Frequently Asked Questions

  • 1.What is the typical course of treatment? How long?
  • 2. Equipment used?
  • 3. Why does TMS work?
  • 4. When is TMS used?
  • 5.Is TMS Therapy safe?
  • 6. What happens during an TMS procedure?
  • 7. What are the side effects of TMS?
  • 8. Am I a good candidate for TMS?
  • 9. What is the difference between TMS and ECT?
  • 10. Does TMS cause memory loss?
  • 11. How long do the TMS treatment results last?
  • 12. Will my insurance cover TMS Therapy?
  • 13. Can I get to see/know more about it in person?
  • 14. What clinical information is available on TMS?
  • 15. What do I do once my TMS treatment is completed?
  • 16. Who administers TMS?
  • 17. How long is an TMS procedure?
  • 18. Do I need to be hospitalized for a course of TMS?
1.What is the typical course of treatment? How long?

A total course of treatment is completed in about 6 weeks for a total of 36 treatments; including the initial mapping appointment. Each treatment is approximately 20-30 minutes long; 5 days a week.

2. Equipment used?

Magventure TMS machine and coil. Each patient receives their own individual treatment cap that they will wear each session.

Magventure TMS Device

Transcranial Magnetic Stimulation (TMS) is a series of brief, repetitive magnetic pulses that are used to stimulate our brain cells. MagVenture TMS is used to treat depression for patients who have had no success with medication. According to studies, approximately 58% of patients respond positively to TMS therapy. The benefits of TMS treatment are a minimal side effects, non-invasive, and has been proven as a treatment for depression. TMS treatment includes four to six treatments that take less than an hour each day, five days a week. The way the TMS machine works is the patient is fitted for a cap on their head. Short pulses of magnetic energy are focused at the limbic system structures. Then the pulses trigger electrical charges, causing neurons to become active. Once the limbic system structures change, so do your emotional and behavioral patterns! This is why we need to do these treatments so frequently.

  1. Magnetic stimulator
  2. Magnetic coil for locating the patient’s exact treatment spot and intensity level (MT determination)
  3. Magnetic coil for the actual TMS treatment
  4. Trolley for the stimulator
  5. Comfortable treatment chair
  6. Pillow that shapes around the head to support and keep the patient stable during the MagVenture TMS Therapy
  7. Cotton caps to facilitate easy marking of the patient’s treatment location and repositioning on the patient’s head after the initial TMS session
  8. Cooling unit which allows consecutive treatment sessions with no issue of the coil overheating.

Who cannot get TMS therapy?

Patients with any type of non-removable metal in their heads (with the exception of braces or dental fillings), should not receive TMS. 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
  • Deep brain stimulators
  • Electrodes to monitor brain activity
  • Cochlear implants in your ears.
  • Shrapnel or bullet fragments in or near the head
  • Facial tattoos with metallic or magnetic-sensitive ink. If someone had an MRI done in past, generally they can do TMS.
3. Why does TMS work?

TMS has been shown to produce changes in neuronal activity in regions of the brain implicated in mood regulation, such as the prefrontal cortex. As each magnetic pulse passes through the skull and into the brain, this induces brief activity of brain cells underlying the treatment coil. The frequency of pulse delivery also influences whether brain activity is increased or decreased by a session of TMS.

4. When is TMS used?

Antidepressant medications and psychotherapy are the first line treatments for major depression. These treatments, however, do not work for all patients. In these instances, TMS might be used as an alternative

treatment, or to augment antidepressant medications or psychotherapy. Patients who have failed to achieve an adequate response from antidepressants, or who are unable to tolerate medications, might consider TMS therapy.

5.Is TMS Therapy safe?

TMS therapy is an FDA-approved treatment for depression and has been known to be used in the treatment of many other neurological conditions. The treatment is always performed by a trained TMS technician and under the supervision of the prescribing psychiatrist. There have been very few risks associated with the treatment and it has been proven to be the least invasive treatment option for depression as well as having the smallest number of potential side-effects.

In recent years, there has been lot more research and studies of various new protocols including multiple sessions per day, there has been no evidence of any cell damage or detereoration.

6. What happens during an TMS procedure?

Because TMS uses magnetic pulses, before beginning a treatment, patients are asked to remove any magnetic-sensitive objects (such as jewelry). Patients are required to wear earplugs during treatment for their comfort and hearing protection, as TMS produces a loud clicking sound with each pulse, much like an MRI machine

7. What are the side effects of TMS?

Virtually none. Compared to other treatments for depression, TMS is generally well tolerated. The most common side effects reported by patients are mild discomfort at the treatment site and the possible development of a slight headache during the first week of treatment. The most serious risk of TMS is seizures. However, the risk of a seizure is exceptionally low and a thorough check on a client’s medical history is conducted to rule-out this risk.

8. Am I a good candidate for TMS?
  • Suffer from Major Depressive Disorder
  • Have not received relief from multiple anti-depressant medications
  • Unable to tolerate anti-depressants or the side-effects caused by them
  • No active drug use or seizure disorder
9. What is the difference between TMS and ECT?

TMS is NOT shock therapy and uses strictly magnetic pulses NOT ELECTRIC. Anesthesia is not required- the patient is awake and alert the entire time and is able to drive themselves to and from treatment. TMS does not prove to cause any of the undesirable side-effects as ECT such as memory loss, dizziness, insomnia, gastric issues, etc.

10. Does TMS cause memory loss?

No. To the contrary, most patients report an enhancement in their cognitive functioning throughout the course of their treatments as the frontal lobes are the seat of executive function.

11. How long do the TMS treatment results last?

Remission rates vary per patient. It is not uncommon to see many enjoy the benefits for more than 1- 3 years or more.

12. Will my insurance cover TMS Therapy?

Most insurances cover the TMS therapy as it’s more cost effective long term and results in substantial improvement in patient quality of life/productivity. The coverage eleigibility policy varies among different carriers eg; Horizon BCBS require failure of at least 4 different types of medications and trials of psychotherapy and Pt is still very depressed. Amerihealth still considers it ‘experimental’ and does not cover it (although FDA approved in 2008 and widely used all over the world).

We currently participate in most commercial insurances including but not limited to Medicare, Aetna, Cigna, United Healthcare, and Blue Cross Blue Shield. Our staff handles all insurance authorizations for you- you are strictly here for your well-being.

13. Can I get to see/know more about it in person?

Our office currently offers Free Consultations as a way for those who are interested to come in, view the machine, and become acquainted with the treatment process. You can discuss any issues with the TMS coordinator for 15-30 minutes, during which you meet the treatment team, ask questions, go over any concerns one may have. You are also given some additional information regarding the treatment such as articles, brochures, etc.

14. What clinical information is available on TMS?

Many studies have been completed regarding the TMS treatment. Our office also provides various articles and information on the treatment at the time of the initial consultation. References will be provided on our website.

15. What do I do once my TMS treatment is completed?

After one completes the first 30 TMS sessions, the last six are tapered out through usually a two-week period. Our office offers additional maintenance sessions two months following the final day of treatment at a discounted rate for those who have completed their full course of treatment with us.

16. Who administers TMS?

TMS is always prescribed by a TMS physician. The initial motor threshold is always determined by a TMS physician. The treatment itself is administered by an experienced TMS technician under the supervision of the TMS physician or by the TMS physician. The TMS technician or physician will always be present to monitor the patient during the treatment. The patient can stop a treatment at any time by asking the staff member present.

17. How long is an TMS procedure?

TMS therapy involves a series of treatment sessions. Treatment sessions vary in length depending on the TMS coil used and the number of pulses delivered but typically last around 20 – 30 minutes. Patients receive TMS 5 days a week. A typical course of TMS is 4 to 6 weeks. However, this can vary depending on an individual’s

response to treatment. There are newer ‘Accelerated’ protocols that have been studied which are very effective which can be completed in 7-10 days (not FDA cleared).

18. Do I need to be hospitalized for a course of TMS?

Unlike ECT, TMS does not require any sedation or general anesthesia, so patients are fully awake and aware during the treatment. There is no “recovery time”, so patients can drive home afterwards and return to their usual activities.

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