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Psychiatric Consultation

Transcranial Magnetic Stimulation (TMS)​

Transcranial Magnetic Stimulation (TMS) is a non-invasive treatment that uses repetitive magnetic pulses to stimulate nerve cells in the brain to improve symptoms of depression. During a TMS session, an electromagnetic coil is placed against the scalp. The electromagnet pulse stimulates nerve cells in the region of your brain involved in mood control and depression.

TMS Therapy is typically used when other depression treatments haven’t been effective.

How Does TMS Work?

Transcranial Magnetic Stimulation (TMS) is a form of non-invasive brain stimulation, with over 30 years of application in neuroscientific and clinical research around the world.

Magstim TMS Therapy uses short pulses of magnetic energy to stimulate nerve cells in the brain. These magnetic pulses are delivered to the area in the brain that researchers believe is responsible for emotional judgement and mood regulation. The rapid magnetic pulses created by the TMS system, pass through the skull and generate an electric current in the brain directly under the treatment coil. These electric currents cause neurons to fire and stimulate surrounding brain cells.

FDA Approved & Recommended by the APA

TMS therapy has been recommended by the American Psychiatric Association (APA) since 2010 for the treatment of Major Depressive Disorder and it is also approved by the UK National Institute of Health and Care Excellence (NICE).

The US Food and Drug Administration (FDA) cleared Magstim TMS Therapy systems for the treatment of Major Depressive Disorder in adult patients who have failed to achieve satisfactory improvement from prior antidepressant medication in the current episode.

TMS Therapy for Major Depressive Disorder (MDD)

With MDD there are biological alterations in the brain, including an imbalance of activity in frontal brain regions. These areas of the brain are involved in important mental processes and also have connections with deeper brain regions responsible for emotions. Due to the ability of rTMS to alter brain activity, it was first proposed as a therapy for MDD in the mid-1990s. Since then, numerous studies have demonstrated the safety and effectiveness of rTMS in MDD, especially in treatment-resistant patients who have not responded to antidepressants.

Approximately 58% of treatment-resistant patients respond positively to rTMS therapy.

Treatment Resistant Depression (TRD)

For many people coping with Major Depressive Disorder (MDD) antidepressants have proven to provide adequate symptom relief enabling them to resume the life they once enjoyed. However, some patients experience a form of MDD known as TRD when standard medications provide little to no relief.

As many as two-thirds of depressed patients aren’t helped by the first antidepressant they try. Approximately one-third of adults with major depression are considered “treatment resistant”, continuing to battle symptoms such as persistent feelings of sadness, sleep disturbances, low energy, and thoughts of death or suicide.

If you think this sounds familiar you should discuss and answer the following questions with your doctor:

  • Has your treatment failed to make you feel better?
  • Has your treatment helped a bit, but you still don’t feel like your old self?
  • Have the side effects of your medication been difficult to deal with?
  • Is TMS a treatment option for me?

Frequently Asked Questions about TMS

TMS is covered by most insurance providers. Prior authorization is typically required for insurance coverage. Your physician will manage this process. Typically, treatment with antidepressant medications and psychotherapy may be needed before insurance will authorize TMS Therapy.

TMS Therapy Systems are indicated for the treatment of Major Depressive Disorder in adult patients who have failed to achieve satisfactory improvement from prior antidepressant medication in the current episode. Your current physician may refer you to us to determine if you are a candidate for TMS Therapy.

The magnetic coil which delivers TMS is positioned on the head. You will hear a clicking sound and feel a tapping sensation on your head when the magnetic pulses are delivered. Many patients watch television or read during treatment.

TMS has few known side effects. The most common side effects are mild scalp discomfort or headaches during treatment, but normal activities can typically be resumed immediately after treatment.

Most insurances allow for TMS treatment over a 6-week period, 5 times per week. Each treatment is typically between 3 and 37.5 minutes depending on what the physician determines to be best for you.

Each patient is different.


You can discuss long-term treatment planning with your doctor. Retreatment is often prescribed and reimbursed if you have responded to TMS therapy in the past.

This will vary from person to person.

 

It is commonly reported that patients need 30 to 36 sessions of TMS to feel relief from their depression symptoms. In clinical trials, approximately 58% of treatment-resistant patients responded positively to rTMS therapy.

TMS has over two decades of clinical and scientific research supporting its safe use and application. FDA-cleared for the treatment of MDD, Magstim TMS Therapy is an effective, non-invasive, outpatient treatment, with few known side effects.

TMS Therapy is well tolerated for most. However, not all patients are appropriate candidates for TMS Therapy.

 

For example, patients with a history of seizures or who have metal implants or objects in or near their head are not appropriate candidates for TMS Therapy. To determine if TMS Therapy may be right for you, your supervising doctor or psychiatrist will carefully screen for the presence of medical conditions or metal objects which may make TMS unsuitable.