Frequently Asked Questions About TMS Therapy

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.

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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.

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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 metal implants or objects in or near their head
• Patients with any type of non-removable metal in their heads (with the exception of braces or dental fillings), or within twelve inches of the coil should not receive TMS Therapy

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.

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.

Our experience has shown that patients will typically receive 30 treatments over a 4-6 week period. However, a course of TMS Therapy can vary and your doctor will recommend and schedule the number of sessions based on your needs and in response to how your treatment proceeds.

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.

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.

There are a couple of minor side effects reported with TMS. They are mild to moderate scalp irritation and mild headaches, that affect nearly one half of all patients. These issues usually go away after the first week of treatment.

These symptoms may be treated with over-the-counter analgesics.  If symptoms persist, the TMS physician or technician can reduce the strength of the magnetic field pulses to make the patient more comfortable.

Note: Less than 5 percent of patients treated with TMS Therapy discontinued treatment due to side effects.

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.

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.