How effective is TMS therapy for depression?
In clinical TMS trials, 1 in 2 patients experienced at least a 50% reduction in the severity of their depression and 1 in 3 patients achieved remission.
Is TMS Safe?
Transcranial Magnetic Stimulation has been studied by researchers for more than 20 years. TMS Therapy is well tolerated and has been shown to be safe in clinical trials. Over 10,000 active treatments were performed across all clinical trials demonstrating its safety. TMS Therapy can produce clinical benefits without the side effect of antidepressant medications:
- No seizures
- No systemic side effects
- No weight gain
- No sexual dysfunction
- No sedation
- No nausea
- No dry mouth
- No adverse effects on concentration or memory
- No device-drug interactions
What are the potential side effects and risks of TMS Therapy?
Treatment with TMS Therapy causes very few side effects and is generally well tolerated by patients. The most common side effect reported during clinical trials was scalp discomfort—generally mild to moderate and occurring less frequently after the first week of treatment. Fewer than 5% of patients discontinued treatment due to adverse events. There is a small risk of a seizure occurring during treatment. This risk is no greater than what has been observed with oral antidepressant medications. While TMS Therapy has been proven effective, not all patients will benefit from it.
Is there a difference in effectiveness between the Neurostar and Brainsway TMS systems?
The two systems have yet to be compared directly in a head-to-head study, so it’s not possible to conclusively state if one is more effective than the other. However, the efficacy of each system for treating depression has been demonstrated in at least one large clinical trial comparing it to a sham TMS treatment (akin to TMS placebo). Whereas, the Neurostar system demonstrated efficacy over sham TMS after 30 treatments, each 37 minutes long (1110 cumulative treatment minutes) , the Brainsway system demonstrated efficacy after 20 treatments, each 20 minutes long (400 cumulative treatment minutes).
Is there a difference in the side effects and risks associated with the Neurostar and Brainsway TMS systems?
No. Both systems have comparable side effects and risks.
How long will it take to start feeling the benefits of TMS treatment?
The majority of patients have experienced results by the fourth week of treatment. However, each patient is different; some may notice benefits sooner, while for others it may take longer.
Does TMS cause memory loss?
No. TMS Therapy was systematically evaluated for its effects on memory. Clinical trials demonstrated that TMS Therapy does not result in any negative effects on memory or concentration.
Does TMS Therapy cause brain tumors?
No. TMS Therapy uses the same type of magnetic fields as MRIs (magnetic resonance imaging), which have been used in tens of millions of patients around the world and have not been shown to cause tumors. The magnetic energy used in a full course of TMS Therapy is a small fraction of just one brain scan with an MRI.
Who is a candidate for TMS?
TMS therapy is an appropriate treatment for adults with major depressive disorder who have failed to achieve satisfactory improvement from antidepressant medications at or above the commonly effective dose and duration. Eligible patients will be evaluated by our board certified psychiatrist, Dr. David Feifel, to determine the clinical appropriateness of TMS therapy. People with conditions other than depression may also be suitable for TMS therapy.
Can TMS be used to treat conditions other than depression?
Though it has, thus far, only been cleared by the FDA for treating depression, TMS has shown a lot of promise as a treatment for a number of other neuropsychiatric disorders including:
- Bipolar Disorder
- Obsessive Compulsive Disorder (OCD)
- Post-Traumatic Stress Disorder (PTSD)
- Parkinson’s Disease
- Chronic Pain
- Stroke Recovery
- Eating Disorders
- Attention Deficit Disorder (ADD/ ADHD)
- Drug Addiction
- Smoking cessation
- Tourette Syndrome
- Blepharospasm (Uncontrolled Blinking)
- Multiple Sclerosis
- Tinnitus (Ringing in Ear)
Contact us if you are interested in exploring TMS therapy for one of these conditions.
Who is not a candidate for TMS Therapy?
Patients with any type of non-removable metal in their heads (with the exception of braces or dental fillings), or within twelve inches of the coil should not receive TMS. The following is a list of metal implants that may prevent a patient from receiving TMS.
- Aneurysm clips or coils
- Stents in the neck or brain
- Electrodes to monitor brain activity
- Non-removable Metallic implants in your ears and eyes
- Shrapnel or bullet fragments in or near the head
- Facial tattoos with metallic or magnetic-sensitive ink
- Other metal devices or object implanted in or near the head
Persons with a history of seizures may not be appropriate for TMS Therapy. Before the first TMS session, patients are carefully screened for the presence of medical conditions and any underlying risk factors that could make the administration of TMS Therapy clinically unsafe.
What is the typical course of TMS Therapy?
TMS therapy is an outpatient treatment that requires a series of treatment sessions. The initial course of treatment typically consists of 5 treatments per week over a 4-6 week period, for an average of 30 total treatments. The actual treatment typically lasts approximately 20-40 minutes. During treatment, the patient is awake in a comfortable chair.
What happens during a TMS procedure?
During the first TMS session, several measurements are made to ensure that the TMS coil will be properly positioned over the patient’s head. Once this is done, the TMS coil is suspended over the patient’s scalp. The TMS physician then measures the patient’s motor threshold, by administering several brief pulses. The motor threshold is the minimum amount of power necessary to make the patient’s thumb twitch, and varies from individual to individual. Measuring the motor threshold helps the physician personalize the treatment settings and determine the amount of energy required to stimulate brain cells. Succeeding treatment sessions do not require that the motor threshold be determined again, unless indicated otherwise, such as when changes in medications are made during the course of the treatment.
Once the motor threshold is determined, the coil is then brought forward so that it rests above the front region of the patient’s brain. Treatment is then commenced. During the treatment, patients will hear a series of clicking sounds and will feel a tapping sensation under the treatment coil. The patient remains fully conscious and aware throughout the procedure and no post-session recovery period is needed. After the treatment session, the patient can immediately return to their normal routine, including driving.
Can I take antidepressant medication(s) if I am receiving TMS therapy?
Yes. Many patients stay on their current medication during TMS, however, Dr. Feifel may recommend adjustment to your medication before starting TMS.
How long does the antidepressant effect last? Will I need any therapy beyond the first 4-6 weeks?
The duration of benefits from TMS varies considerably from patient to patient. Booster or maintenance TMS treatments consisting of a small number of TMS session every few months or scheduled as needed, based on early signs of re-emerging depression can be effective in maintaining the benefits of TMS therapy and prevent recurrence of symptoms. Our staff will discuss an individualized maintenance plan with you at the end of your treatment.
How Much Does it Cost and How Do I Pay?
Most health insurance plans now cover TMS therapy for depression if a patient meets certain eligibility criteria. To be eligible for insurance coverage a patient needs to have a diagnosis of Major Depressive Disorder and have failed to benefit from at least four trials of antidepressant medication due to lack of effectiveness or side effects. Please note that we do not accept Medicare. Ketamine treatment is not covered by insurance at this time. For more information contact us at info@KadimaNP.com.