What is Transcranial Magnetic Stimulation?
By Stefani LaFrenierre, MD
Transcranial Magnetic Stimulation (TMS) is an FDA-approved magnetic stimulation treatment targeting the brain cells. TMS is used to treat major depressive disorder, post traumatic stress disorder, and other mental health conditions when antidepressant medications aren’t working. Covered by most insurances, TMS offers a safe and effective option for those who have not found relief with medication.
Unlike ECT (electroconvulsive therapy), Transcranial magnetic stimulation is non-invasive, requires no anesthesia, and does not have any associated memory loss. There is no downtime in between treatments, and patients can drive themselves to and from treatment.
During Transcranial Magnetic Stimulation (TMS) treatment, patients can expect a comfortable and non-invasive experience. At Resiliency Mind+Body Medicine, we use the Brainsway Deep TMS machine, an FDA-approved system that utilizes magnetic coils to stimulate nerve cells deep in the brain in areas related to depression, anxiety, OCD, and PTSD (Deep TMS™). Deep TMS treatment has been proven to offer significant results by directly stimulating deeper and broader areas of the brain, effectively treating conditions such as depression, anxious depression, obsessive-compulsive disorder, and smoking addiction.
What Happens at your TMS Consultation?
Our psychiatrist takes a thorough history of your mental and physical health. We determine if you meet the criteria for major depressive disorder, obsessive compulsive disorder, post traumatic stress disorder, or other mental health conditions. There are a few things that may need special consideration, including a history of seizures, metal in the head or neck area, a history of bipolar disorder or schizophrenia. These conditions may require close monitoring during Transcranial Magnetic Stimulation treatments, and in some cases may prevent you from receiving treatment. The initial TMS consulation lasts approximately one hour, and is covered by insurance if you are in-network with us.
What to Expect at your first TMS appointment
The first visit involves initial mapping, which refers to the initial TMS therapy session where your psychiatrist will measure and record accurate placement of the magnetic coil based on the specific anatomy of your head. A tight-fitting cap will be placed on your head which will assist in mapping the correct area for targeted TMS treatment. This session is non-invasive and you will be comfortable the entire time in our treatment chair. This session takes approximately 30 minutes.
What Do Typical Treatment Courses Look Like?
Each patient typically undergoes 34-36 total TMS treatments that are done daily Monday through Friday for five to six weeks. Each session will take approximately 15-20 minutes, with total clinic visit time expected to be 30 minutes each of these visits. By then end of treatment for major depressive disorder, with Brainsway Deep TMS you can expect a 65% or more remission rate (meaning symptoms are gone), and an 82% or more response rate (meaning symptoms significantly decrease by 50% or more).
What To Expect for Repeat TMS Sessions
- Preparation: Patients will be comfortably seated in a chair, and the TMS technician will ensure proper positioning of the magnetic coil and comfortable placement. The patient’s specific head measurements that were recorded during mapping will be used each visit for optimal placement of the magnetic coil.
- Coil Placement: The TMS technician will place a specially designed magnetic coil on the patient’s scalp that is contained in a Brainsway helmet. The coil is positioned over the targeted brain region, typically the dorsolateral left prefrontal cortex. The coil is on a moving stand and will rest comfortably against the scalp.
- Magnetic Stimulation: Once the coil is in place, the TMS machine will be activated, delivering rapid and painless magnetic pulses. Patients may hear clicking sounds and feel a tapping or tingling sensation on the scalp during the stimulation.
- Treatment Duration: A typical TMS session lasts approximately 15 minutes, depending on the specific treatment protocol prescribed by the psychiatrist.
- Post-Session Activities: After each session, patients can resume their normal activities immediately, as there is no recovery time needed. TMS therapy does not impair cognitive functioning, so individuals can drive or return to work or daily tasks without restrictions.
Insurance Coverage:
Insurance coverage for TMS treatment varies depending on the specific insurance plan and the diagnosed condition. Major depressive disorder (MDD) is the most commonly covered diagnosis for TMS therapy. Many insurance providers recognize the effectiveness of TMS for MDD and may provide coverage for a predetermined number of treatment sessions. However, it is essential for patients to contact their insurance provider to determine the extent of coverage, any pre-authorization requirements, and potential out-of-pocket costs. Our team at Resiliency Mind+Body Medicine will assist in the pre-authorization and verification of benefits process.
While insurance coverage for other mental health conditions, such as anxiety disorders or obsessive-compulsive disorder (OCD), may also be available, it is advisable to check with the insurance provider for specific details. Some plans may require documentation of treatment resistance by having failed one or more antidepressant medication trials, or documentation of intolerance to traditional therapies before approving coverage for TMS.
Additionally, it is important to consult with your team at Resiliency Mind+Body Medicine to navigate insurance coverage. We can assist in verifying benefits and obtaining prior authorizations if needed. We also offer alternative payment options or financial assistance programs for those without insurance coverage.
TMS Therapy with Resiliency Mind+Body Medicine
At Resiliency Mind+Body Medicine, you can expect the highest level of personalized care when it comes to your TMS treatments. Unlike other TMS clinics, we make sure our patients heal and recover with weekly check-ins with the psychiatrist, weekly assessments to capture progress, and closely monitored treatments that are adjusted as needed to get your symptoms into remission. We offer a modern, state-of-the-art clinic environment with refreshments to nurture the mind and body while you undergo TMS therapy. Our clinic in Newport Beach is located right next to Hoag Hospital, and we offer validated valet parking to make your daily journey to your TMS sessions as stress-free as possible.
In conclusion, a TMS session is a comfortable and non-invasive procedure that involves the placement of an electromagnetic coil on the scalp to deliver magnetic pulses to specific nerve cells in the brain regions involved in mood disorders, PTSD, and other mental health conditions. Insurance coverage for TMS varies, with major depressive disorder being the most commonly covered diagnosis. Join us today to experience the break through healing of Transcranial Magnetic Stimulation.
