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, and it won’t work on its own. 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. There are no guarantees in medical treatment. What we offer people is a research-based treatment at the cutting edge of treating depression. TMS therapy increases your chances of getting better after having failed multiple antidepressants. Despite this, not everyone gets better. Regardless, 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.
If you are interested in learning more about TMS Therapy for treating depression.
Holly B. (Cherry Creek)
Of course! ! You are free to do whatever you would like with your treatment time, except 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.
All TMS Solutions clinics operate from 9-5. 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 the patient fulfill their commitment to TMS treatments
Insurance and cash 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 cash 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.
We'll be in touch to begin a conversation as to whether TMS Therapy might be a good fit for you, and if it can help treat your depression. Below are more questions and answers.
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.
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.
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 the prescription by a licensed physician. It can be used in both inpatient and outpatient settings including physicians’ offices, clinics, and hospitals.
If you or someone you care about has been diagnosed with clinical depression or MDD, then TMS Therapy may be able to help.
While TMS Therapy is considered to be a well tolerated treatment, there are some patients it is not suitable for:
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:
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.
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.
In many cases, TMS Therapy can be a life changing treatment for patients suffering from severe depression symptoms. Some of the benefits of TMS include increased vitality, where "the gray is gone", enjoyment of the little things in life, better quality of life and improvement in relationships. Remission from depression is possible, and it may even be possible to reduce the current levels of medication. Your doctor can advise you about what happens after the treatment is over.
No, TMS Therapy doesn't cause brain tumors.
As far as memory loss; 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.
If you find that you or your loved one has not experienced results from TMS, 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.
The term "Dip" is used to refer to the effect which sometimes happens when 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 appear to usually gain it back, and tend to continue onward towards the goal of alleviating their depression symptoms.
Patients typically begin TMS Therapy after being prescribed the treatment by their doctor or psychiatrist.
You can also call us directly at 970-697-1020 to talk with Chris about suitability of TMS Treatment, to schedule an initial assessment and to see if TMS Therapy makes sense for you. At that time Chris will advise you as to next steps.
TMS Therapy is an outpatient procedure, as such it takes place right in your doctor’s office or clinic. 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 treatment, TMS patients can immediately resume normal daily activities and do not need to be hospitalized for treatment. In fact, you can safely drive yourself to and from appointments, as there are no adverse effects and nothing is circulating in your body's system.
Regardless of who prescribed TMS Therapy, a trained TMS technician or doctor should administer actual TMS treatments and guide you through each session.
A doctor or TMS technician should always be present to monitor the patient during treatment. The patient should be allowed to stop a treatment at any time by asking the staff member present.
FDA protocol for TMS Therapy is 30 treatments, which is typically performed 5 days a week for six weeks. Taper sessions may be included depending on insurance coverage and can be stretched over 2 to 3 weeks. Treatment is 35 minutes long and each appointment is roughly 45 minutes to an hour.
Each treatment is administered five days a week, Monday through Friday. We have found it important to link treatments back to back, and provide weekends off as a breather of sorts.
While each visit lasts approximately 60 minutes, part of the time is spent calibrating the system to the patient. The actual treatment phase with the device is approximately 37 minutes long. There are no side effects, there is no recovery time, so you are able to safely drive yourself home or go back to work.
All TMS Solutions clinics operate from 9-5. 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 the patient fulfill their commitment to TMS treatments.
NeuroStar TMS Therapy is proven safe and easy to tolerate. It is FDA approved for the treatment of depression. Because it is not a depression drug, NeuroStar TMS Therapy doesn’t have the side effects that are often associated with antidepressant medications.
To date, more than 25,000 patients have been treated with NeuroStar TMS Therapy. In the 10,000 treatments during the clinical trials, the most common side effect was mild to moderate scalp discomfort and mild headaches, both of which usually went away after the first week of treatment.
In a very small percentage of instances there were reports of acute memory loss, minimal cognition interruption, facial twitching, and seizures. These side effects were acute and the TMS treatment showed no long-term issues.
The overwhelming majority of patients experience no side effects. However, some patients may experience a headache after treatment and sensitivity at the treatment site. An over the counter pain reliever is recommended when starting TMS Therapy which will help patients as they acclimate to treatment and may be discontinued once the patient is able to tolerate at the prescribed treatment level. Some may report slight dizziness or lightheadedness after treatment, which typically resolves before the patient leaves the treatment room.
After more than two decades of research and clinical trials, TMS Therapy was cleared by Canada Health in 2003 and cleared in the USA by the FDA in 2008. TMS has also been approved in Europe, Israel and Australia for treating patients. As such, the actual administering of TMS is very precise and well regulated the world over.
The actual TMS feels like a tapping on the skull. TMS is an essentially painless process. The magnetically induced current does not pass through the skin, where most of the pain nerve endings are located.
However, there are some side effects that may cause mild to moderate discomfort. The most common of these side effects is scalp irritation and headaches. These and all observed side effects are acute and should only last temporarily.
If symptoms persist, an over-the-counter analgesic may be taken or the TMS physician can reduce the strength of the magnetic field pulses being administered to make treatment more comfortable.
Less than 5 percent of patients treated with TMS Therapy discontinued treatment due to side effects.
TMS therapy works by stimulating the neurons in the brain, increasing that activity over time and helps to re-establish hypoactive neural pathways. This increased neural activity alleviates the symptoms of depression. The patient is awake throughout treatment with no applied medications necessary. Side effects of TMS can be mild to moderate headache and discomfort at the treatment site, both of which are temporary.
ECT, or electroconvulsive therapy, 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.
Yes, your doctor may advise you to continue taking your antidepressant medication while receiving TMS therapy.
After treatment, you and your doctor can discuss your medication and take an appropriate course of action.
No. The goal of TMS is not to discontinue medication as treatment resistant depression is a chronic and recurring condition. It is possible that TMS may increase the ability of current medications to be more effective. This allows us to attribute any changes to TMS treatment and not changes in medications. Medication management is under complete control of the primary physician and can be increased or decreased at their discretion.
Currently, research studies are looking into combining Ketamine/ECT and TMS Therapy. Because this is still experimental, it is recommended that the patient finish their course of treatment two weeks prior to the start of TMS Therapy.
All major medical insurance covers TMS Therapy, including Medicare and TriWest (VA). Our insurance and financial counselors will determine eligibility for treatment and inform the individual of any applicable out of pocket cost, depending on the plan’s deductible/co-insurance/co-pay.
For a list of providers that currently cover TMS, see our TMS Insurance page.
Currently, Medicaid covers TMS therapy in Washington state.
The typical cost of TMS Therapy ranges from $400-500 per session, or $7,600-13,000 for the full 30 session course.
If your insurance provider is not presently covering TMS and you would like assistance in securing coverage, TMS Solutions can check on your benefits and help you negotiate with your insurance provider for reimbursement, which is determined on a case-by-case basis.
In some cases, insurance companies do not list TMS as a regular benefit. However, TMS Solutions will work on your behalf to appeal these decisions to your insurance provider. In many cases where we have appealed to an insurance provider 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 of TMS Therapy. Then the burden of payment falls squarely on the shoulders of the patient. However, TMS Solutions has options to help patients handle the costs of TMS Therapy, including use of credit cards and Patient Financing Loans.
If your insurance provider is not presently covering TMS and you would like assistance in securing coverage, TMS Solutions can advocate on your behalf, to check on your benefits and help you negotiate with your insurance provider for reimbursement.
When this isn't possible there may be other financial options which are determined on a case-by-case basis.
A doctor’s referral is not needed for TMS therapy. However, one of our psychiatrists will perform an evaluation to determine the medical necessity and safety of treatment.