TMS stands for Transcranial Magnetic Stimulation. It is a revolutionary, non-invasive treatment for depression that uses highly focused, brief magnetic pulses to stimulate and activate targeted areas of the brain that have been shown to be under-active in depression. rTMS stands for repetitive stimulation using TMS, whereas dTMS indicates the use of deep rTMS treatment that stimulates a wider cortical tissue area 4 cm deep.
Who can get TMS? TMS was approved by the FDA in 2008 for the treatment of depression in patients who have not responded to antidepressant medication or have been unable to tolerate antidepressant medication. However, TMS is also an option for anyone with depression who wishes to pursue non-pharmacological treatment. Initially, we screen each patient to rule out any contraindications for TMS prior to scheduling a consultation with one of our psychiatrists. To see if TMS is appropriate for you, please call 206-535-6292 to set up a telephone screening.
TMS uses brief magnetic pulses to stimulate specific regions of the brain. The magnetic field is similar to the strength of an MRI machine. The device uses an electromagnetic coil that creates the magnetic field. The coil is placed next to the head over a region of the brain which has been shown to be underactive in depression, the left dorsolateral prefrontal cortex.
What is an individual TMS treatment like?
An individual treatment lasts about 20 to 30 minutes. The first treatment will take longer in order to map out the specific brain region to be stimulated, which is different for every individual. The treatment is administered in an office setting. Patients sit comfortably during a treatment session with the electromagnetic coil placed over their head. They can hear and feel a tapping sensation. Many patients are able to talk with their TMS clinicians between pulses during their treatment. There are no limitations on activities after a treatment. Patients can drive to and from treatments and then go home or to work immediately afterwards. There are no cognitive side effects.
Are there side effects associated with TMS?
Some patients report headaches and scalp discomfort during TMS treatment, although these usually improve over time with subsequent treatments. Although all medical treatments carry risks, the risks of TMS treatment are considered to be very minimal, and it is generally a very well tolerated treatment.
How long is a course of TMS?
The average course of TMS is approximately 20 sessions over one to two months. A TMS therapy session lasts approximately 30 minutes. The goal of a course of TMS treatment is to fully treat a depressive episode and for symptoms of depression to completely remit. Some people may need a longer course of treatment, and some people may decide to continue TMS treatments on a less frequent basis in order to prevent a recurrence of depression.
Is TMS different than ECT?
Electroconvulsive therapy (ECT) uses an electrical stimulus to generate a controlled seizure in the brain while a patient is under general anesthesia. While it is a very effective treatment option for severe depression, significant side effects such as memory loss are common.
TMS uses magnetic pulses to affect brain regions but does not use an electrical stimulus or cause a seizure. No anesthesia is required, and patients are fully awake during a TMS treatment. The side effects of TMS are generally significantly less than those of ECT.
Should I continue other psychiatric treatments while receiving TMS?
Generally, we recommend continuing medications and other psychiatric treatments while receiving TMS. However, you should consult with your psychiatrist or mental health provider regarding this decision.
Should I start or continue psychotherapy while receiving TMS?
We strongly recommend combining psychotherapy with TMS treatment. Studies show that TMS stimulation of the prefrontal cortex can reinforce gains made in psychotherapy. We recommend that our patients continue ongoing psychotherapy with their primary mental health providers. Additionally, our clinic offers the opportunity to engage in psychotherapy with our TMS Clinicians during your treatments. Our clinicians are trained masters-level mental health professionals who can provide these types of psychotherapy during TMS:
Cognitive Behavioral Therapy (CBT)
Behavioral Activation Therapy
Mindfulness Based CBT
Dialectical Behavioral Therapy
Can other health conditions be treated with TMS?
While major depressive disorder is the only medical condition for which Brainsway Deep TMS is currently FDA-approved AND covered by most insurance plans, there is ongoing research into the treatment of other medical conditions, including bipolar disorder, schizophrenia, tinnitus (ringing in the ears), anxiety, chronic pain, tobacco use disorder (quitting smoking), and migraine headaches. Contact us if you would like further information about TMS treatment for these conditions.
Where can I get more information about TMS?
Please go to www.brainsway.com/us for more information about TMS and Brainsway’s Deep TMS technology.
How do I start treatment at the Pacific Center for Neurostimulation?
Please contact us for more information. We will be in touch with you as soon as possible!