What is TMS?
Transcranial magnetic stimulation, or TMS, is a non-invasive, drug-free treatment for depression that is FDA approved and covered by most insurance companies. It is a targeted therapy for treatment resistant depression that uses magnetic fields to stimulate a region of the brain that has been found to be underactive in those suffering from depression.
TMS has been shown to be effective in people who have tried and failed multiple antidepressants and augmentation strategies. Because TMS is a targeted treatment, it has fewer systemic side effects than most medications.
Is TMS Therapy like electroconvulsive therapy (ECT)? What is the difference?
No, the two procedures are very different. While both are effective in the treatment of depression, there are many differences in safety and tolerability. TMS is a non-invasive therapy that stimulates activation of a patient’s brain with pulsed magnetic fields. TMS patients sit in a chair and are awake and alert throughout the entire 19-37 minute procedure – no sedation is used with TMS Therapy. Patients can transport themselves to and from treatment. In contrast, "shock therapy," or electroconvulsive therapy (ECT), intentionally causes a seizure through the direct application of electrical current. Patients receiving ECT must be sedated with general anesthesia and paralyzed with muscle relaxants. Recovery from an ECT treatment session occurs slowly, and patients are usually closely monitored for minutes or a even few hours after a treatment.
What are the common side effects of TMS?
Unlike ECT (electroconvulsive therapy) where short-term confusion and memory loss and long-term disruptions in memory have been shown to occur, TMS has little to no side effects. Some patients who undergo TMS therapy report headache, fatigue, scalp soreness, or dizziness. However, these side effects tend to fade within the first week of treatment.
How long does the antidepressant effect last? Will I need any therapy beyond the first treatment regimen?
The TMS system has a durability of its effects established over 12 months. In a clinical trial, two out of three patients who had either responded to treatment or completely remitted their depression symptoms reported 12 months later that they remained at the level they were at the end of the trial. Additionally, after the trial, only one in three patients needed to return for 'maintenance' TMS sessions.
Does TMS cause memory loss?
Unlike ECT (electroconvulsive therapy) treatment where memory loss is the primary side effect, TMS is seen to improve memory function. In the last few years there have been scores of studies evaluating the effect of TMS on people's ability to perform mental tasks, particularly those that involve discerning visual patterns, re-calling lists of unrelated words, or doing math problems. Overall, the results indicate that TMS could be combined with cognitive exercises to improve function and memory.
Does TMS require sedation?
TMS does not require sedation. All that is required is that the patient sit still in the ergonomic treatment chair for the duration of treatment. Patients undergoing TMS therapy can return to their daily activities immediately following treatment.
Can TMS Therapy cause brain tumors?
No,TMS Therapy uses the same type and strength 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.
Am I a good candidate for TMS?
Our patients complete an initial evaluation appointment with our board-certified Psychiatrists in order to determine if TMS is a good treatment option. During the appointment, we review your treatment and medication history. You will also have the opportunity to discuss your current medications, and ask any remaining questions you may have regarding treatment.
Is TMS effective for other conditions?
Yes, TMS has been shown to be effective in the treatment of conditions such as Obsessive Compulsive Disorder, Schizoaffective Disorders, Bipolar Depression, Chronic Pain and Addiction (tobacco, drugs, and other substances).
Does insurance cover TMS therapy?
Many insurance companies will cover a large portion of the cost of TMS treatment. At Boulder Center for TMS, we are often able to contract single case agreements with insurance companies. This means that even if we are considered out of network by your insurance company, they will cover treatment at an in-network level. We research your insurance benefits for you and make sure you are aware of any out-of-pocket costs before beginning treatment, so that you can make an informed decision based on your unique financial needs.
How does my insurance company determine whether or not they will cover my TMS therapy?
The coverage determination guidelines for TMS vary among insurance companies, but in general TMS therapy will be covered if you have met certain criteria.