Initial Consultation
The goal of the initial consultation is to assess whether TMS treatment is likely to be safe and effective for you, and to help you understand how TMS compares with other available treatment strategies. We will review the potential benefits, risks, and possible side effects. If we feel that other treatments are more likely to be effective, we will advise you of this. In some cases, additional diagnostic testing will be recommended, such as hormone levels, other lab tests, sleep studies, or brain imaging.
Motor Threshold Determination
If TMS is the right treatment for you, your treatment can be scheduled to begin quickly. In the first session, we establish the optimal placement of the TMS coil and the optimal strength of the magnetic field for you. This is referred to as Motor Threshold Determination. Motor Threshold Determination takes 45 to 60 minutes. There is rarely any discomfort during this procedure. When optimal coil placement and magnetic field strength have been determined, you are ready to begin treatment sessions.
Treatment Sessions
Treatment sessions last 37 to 55 minutes, depending on your individualized treatment parameters. You will be awake and alert, reclining in a comfortable chair. The magnetic pulses produce a moderately loud clicking sound and a tapping sensation on the scalp. You will be given earplugs for hearing protection. The tapping sensation is usually well-tolerated, but may result in mild discomfort. Your doctor may advise pre treatment with Advil or Tylenol if the tapping is bothersome. If you wish, you can watch a video or listen to music during the TMS session. After the treatment you can drive and resume your normal activity. Side effects may include mild headache or fatigue and usually resolve quickly.
A typical course of TMS treatment for depression involves TMS sessions five days a week for four to six weeks, although this can vary depending on your response. As you progress through your treatment, we will regularly assess with you your response and determine with you the eventual number of treatments.