TMS THERAPY

TMS stands for transcranial magnetic stimulation. This form of therapy uses magnetic fields similar to that of an MRI machine, but targets certain parts of the brain to stimulate or inhibit neurons. During TMS Therapy, a magnetic field is administered in very short pulses to the part of the brain that research has demonstrated to be associated with depression. The typical initial course of treatment is about 19-37 minutes daily over 4-6 weeks.

Most patients can expect to start experiencing relief after 5-10 TMS treatment sessions. However, this can vary greatly depending on the severity of depression and the individual’s unique genetic makeup. Some patients may not feel the effects of TMS for several weeks, while others may  experience a near immediate relief. 

The most commonly reported side effects during TMS therapy clinical trials were headache and scalp discomfort. These potential side effects were typically mild to moderate, and were less common after the first week of treatment. During clinical trials, less than 5% of patients treated with TMS discontinued treatment due to side effects. If necessary, headaches from TMS can be treated with over-the-counter pain medications. If the side effects persist, the strength of the TMS pulses can be temporarily reduced to ensure the comfort of the patient. As with many antidepressant medicatons, there is a rare incidence of seizure (1 in 30,000). 

Yes, patients are able to resume normal activities after the TMS treatment. There is no downtime or restrictions of any kind after a TMS therapy treatment session.

Painful? No. Uncomfortable? It depends on the individual. In the majority of patients, TMS is well tolerated with only minor discomfort on the scalp where TMS is applied. Most people describe TMS as a light to moderate tapping sensation where the coil is being applied. The sensation of the pulse may feel similar to a TENS unit.

Slight discomfort may be felt because there are several nerves in the scalp where TMS is being applied. Naturally some of these nerves will also be lightly stimulated by the TMS coil as they are also conductive and will pick up the electromagnetic pulse. You cannot feel TMS in your brain, as the brain has no pain receptors itself.

And even though stimulation of the scalp nerves may cause some discomfort at first, this too subsides as the patient progresses through treatment, generally after the first few treatment sessions.

TMS uses magnetic pulses to stimulate a specific are of the brain. These magnetic pulses are similar to those used in MRI (magnetic resonance imaging). For example, when treating a patient who suffers from depression, the physician locates an area of the brain called the dorsolateral prefrontal cortex. Research has found that the neurons in this particular area of the brain are underactive (hypoactive).  With repetitive stimulation of this area of the brain, TMS works to restore the activity of the neurons in the area being treated. As the neurons begin to 'wake up' they produce neurochemicals, such as dopamine, epinephrine, and norepinephrine - thus bringing balance to these neurochemicals in your brain. In turn, as these neurochemicals begin to normalize and take on activity, TMS restores the pathways to other areas of brain so that communication between one area of the brain to another is restored. 

For a deeper look into TMS and how it works, please visit our TMS therapy page HERE.

Before your initial treatment, which is your mapping session (when Dr. Stepkovitch with locate the area of the brain to be treated), you may be asked to refrain from taking medications that might prevent a successful mapping.

Yes.  For patients who have failed four or more trials of antidepressants, most major insurers will cover TMS treatment.  Insurance will require a prior authorization which we can get in approximately 2 weeks following your consult visit. For off-label treatment or other situations in which insurance will not reimburse directly, using a health savings account or Advanced Care Card are common options.  We offer discounted rates for those paying in full at the beginning of treatment and flexible payment plans.