About TMS Therapy
TMS treatment is an innovation in the treatment of depression. It is not a medication and no surgery is involved.
TMS therapy has been approved by the U.S. FDA for treatment of patients with Major Depression who have not achieved adequate improvement from antidepressant medications and counseling.
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How TMS therapy works
TMS treatment is conducted using a device called the NeuroStar TMS Therapy System.
TMS therapy stimulates nerve cells in an area of the brain believed to be linked to depression. A treatment coil is applied to the patient’s head through which the NeuroStar TMS therapy system generates highly concentrated magnetic field pulses that turn on and off rapidly. The pulses continue for the duration of the session.
While treatment is administered, patients remain awake while sitting in a comfortable reclining chair.
Each TMS therapy session is a 40-minute outpatient procedure that is prescribed by a psychiatrist, does not require anesthesia or sedation, and patients remain awake and alert. The treatment is typically administered daily for 4 to 6 weeks and the patient is able to maintain their normal routine before and after treatment.
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Is TMS right for me?
All patients begin by scheduling an initial assessment with one of Lindner Center of HOPE’s psychiatrists, Dr. Dallas Auvil, Dr. Michael Keys or Dr. Nelson Rodriguez.
Dr. Dallas Auvil Dr. Michael Keys Dr. Nelson Rodriguez.
Patients can be referred for an initial assessment by their physician or can schedule this appointment themselves by calling 513-536-0537 or 1-888-537-4229.
All patients are required to get a History and Physical examination from their primary care doctor prior to being approved for treatment.
During this initial assessment, the psychiatrist will:
The psychiatrist will ask for as much detail as possible about your previous treatment for your depression including history of counseling, names of the medications you have taken, maximum dosage, duration of treatment and the reason medication was discontinued such as lack of benefit or side effects.
Please keep in mind that this appointment is an assessment. At the end of the appointment the psychiatrist will let you know if TMS therapy is right for you.
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Beginning TMS therapy
If TMS therapy is right for you and you choose to pursue treatment, your next appointment will last two hours. During this visit, the psychiatrist will create a plan for your treatment.
Dr. Auvil, Dr. Keys or Dr. Rodriguez will determine the specific location on your head and the amount of energy necessary to increase blood flow in the area of your brain necessary for anti-depressant activity. The psychiatrist does this by initially stimulating the part of the brain called the “motor cortex.”
When the motor cortex is stimulated, your thumb will move up and down. The psychiatrist then moves the machine to stimulate the “prefrontal cortex.” After mapping the location for future sessions, you will have your first TMS treatment session.
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What does treatment feel like?
During a TMS treatment, the patient will feel a tapping sensation on the scalp. TMS therapy produces a loud clicking sound, so earplugs are provided.
The most common adverse reaction related to treatment was scalp pain or discomfort at the treatment area during active treatments. This reaction was brief, mild to moderate in severity and declined markedly after the first week of treatment.
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How long does treatment take?
Once approved for TMS therapy, the patient will be enrolled in a course of 5 treatments per week over a 4-6 week period for an average of 20-30 total sessions.
Each TMS therapy session lasts about 40 minutes.
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What should a patient expect after a TMS treatment?
Since TMS treatment does not involve any anesthesia or sedation. During a treatment session patients remain awake and alert during the treatment. Patients are able to drive and/or return to work and/or other daily activities immediately after treatment.
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Benefits of treatment
Most patients have experienced results by the fourth week of treatment, however each patient is different and some patients may notice benefits over a shorter or longer period of time.
In an open-label clinical trial (resembling real world practice) approximately 1 in 2 patients treated with TMS therapy experienced a significant improvement in depression symptoms, and 1 in 3 experienced complete resolution.
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Side Effects
The most commonly reported side effect was headache or scalp pain and these side effects were generally mild to moderate and occurred less frequently after the first week of treatment.
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Difference between TMS & Antidepressants
TMS therapy does not cause systemic side effects such as weight gain, sexual dysfunction, nausea, dry mouth, and sedation.
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Difference between TMS and ECT
TMS and ECT are both procedures that treat major depression. The important differences between TMS therapy and ECT include:
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ECT requires anesthesia whereas TMS does not
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ECT uses applies electrical energy whole brain, while TMS uses magnetic energy applied only to the left prefrontal cortex.
- TMS therapy is a non-invasive procedure that does not require anesthesia and does not produce a seizure.
With any treatment, patients and clinicians should work together to determine the most appropriate option.
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Does TMS cause memory loss?
TMS therapy was systematically evaluated for its effects on memory. The clinical trials demonstrated that Neurostar TMS Therapy does not result in adverse effects on memory or concentration.
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Who should NOT have TMS
TMS therapy should not be used by anyone who has magnetic-sensitive metal in their head or within 12 inches of the Neurostar Magnetic Coil that cannot be removed. Objects that may have this kind of metal include:
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Aneurysm clips or coils
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Stents
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Implanted Stimulators
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Electrodes to monitor brain activity
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Ferromagnetic implants in your eyes or ears
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Bullet fragments and other metal devices or objects implanted in the head
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Payment Considerations
TMS Therapy is not typically covered by insurance; however it is sometimes covered on a case-by-case basis. Lindner Center of HOPE financial counselors can offer suggestions for how seek case-by-case coverage. In the meantime, out-of-pocket payment by the patient is required.
TMS therapy costs $325 per session and typically requires 20-30 sessions. During treatment, a psychiatrist will consult with patients to evaluate their progress. TMS sessions are prepaid in packages of ten sessions for $3,250. Subsequent maintenance treatments after the initial treatment series cost $325 and can be paid prior to each visit.
The initial consultation with a psychiatrist to determine if TMS therapy is appropriate will be billed to insurance or can be paid by the patient separately from the TMS package.
Financing options are also available. Ask the financial counselor at Lindner Center of HOPE for more information by calling 513-536-0537 or 1-888-537-4229.
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Read more about Neurostar
Watch a video about Nuerostar and TMS Therapy
Fair Balance Statements
For more information about the Lindner Center of HOPE and TMS treatment, call 513-536-0537 or 1-888-537-4229.