to 30 sessions of TMS to gain the most benefit in the treatment of their depression symptoms. 

In clinical trials, 1 in 2 patients achieved significant relief of symptoms after four weeks of treatment (20 sessions), and 1 in 3 experienced complete remission after six weeks of treatment (30 sessions). Some patients may experience results in less time, while others may take longer.

What are some benefits of TMS Therapy?

For many patients suffering from severe depression symptoms, TMS Therapy can be life changing. Some of the benefits of TMS Therapy include increased vitality, enjoyment of the little things in life, improvement in relationships, and an overall better quality of life.

Remission from depression is possible, and it may even be possible to reduce your current levels of medication. Your doctor can advise you about what happens once you complete treatment.

Does TMS Therapy cause brain tumors or memory loss?

No, TMS Therapy doesn't cause brain tumors.

In clinical studies, approximately 5 percent of patients experienced slight memory loss or confusion.  However, these effects were only temporary, and there is no evidence that TMS Therapy causes permanent or even long-term memory loss.

What if I don't feel the benefits from TMS Therapy?

If you feel that you or your loved one has not experienced positive results from TMS Therapy, there are other options available. Some patients with more severe, or resistant depression, may find greater improvement from other brain stimulation techniques such as Electroconvulsive Therapy (ECT) and Vagus Nerve Stimulation® (VNS).

Your doctor or psychiatrist will be able to assist you with other treatment options. 

What I feel a "dip" during my TMS Therapy?

The term "dip" refers to the effect which sometimes happens when you feel the progress of your TMS Therapy is temporarily reversed. 

Symptoms of the dip can include a sudden and deepening increase in depression, and it can appear as though there has been an almost complete reversal of progress. For this reason, the dip can feel very defeating and cause undue stress to a patient undergoing TMS Therapy.

It is important to remember that these effects are only temporary. People who experience this reversal in progress generally bounce back and continue onward toward the goal of alleviating their depression symptoms.

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The TMS Therapy Process

How do I get started with TMS Therapy?

Patients typically begin TMS Therapy after being prescribed the treatment by their doctor or psychiatrist. 

You can also call us directly at 844-537-6747 to talk about the suitability of TMS Treatment, to schedule an initial assessment, and to see if TMS Therapy makes sense for you. At that time, we will advise you of next steps.

Is the treatment in an office or at a hospital?

TMS Therapy is an outpatient procedure that takes place in your doctor’s office or one of our clinics. Though not as common, it is possible to receive TMS at a hospital such as the Mayo Clinic, or any major hospital offering the treatment.

Because there is no sedative or anesthesia administered during TMS Therapy, patients do not need to be hospitalized for treatment and can immediately resume normal daily activities. In fact, because the treatment is non-systemic (nothing is circulating in your body's system), you can safely drive yourself to and from appointments.

Who administers the TMS treatment?

Regardless of who prescribed TMS Therapy, a trained TMS technician or doctor should administer actual TMS treatments and guide you through each session.

A TMS technician or doctor should always be present to monitor the patient during treatment, and the patient should be allowed to stop a treatment at any time by asking the technician or doctor.

How long is TMS Therapy treatment?

FDA protocol for TMS Therapy is 30 treatments, which are typically performed five days a week for six weeks. We have found it important to administer treatments back-to-back and provide weekends off for a breather of sorts.

While each appointment lasts approximately 60 minutes, part of that time is spent calibrating the machine for the patient’s protocol. The actual treatment is approximately 37 minutes long.

Depending on insurance coverage, taper sessions may be included and can be stretched over two to three weeks.

Are appointments available before or after usual work hours?

All TMS Solutions clinics operate from 9am-5pm. Our technicians do an incredible job of balancing current patient load with after-hours requests. They will be as flexible as possible, within reason, to help each patient fulfill their commitment to TMS treatments. Improving a patient's quality of life is our #1 goal!

What can I do during my appointment?

Because TMS Therapy is non-invasive, you are awake and alert throughout your sessions. You are free to do whatever you would like with your treatment time-except sleep! Studies show that if a patient is not alert during treatments, efficacy of TMS Therapy is reduced as brain wave patterns change during sleep.

Listening to music, an audio book, or guided meditation through a mobile device may prove useful while receiving TMS treatments. If you choose to listen to music, please make sure your headphones or earbuds are rated to 30 dB of hearing protection.

Positive and constructive outlets or conversation with the technician are highly encouraged. Studies show that neural activity is increased by TMS Therapy, so during this time it is beneficial for patients to be engaged in a nurturing, interactive environment.

Can I bring friends, family, support animals into the treatment room with me?

To decrease the risk of exposure during COVID-19, we ask that only patients are present in the treatment room with the technician.

Service animals are welcome. We kindly ask that non-service animals or pets are kept at home.

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Success And Safety Of TMS Therapy

Is TMS Therapy safe?

NeuroStar TMS Therapy has been cleared by the FDA, and is a proven safe, easy to tolerate treatment for depression. It doesn’t have the side effects often associated with antidepressant medications.

Worldwide, more than three million patients have been treated with TMS Therapy.

Are there short or long term side effects?

The overwhelming majority of patients experience no side effects. However, some patients may experience a headache after treatment and sensitivity at the treatment site. Some may report slight dizziness or lightheadedness after treatment, which typically resolves before the patient leaves the treatment room. 

An over-the-counter pain reliever is recommended when starting TMS Therapy. It can help patients acclimate to treatment and may be discontinued once the patient is able to tolerate the prescribed treatment level.

In 10,000 treatments administered during clinical trials, the most common side effects were mild to moderate scalp discomfort and mild headaches, both of which usually went away after the first week of treatment.

In rare instances, there were reports of acute memory loss, minimal cognition interruption, facial twitching, and seizures. These side effects were acute and TMS treatment showed no long-term effects.

Has TMS Therapy been cleared or approved by the FDA?

After more than two decades of research and clinical trials, TMS Therapy was cleared by Canada Health in 2003 and cleared by the US Federal Drug Administration (FDA) in 2008. It has also been approved in Europe, Israel, and Australia. As such, the actual administering of TMS is very precise and well regulated the world over.

Does TMS Therapy hurt?

TMS is an essentially painless process. Because the magnetically induced current does not pass through the skin, where most of the pain nerve ending are located, the actual treatment feels like a tapping on the skull.

However, some patients may experience scalp sensitivity at the treatment site or a headache. These and all observed side effects are acute and should be temporary.

If symptoms persist, an over-the-counter pain reliever may be taken or, to make treatment more comfortable, the TMS technician can reduce the strength of the magnetic field pulses being administered.

Less than five percent of patients treated with TMS Therapy discontinued treatment due to side effects.

I am prone to migraines. Can I still receive TMS Therapy?

Yes, a patient who suffers from chronic migraines can still undergo TMS Therapy. Although mild headaches have been reported during treatment, this is not a frequent occurrence. There are actually ongoing research studies looking into TMS as a potential treatment for migraine sufferers. 

I have metal in my mouth from dental work. Will that interfere with TMS?

In most cases, dental work does not interfere with TMS therapy. Consult with a physician or TMS technician to be sure it's safe for you to begin treatment.

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TMS vs. ECT And Other Treatments

Is TMS like Electroconvulsive Therapy (ECT)?

TMS therapy works by stimulating the neurons in the brain, increasing that activity over time and helping to re-establish hypoactive neural pathways. This increased neural activity alleviates the symptoms of depression. The patient is awake throughout treatment and no sedative or anesthesia is necessary. Side effects of TMS can be mild to moderate headache and discomfort at the treatment site, both of which are temporary.

Electroconvulsive therapy or ECT, is designed to trigger a seizure in the brain, like a hard reboot in a computer. It requires an anesthesiologist to administer an intravenous anesthetic and muscle relaxer. ECT has potential side effects, such as an acute state of confusion upon coming out of anesthesia, and loss of short-term memories.

>Learn more about TMS and ECT

What are the main differences between TMS and antidepressants?
The main differences between antidepressant medications and TMS Therapy include:
  • Antidepressants are systemic, meaning that the medicine enters the body and blood stream.
  • TMS is non-systemic. It is a drug free, FDA-cleared process for treating depression.
  • Like many drugs, antidepressants have numerous side effects such as insomnia, blurred vision, dry mouth, fatigue, weight gain, nausea, GI distress, diarrhea, sedation, lack of emotion, and sexual dysfunction. 
  • Some TMS patients have experienced a headache or scalp sensitivity at the treatment site. 
  • TMS is usually prescribed when antidepressants fail, or the side effects are intolerable.

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Is TMS Therapy a good alternative to antidepressants?
Yes, many doctors and psychiatrists now agree that TMS Therapy can be good alternative for patients who cannot tolerate the side effects associated with antidepressant medications, do not wish to take them, or are not getting the results they had hoped for. Like many drugs, antidepressant medications have numerous side effects such as insomnia, blurred vision, dry mouth, fatigue, weight gain, nausea, GI distress, diarrhea, sedation, lack of emotion, and sexual dysfunction.
Should I take my medication(s) before, during, and after TMS Therapy?

The goal of TMS Therapy is not to completely discontinue medication, as treatment resistant depression is a chronic and recurring condition.

You should take your medication(s) before beginning treatment.

Your doctor may advise you to continue taking your antidepressant medication while receiving TMS therapy. It is possible that TMS may increase the ability of current medications to be more effective. 

After treatment, you should discuss your medication(s) with your doctor and take an appropriate course of action.

Medication management is under complete control of the primary physician and can be increased or decreased at their discretion.

Can I receive Ketamine or ECT treatments at the same time as TMS?

Currently, research studies are looking into combining Ketamine and ECT with TMS Therapy. Because this is still experimental, it is recommended that the patient finishes their course of treatment two weeks prior to starting TMS Therapy.

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TMS Cost And Insurance Coverage

Is TMS covered by my insurance?

All major medical insurance covers TMS Therapy, including Medicare and TriWest (VA). Our patient advocates will contact the patient's insurance provider to determine eligibility for treatment. Depending on the plan’s deductible, co-insurance, or co-pay, there may be out-of-pocket costs for treatment. The patient advocate will go over that with the patient before treatments begin.

For a list of providers that currently cover TMS, visit our Insurance page.

Does Medicaid cover TMS Therapy?

Currently, Washington state is the only state where Medicaid will cover TMS therapy.

How much does TMS Therapy cost if paid out of pocket?

The typical cost for a complete 30-session course of TMS Therapy ranges from $7,600-$13,000, or $400-$500 per session.

If your insurance provider does not presently cover TMS Therapy and you would like assistance in securing coverage, TMS Solutions can help you negotiate with your insurance provider to see if they will provide coverage, which is determined on a case-by-case basis.

Please click to visit our Insurance page

What if my insurance doesn't cover TMS Therapy?

In some cases, insurance companies do not list TMS Therapy as a regular benefit. However, TMS Solutions will work on your behalf to get your insurance provider to appeal this decision. In many cases, we have been able to obtain some or complete coverage of the treatment. 

In some cases, or for treatments outside of depression, your insurance provider may not cover any costs associated with TMS Therapy. Then, the burden of payment falls on the patient. TMS Solutions has options to help patients handle those costs, including a sliding payment scale and Patient Financing Loans.

>Please click here to talk to a patient advocate about your options

Do I need a doctor's referral for TMS Therapy?

A referral from a doctor is not needed for TMS Therapy. However, one of our psychiatrists will perform an evaluation to determine if TMS Therapy is medically necessary and safe for each patient.

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Call: 1-800-273-8255

TMS+YOU Online Community
TMS&you logo. v2TMS+YOU is an online community and national patient advocacy site for TMS Therapy. Those considering Transcranial Magnetic Stimulation can connect with patients who have had the treatment to answer questions, share insights, and get the latest information.