TMS Therapy Accepting New Patients
What is TMS?
Transcranial magnetic stimulation (TMS) is a non-medication treatment for depression. It uses a magnetic coil placed against the scalp to stimulate areas of the brain involved in mood regulation. TMS was first cleared by the FDA for depression in 2008, and it has been studied in thousands of patients since then.
TMS does not require anesthesia or sedation. You are awake and alert during treatment, and you can drive yourself home or return to work afterward.
At Lott Behavioral Health, we use the MagVenture MagPro R30 TMS system. It is FDA-cleared to treat major depressive disorder in adults who have not improved enough with antidepressant medication, and to be used alongside other treatment for obsessive-compulsive disorder (OCD).
What to expect
Starting a new treatment can be a lot to take on, especially when you are already dealing with depression. TMS works differently from medication. It acts directly on the brain rather than through the bloodstream, so it does not cause the weight gain, drowsiness, or sexual side effects that some antidepressants do.
Treatment takes place at our office in a private room. You sit in a reclined chair, and a technician positions the coil and stays with you for the session. You can talk, listen to music, or rest during treatment. Afterward, you can drive, work, and go about your day as usual.
If you are considering TMS for yourself or a family member, call our office. We can answer questions about the process and whether it may be a fit.
Who can benefit?
TMS may be a good option if you have depression and have tried one or more antidepressants without enough improvement, or if you could not tolerate their side effects.
TMS may also help adults with OCD whose symptoms continue despite standard treatment.
TMS is not right for everyone. People with non-removable metal in or near the head, such as aneurysm clips, cochlear implants, or certain implanted stimulators, generally cannot receive TMS. A history of seizures also needs careful review. We will go over these questions during your evaluation.
How it works
Depression is associated with reduced activity in certain brain regions, especially the left dorsolateral prefrontal cortex, an area involved in mood and decision-making. The TMS coil produces brief magnetic pulses. These pulses pass through the scalp and skull and create small electrical currents in the brain tissue beneath the coil.
Repeated over a course of treatment, this stimulation is thought to strengthen activity in mood-regulating circuits and the connections between them.
In clinical studies of patients who had not responded to medication, about half responded to TMS, and about one-third had full remission of their symptoms.
What is treatment like?
At LBH, the process starts with a screening phone call to gather information about your symptoms and treatment history. Next, we schedule you for an evaluation with one of our licensed providers. During this psychiatric evaluation, you will meet one on one with the provider, who will review your history and make a diagnosis. At the end of this process, we will review our findings and discuss treatment recommendations. If TMS is recommended, we will go over its risks and benefits in more detail.
If you are using insurance, we will request authorization from your insurance company before treatment begins.
Your first session takes longer than the rest. During this visit, we find the correct coil position and measure your motor threshold, the amount of stimulation needed for your treatment. After that, treatments are given in a comfortable chair while you are awake. You will hear a tapping sound and feel a tapping sensation on your scalp. Most people get used to this within the first few sessions. Standard treatment sessions take 15 to 40 minutes, depending on the protocol.
A typical course is 5 sessions per week for about 6 weeks, followed by a short taper. However, newer accelerated protocols can be completed in as short as 5 days, but these faster courses are not yet covered by insurance. The most common side effects are scalp discomfort and headache, which usually lessen as treatment continues. Seizures are a rare but serious risk.
What other options are there?
If TMS does not work, or if it is not the right choice for you, there are other options for treatment-resistant depression:
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Esketamine (Spravato) (click here to learn more)
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Ketamine (click here to learn more)
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Continued medication trials
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Psychotherapy
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Electroconvulsive therapy (ECT)
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Vagus nerve stimulation (VNS)
We provide esketamine, ketamine, medication management, and psychotherapy at our office. We refer to other local providers for ECT and VNS.
Payment & Insurance
TMS for depression, using standard FDA-cleared protocols, is covered by most insurance plans. Most plans require that you have tried a certain number of antidepressants before they approve TMS. You may still owe a payment depending on your plan and deductible. We will tell you about any amount you owe before treatment begins.
Some newer TMS protocols are not yet covered by insurance. If one of these is recommended for you, it is available on a self-pay basis. We will review the cost with you before you begin.
Call our office at 630-730-5506 to schedule or to get more information.