An Effective New Depression Treatment Without Medication.

Transcranial Magnetic Stimulation (TMS) is a technological breakthrough in the treatment of depression.
As technology advances researchers are finding more ways to treat illnesses in the brain without medications.

TMS is a non-invasive treatment that uses magnetic waves, similar to the MRI, to stimulate areas of the brain that are underacting and causing depression or other mental illnesses such as anxiety, OCD, addictions, etc.

TMS treatments require no surgery or anesthesia. After the session the patient is able to get into a car and drive.

This procedure is a safe alternative to traditional ways of treating common mental illnesses. There are no systemic side effects from TMS as with anti-depressant medications.

TMS magnetic waves produce no radiation, and the TMS technician is in room with the patient for the entire time during treatment.

TMS began to be widely used in the United States after receiving FDA clearance in 2008. In 2015 insurance companies started providing coverage for TMS when they realized how effective the TMS treatments are.

Numerous studies over the years have demonstrated that TMS treatment is effective for 70-80% of medication resistant patients of Major Depression, with about a 50% remission rate after struggling with depression over many years.

Today there are 7 different manufacturers worldwide who supply FDA cleared TMS machines. All major hospital systems in the United States currently treat patients with TMS for many different types of disorders.

Millions of patients worldwide have already received TMS treatments with great results, and no systemic side effects reported.

Transcranial Magnetic Stimulation is administered by placing a TMS helmet over the patient’s head.

Patients are not anesthetized and are fully conscious and aware during their treatment.

TMS uses safe, non-invasive magnetic pulses to facilitate neural activity in the brain.

During a TMS treatment, hundreds of these pulses are delivered to the frontal lobe of the brain associated with mood control and depression. This is delivered in short 2-second bursts with 20-second intervals in between bursts, for a total of under 20 minutes. It is done while the patient is awake.

Patients sit in a comfortable chair and are able to chat with the TMS Technician or friends and family, watch tv, read a book, or use an iPad during their appointment.

TMS treatments are completely non-invasive and well tolerated. A loud clicking sound emanates from a helmet placed close to the head. The patient will experience a tapping sensation on the scalp, often described as the feeling of a woodpecker.

The most common adverse effect related to TMS therapy is scalp pain or discomfort, clenched jaws, or other minor discomfort at the treatment site. This goes away by the end of the session and declines markedly after the first few treatments.

Some patients experience mild headaches after the session, but this is even less common.
During treatment the TMS technician monitors the intensity of the TMS pulses to ensure the patient’s comfort.

There is a small risk of seizure induction during treatment, which is rare and estimated to be in less than 1 in 30,000 cases, with no further adverse results. This is at a rate lower than the seizure rate of anti-depressants.

TMS treatment does not involve any anesthesia or sedation and 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.

There are no reported systemic side effects from TMS as in what may be experienced with anti-depressant medications

Yes, it is advised that patients continue their medication regimen as prescribed by their providers, and for patients to continue seeing their mental health providers during and after TMS treatment.

Psychiatrist may start tapering patients off anti-depressant medications sometime after the TMS treatments and develop a long-term treatment plan for maintenance from relapse of depression.

Treatments are generally delivered 5 days a week over an approximate 6 week period.
The individual session lasts no longer than 20 minutes.

Patients are able to drive and/or return to work and/or other daily activities immediately after treatment.

We understand that it may be unavoidable to miss a day here and there. The efficacy of the treatment should not be impacted from sporadic skipping of sessions.

In the United States, the Food and Drug Administration (FDA) has approved TMS for treatment-resistant major depressive disorder (MDD).

The only device that is FDA approved for obsessive-compulsive disorder (OCD), anxious depression and smoking cessation is the Brainsway dTMS machine which is the one we utilize in our practice.

Numerous clinical trials provide evidence that TMS can safely and effectively treat other conditions, such as anxiety, PTSD (post-traumatic stress disorder), Parkinson’s disease, ADHD, and some other illnesses as well.

Our primary treatment goal currently in our practice is to alleviate symptoms of clinical depression, anxious depression and/or OCD.

TMS treatment should not be used by anyone with a seizure disorder or high seizure risk.

TMS should also not be used by anyone who has magnetic-sensitive metal in their head within 10 cm or 4 inches from the TMS coil, that cannot be removed.
This would include patients with any unremovable metal, implanted in or around the head, including metal plates, aneurysm coils, cochlear implants, ocular implants, brain stimulation devices, stents or bullet fragments.

The durability of TMS treatment for depression is usually maintained for at least 6-12 months after treatment.

When patients feel an increase in their symptoms of depression they should contact us to discuss continued TMS depression maintenance treatments, or possible complete TMS re-treatments.

Study after study has demonstrated, both the evidence-based studies and those done in individual clinics, including ours, that Deep TMS (dTMS) provides substantial relief from depression for medication-resistant patients in 70%-80% of the cases. More than half of patients experience complete remission from depression.

During the TMS treatment patients will feel a very short rapid 2-second pulse-like tapping against their forehead. This happens in 20-second intervals. It is not painful and is often described like the tapping of a woodpecker.

Some patients will feel scalp discomfort with a possible mild to moderate headache during session. This mostly dissipates after the session, and markedly improves after the first few treatments.

The TMS Technician will monitor the intensity of the pulses to insure the patient’s comfort.

Patients remain awake and alert during the treatment and are able to drive and/or return to work and/or other daily activities immediately after treatment.

Less than 5% of patients discontinue treatment due to discomfort.

Most patients feel a positive difference in their moods by the 2nd or 3rd week. For others it could take 4-5 weeks to enjoy significant response. A minor few will not experience any, or just minimal help from TMS. They will need to seek other alternative treatments. There will however not be any downside to the TMS treatment.

Antidepressants work for some individuals. Many in the depressed population however, are resistant to antidepressant medications or cannot tolerate the side effects of the medication.

Antidepressants can cause numerous side effects including nausea, diarrhea or constipation, insomnia or drowsiness, lack of emotion, weight gain, headaches, dizziness, anxiety and sexual dysfunction.

This is where TMS becomes a very good option.

TMS is non-systemic, it does not circulate in your blood or inside your body so it will not have any bodily side effects.

TMS substantially reduces depression in 70%-80% of medicine resistant depression patients, with about half reporting remission from their symptoms of depression.

Both ECT (Electroconvulsive Therapy) and TMS (Transcranial Magnetic Stimulation Therapy) are forms of brain stimulation that are proven to be very effective in the treatment of depression, yet there are vast differences in side effects and tolerability between the two.

ECT is an invasive shock therapy treatment. It requires anesthesia, electrodes, and electric shocks.

For many people ECT can be too difficult to tolerate due to possible side effects on memory loss, cognition, dizziness, dry mouth, insomnia/drowsiness, and nausea.

TMS uses safe, non-invasive magnetic pulses to facilitate neural activity in the brain. It has been shown to be effective on treatment resistant patients suffering from depression with minimal to no side effects.

Unlike ECT, TMS patients are awake and alert during treatment and can drive themself home or to work after their session.

rTMS stands for RepetitiveTMS, where thousands of repetitive pulses are generated to deliver magnetic waves into the prefrontal cortex of the brain by figure-8 coils. These older figure-8 coils used by all previous TMS machines are placed on the left side of the brain and are limited in how far the magnetic waves can penetrate into that section of the brain.

dTMS which stands for Deep TMS is a newer technology developed by Brainsway Ltd, which uses a three-dimensional helmet design that is placed on top of the head.

Its advantage lies in its combined ability to encompass a broader surface area of the brain stimulating deeper structures more directly within the brain, and to also more efficiently target those crucial structures in the brain linked to mood control and mental health conditions.

A 2019 study published in the Journal of Psychiatric Research found the difference between these treatments to significantly favor Deep TMS, noting that patients with depression reached higher rates of response under the Deep TMS treatment, when compared to the traditional rTMS.

Brainsway’s Deep TMS system is currently the only system on the market that is cleared by the FDA to treat OCD, anxious depression and smoking cessation.