Transcranial Magnetic Stimulation, or TMS, is a non-invasive depression treatment. It uses an electromagnetic coil placed against the head to target brain regions that are implicated in the disease of depression to stimulate the brain. Targeted magnetic pulses are painlessly delivered to neuronal circuits while the patient is awake. TMS devices are FDA approved for the treatment of patients who have failed or cannot tolerate other depression treatments. TMS can be used alone although many patients will continue their medication while receiving TMS. Depression is a debilitating and painful illness and TMS can help.
We provide consultations to help you decide if TMS is an option for you. About 1/3 of patients who have been treatment resistant to other depression treatments will have complete resolution of their symptoms. Even more will see symptom improvement. In general, treatment should not be done if you have metal implants in or around your head (except for standard dental fillings) or if you have a seizure disorder. Our patients tell us that it is not scary or painful and that they feel comfortable in our offices. A trained technician or your physician is with you at all times.
Our center provides a type of TMS called deep TMS. The targeted electromagnetic pulses reach deeper and wider into the brain. This is likely an important part of the success of TMS. In addition, sessions are only 20 minutes while with standard TMS they are usually 40 minutes.
TMS has few side effects and they are not long lasting. Patients are awake and able to interact throughout the treatment. It is loud so we provide ear plugs. Sometimes after the first few sessions headaches or jaw pain have been reported. We recommend wearing a mouth guard if you notice teeth clenching or jaw pain. Headaches are usually mild and are unusual after the first week of treatment. We will screen you for medications, illnesses or issues that may need to be addressed before you can start TMS. If you have a seizure disorder, TMS is generally avoided.
Some antidepressants cause weight gain, gastrointestinal problems, increased anxiety, changes in sleep and dream quality, changes in sexual functioning, and/or sweating. Electroconvulsive therapy (ECT) requires anesthesia and can have effects on cognition and memory. While both medications and ECT are important depression treatments, TMS does not have these side effects.
Each session is 20 minutes. We start with 36 daily treatments Monday-Friday. After those are completed we taper to two sessions per week for six weeks and then one session per week for six weeks. After the taper is completed, you and your doctor will decide on a maintenance schedule – usually once per month. This regimen has been shown to be effective for long term results. Of course, you can stop the treatments at any time.
Our office provides TMS out-of-network with insurance companies which means patients pay us first and we will provide the necessary documents for them to submit for reimbursement. If you are not sure whether your plan covers TMS treatments, just give us a call and we will be happy to discuss the cost and verify for you if you will get any reimbursement from your insurance company. Our office accepts checks and all major credit cards. There is a cost for both the initial consultation as well as each treatment session.
During your first treatment, Dr. Rushing and/or Dr. Kim will perform a test to identify the minimal amount of electromagnetic field necessary to stimulate your brain. Each treatment is 100% customized to each patient, so we can deliver the correct treatment dose the specific area of your brain. Once the treatment starts, you will feel like TMS is tapping on your scalp. You may notice some painless facial twitching during the treatment. This is normal and will not continue once the TMS session is over. Over the course of the first few sessions, we gently increase the power so that you can accommodate over time. You can resume your normal activities immediately after each session.
Call our office at 610-726-1020 and we will answer any further questions you may have. We will also be happy to work with your psychiatrist if you are referred to us for TMS.