1. What is TMS?
TMS stands for “Transcranial Magnetic Stimulation.” TMS therapy is FDA-cleared for the treatment of Major Depressive Disorder. This occurred in 2008.
2. How does it work?
TMS works by delivering MRI-strength magnetic pulses to safely stimulate the left side of the brain area called Dorsolateral Prefrontal Cortex (DLPFC). Left DLPFC is one area that has a function of regulating mood. For those that struggle with depression, this area has low activity. TMS treatments are thought to help reactivate this brain area and normalizing its activity. Once this area has increased activity, it begins to communicate with deeper brain regions also responsible for depression.
*It is not Electro Convulsive Therapy (ECT), or a systemic medication-TMS can treat only the target area, so it does not negatively affect the other part of the brain not related to mood regulation.
3. How affordable is TMS?
Fortunately, Medicare, Vermont Medicaid* and most private national and local insurance companies have approved TMS for their members. Those that have coverage policies include:
We will at no cost provide a benefits investigation by calling your insurance company.
4. Is TMS therapy like ECT (electroconvulsive therapy)?
No TMS is not like ECT. TMS is performed in our office and does not require anesthesia or any sedation. The patient can return to normal activities immediately afterward. TMS also does not have the same side effects as ECT. Two significant ECT side effects that TMS does not have is memory loss/cognitive ability. TMS side effects are rare but include mild scalp discomfort and a slight headache. Each side effect lessens after several treatments.
5. How does TMS and Antidepressant Medications differ?
TMS is a focused treatment that has no systemic effects because it does not travel in the bloodstream. Medications are known to enter in the blood. Since it is non-systemic, it does not have medications side effects, such as weight changes, dry mouth, fatigue, sexual dysfunctions, and a myriad of others.
*It is important to note that medications have helped many with depression We recognize this, and although TMS is a non-medication treatment our doctors at North Country TMS will likely keep you on medications that you can tolerate and are providing some benefits. In this way, TMS, medications, and psychotherapy can all work together toward the goal of remission.
6. Can TMS help beyond Depression?
Scientific research is studying TMS for other mental health and physical indications. Mental health concerns like OCD, schizophrenia, PTSD, ADD, hallucinations and beyond. TMS is also in research for physical ailments in the treatment pain (including fibromyalgia) and tinnitus.
7. What are some facts about TMS therapy?
• Non-drug treatment
• Non-Surgical treatment
• No anesthesia or sedation required –You are awake during TMS therapy
• Out-patient treatment –You can maintain your normal daily activities (at school/work)
• Safe, Few or No Side Effects – Over 1 million patients have been treated with TMS therapy. There are no adverse effects on memory or cognition (as compared to ECT) and no weight gain, sleep, sexual side effects nor drug interactions (as compared to commonly used medications) (Some patient may experience a headache or scalp discomfort temporally, but it is usually easily tolerated)
• Proven –Statistically and clinically significant improvement in depression symptoms.
In an open-label trial, 1 in 2 patients suffering from depression improved significantly, and 1 in 3 patients was completely free of depression symptoms2. (*those patients failed one or more medication trial.).
In private practice, TMS has achieved excellent results when care is combined with adequate medication and psychotherapy. Our assessment of private practice results are:
• 70-75 % patient response rate
• 55-65 % remission rate
8. How long does TMS Therapy take?
Each treatment takes approximately 20 minutes. Generally, the initial course of treatment will involve thirty treatments over the 5 weeks. Then we will finish the treatments by delivering three treatments in week 6, two treatments in week 7, and one final treatment in week 8.
9. How does the treatment feel?
Patients who have undergone TMS Therapy described the first treatments as a tapping sensation. The sensation may feel uncomfortable and at times mildly painful. Those that feel slight pain can manage it effectively with over the counter pain reducers. This pain is usually short-lived as it is handled less with each subsequent treatment.
10. How long does TMS treatment effects last or endure?
TMS treatment effects are known to have long-lasting effects. Some patients have maintained wellness on medications alone for over two years. Others may require medication changes or reintroduction of a short session of TMS. It differs for each since depression is a complex illness affected by your specific biological and environmental factors.
11. Am I Eligible?
The following general requirements will need to be understood by our doctors met before receiving TMS therapy:
• Currently diagnosed with treatment-resistant depression (without psychosis) by a psychiatrist, physician or qualified health care professional. Treatment- resistance is defined as several antidepressant failure at or above the minimal effective dose and duration in the current episode.
• No previous history of epilepsy unless stable on medication
• No foreign metal cranial bodies or metallic/magnetic implants above the shoulders (pacemakers and dental fillings are safe)
12. Am I a good candidate for TMS?
The best way for you to determine if TMS is right for you is by speaking with a member of our TMS clinical team. You can also take this survey to gain a better understanding.