Is TMS right for me?

FDA Cleared

FDA cleared in 2008, Transcranial Magnetic Stimulation is a medical technology breakthrough that utilized short magnetic pulses to stimulate neurons in the brain to improve the symptoms of depression.

Safe

TMS is drug-free, and unlike antidepressants it is non-systemic, meaning nothing is circulating throughout your body. It is non-invasive, so there is no sedation or anesthesia, and most patients don't experience any side effects.

Insurance Approved

Best of all, TMS is covered by major insurance providers, including Medicare, the VA, and Medicaid (currently only in Idaho and Washington state). For more information about coverage, visit our Insurance page.

What is TMS Therapy?

Transcranial Magnetic Stimulation, or TMS, is a process that uses short, MRI strength magnetic pulses to stimulate neurons in the area of the brain known to regulate mood. This magnetic stimulation can have a positive effect on the brain’s neurotransmitter levels.

TMS treats depression at its source.

A patient sits in a chair similar to that in a dentist’s office, and a paddle containing a magnetic coil is positioned over the left dorsolateral prefrontal cortex on a patient’s head (the left side just above the forehead). That is the area of the brain known to affect mood. In depressed patients, that area is shown to be very non-responsive compared to non-depressed patients.

 

The coil transmits short magnetic pulses in rapid succession. The pulses travel approximately 1 inch into the brain, targeting and stimulating neurons, causing them to fire and release neurotransmitters. In a domino-like effect, this causes other cells to fire, in turn restoring normal function to the under-performing area of the brain.

Neurons are the brain’s messengers. They use naturally occurring electrical impulses and chemical signals, known as neurotransmitters, to transmit information between different areas of the brain. If the neurons aren’t working properly, also known as firing, the pathways become sluggish and a person can become depressed.

In simpler terms, it’s like a car that isn’t working properly. If the car can only go 45 mph in a 70 mph zone, it isn’t very efficient. It will get you where you need to go, but it will take longer, and many times, cause greater problems. When the car is fixed and working the way it should, it’s easier to get where you need to go.

Is TMS for me?

TMS Therapy is for those who…

  • Have been diagnosed with treatment resistant Major Depression Disorder (MDD)
  • Have not benefitted from the use of antidepressants and/or had side effects from them
  • Are searching for a non-invasive, drug-free depression solution

 

While TMS Therapy is a well-tolerated treatment, it is not for those who…

  • Have a seizure disorder or a history of seizures
  • Have been diagnosed with Schizophrenia
  • Have any type of permanent ferromagnetic metal implant in or near their heads (with the exception of braces or dental fillings) or within twelve inches of where the coil is placed, including but not limited to
    • Cochlear Implants
    • 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

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

Prior to receiving TMS Therapy 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.

TMS doesn’t hurt any more than holding a magnet in your hand hurts. Because it is non-systemic and non-invasive, there are no injections, anesthesia, or sedation – nothing is circulating through your bloodstream.

The most common side-effect is discomfort from the paddle vibrating against your scalp. Modifications can be made to reduce that discomfort and it usually subsides after the first week.

Because TMS therapy is non-invasive, you are awake and alert throughout your sessions, and are free to listen to music or an audio book or read during your treatment. 

TMS Therapy is an outpatient treatment that takes place in one of our clinics. Though not as common, it is possible to receive TMS at a hospital that offers the 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. Depending on insurance coverage, additional sessions, called taper sessions may be included and can be stretched over two to three weeks.

While each appointment is approximately 45 minutes, part of that time is spent calibrating the machine for the patient’s protocol. The actual treatment is about 37 minutes long.

TMS vs. Other Methods of Treatment

The main differences between TMS Therapy and antidepressant medications include:

  • Antidepressants are systemic, meaning that the medicine enters the body and blood stream.
  • TMS is non-systemic and drug-free.
  • 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. These symptoms usually subside within the first week of treatment.
  • TMS is usually prescribed when antidepressants fail, or the side effects are intolerable.

KETAMINE: For depression, ketamine is administered at low doses. Changes in the brain are activated because of the medicine, but once a patient stops taking it, that activation begins to subside and isn’t long-term. The most commonly reported side effects are elevated heartbeat, nausea, slight muscle tremors, and hallucinations. They don’t usually last longer than 4 hours after treatment.

Ketamine also has some interactions with certain psychiatric medications, so you may not be able to continue taking current medications if you start ketamine therapy.

TMS: TMS engages the neurons to function on their own with long-term efficacy and without drug interaction. The most common side-effect of TMS is discomfort from the paddle vibrating against your scalp. Modifications can be made to reduce that discomfort and it usually subsides after the first week. Because TMS is non-systemic, there are no drug interactions, so it’s safe to continue your current antidepressants or other medications during treatment.

TMS

  1. TMS uses short pulses of a magnetic field (similar to an MRI) to stimulate nerve cells in the brain.
  2. Typically 30-36 sessions, five days a week, over a six-week period.
  3. Considered a first-level of treatment, a Psychiatrist prescribes TMS when previous attempts at treating depression with medications have produced unsatisfactory results.
  4. Treatments are non-invasive and don’t require anesthesia or sedation. You can drive yourself to and from appointments which take place in a doctor’s office or clinic.
  5. Treatment costs $400-$700 per session or $7,600-$21,000. Because every insurance is different, TMS Solutions runs a Benefits Investigation for each patient.
  6. Currently, all insurers cover treatment, including Medicare and TriWest-VA.
  7. Scalp irritation and headaches can possibly occur for the first week. Very rarely, seizures have been reported.
  8. Over 73% of patients have symptoms reduced by more than 60% reduction in symptoms; over 49% of patients receive complete remission.
  9. Patients may need occasional maintenance treatments and may be able to reduce or discontinue medication upon their Physician’s approval.
  10. A long-term study showed that one year after TMS Therapy, 69% of patients showed an improvement in symptoms and 45% of patients reported complete remission.

ECT

  1. ECT, formerly known as shock therapy, uses an electrical current to create a therapeutic seizure, which causes a dramatic reset of the brain.
  2. Typically 10 sessions, two-three times a day, over a four-week period. The first three sessions require hospitalization.
  3. A psychiatrist prescribes ECT when previous attempts at treating depression have produced unsatisfactory results, the depression is serious, a patient is possibly suicidal, or nothing else works.
  4. Treatments require anesthesia and muscle relaxants, and a patient is hospitalized for the first three treatments. Transportation to and from each session has to be arranged , as patients require 2-3 hours to recover.
  5. Treatment costs $2,500 per session or $25,000, plus one week of hospital care, which is not included. (Answers.com estimates $50,000 for one week in the hospital).
  6. Most insurers cover the treatment.
  7. Headaches, muscle aches, cognition issues, short-term memory issues, possible long-term memory loss, and in some cases, possible improvement in memory.
  8. The initial efficacy is 50% to 80%.
  9. Patients may need maintenance treatments and antidepressant drug therapy is usually continued.
  10. About 64-84% of patients who initially responded to treatment relapsed within six months.

Other Resources

Mental health help resources can be difficult to find. There are many websites you can visit for information on mental health.

The National Alliance on Mental Illness and the American Foundation for Suicide Prevention are just a couple.

We have also compiled a list of local, national, and online resources that are available whenever you need them.