TMS utilizes magnetic pulses to treat depression, anxiety, OCD, and other mood disorders. TMS stands for Transcranial Magnetic Stimulation so it uses magnets, it NOT electricity like ECT! These magnetic pulses gently stimulate a specific area of the brain that stopped working properly in individuals with depression symptoms. If you're depressed, areas of your brain don't function the way they should. The communication, using neurotransmitters, is just not active enough. TMS therapy encourages the brain to stimulate electrochemical signaling, which is how different parts of the brain communicate with each other. Notice how little brain activity you have when you're depressed?

The area needing help is called the Dorsolateral Prefrontal Cortex or DLPFC for short. The DLPFC is a relatively superficial location, which makes it easy for the magnetic pulses to reach. We're lucky because your DLPFC is connected to deeper brain structures that are also involved in mood regulation. So, when you treat the DLPFC, you treat that entire circuit, like a domino effect! With TMS, the brain can "relearn" how to modulate the neurotransmitters involved in electrochemical signaling.

TMS therapy is a well-tolerated treatment for most patients,although it does not work for everyone. Side effects, whileinfrequent, can include minimal headaches.TMS very targeted treatment so it does not cause side effects.The pulses can cause scalp tenderness when the pulses are emitting, but rarely causes a lasting headache. TMS has a less than 0.1% risk of seizure. Some patients can feel a little tired after the first few treatments, as it is like a "work-out" for thebrain.

At CalTMS, a typical TMS session lasts approximately 20 minutes. The sessions continue for five days a week over a duration of four to six weeks. Occasionally, a two-week tapering period may follow consisting of just a few sessions a week.

Yes. TMS is an FDA-approved treatment, which means it's completely safe to administer to patients. It's also noninvasive and virtually pain-free.

Many TMS patients experience an increase in mood, energy, and appetite, while also experiencing a reduction in anxiety. 83% of people experience improvements, 62% achieve complete remission from their depression.

To date, there is no evidence that TMS causes any kind oflong-term damage to the brain. TMS does carry a very minor risk or seizure during treatment, specifically less than0.1%. This risk seems to be more associated with those who are already at risk of seizure, whether due to a medication, a chronic condition such as epilepsy, or secondary to drug and alcohol use.

Yes, a person can have additional courses of TMS. In fact, patients who respond well to TMS initially, are more likely

to continue to respond positively to TMS if needed again in the future.

Yes, there is lots of data to support the benefits of TMS for anxiety. In fact, there iS a separate treatment protocol for anxiety, though it is not FDA approved at this time. However it is approved for Anxious Depression Use.

It is very unlikely for TMS to worsen symptoms, but there is a remote possibility for some patients that their symptoms can seem to get worse before they get better.  This is commonly referred to as a “Dip”  This is usually short lived only lasting 5-7 days and typically self resolving.

Yes, however, there is a less than 0.1% risk of seizure associated with TMS. If a patient has a history of seizures, or if they could be withdrawing from alcohol or a benzodiazepine, the risk could be higher and the TMS provider should be notified of any increased risk potential prior to starting TMS treatment.

Yes, deep TMS has the FDA approval as a treatment for OCD. Currently, only deep TMS has FDA approval for its use in treating OCD, but there currently is no 'cure" for OCD but it can be minimized by treating the symptoms.

Yes, TMS has been used off-label to help treat PTSD, but it should always be used in conjunction with trauma therapy to prevent exacerbation of memories that can trigger symptoms.

Yes, TMS has been shown to help improve long term memory in older adults.

83% of people experience improvements, 62% achieve complete remission from their depression.

Yes, unlike ECT, you can continue to drive your car after TMS treatments.

Training is provided by manufacturers of the device, as well as ongoing support. Many medical centers offer advanced courses on the treatment.

Patients who have failed to respond to antidepressants or psychotherapy are the ideal candidates for TMS. People who are not a good fit for TMS are those with metallic implants in ears or eyes, stents in the neck or brain, and other metal devices implanted in or near the head should refrain from undergoing TMS therapy.

No. While TMS is safe, painless, and has little-to-no side effects, ECT or electroconvulsive therapy requires general anesthesia which can carry some risk. And unlike TMS, whose patients can immediately resume activities like driving and physical exercise, electroconvulsive therapy (ECT) patients require an extended recovery period and heightened risk of seizure and memory loss.

TMS has been shown to produce changes in the activity of neurons of the limbic system, which is linked to mood regulation. The procedure consists of magnetic pulses inducing brain activity in the cells of that region. These pulses activate the limbic system cells to improve symptoms of depression. TMS is most often prescribed when other treatments for depression have not been effective.

It is very unlikely for TMS to ever cause anxiety, in fact, it is used to treat anxiety off-label. However, there is a remote possibility for TMS to unmask anxiety symptoms that were underlying a severe depression.

No, in fact, recent studies have shown TMS, when targeted at the Parietal lobe, can help with age-related memory loss as well as possible Alzheimer's dementia-related memory loss.

TMS is currently under investigation for its use in treating Bipolar disorder. It is currently not FDA-approved for Bipolar Depression, but the ongoing studies are showing some positive results.

Yes, mild fatigue is not uncommon after the first few treatments of TMS, as it is a like a "work-out" for the brain. However, for many patients, this is a very welcomed effect and can be a benefit for a many patients who experience insomnia due to their depression.

TMS can cause scalp tenderness during the treatment pulses but typically does not cause a lasting headache. For patients who are prone to headaches, they can premedicate with ibuprofen or acetaminophen prior to treatments to prevent a headache.

TMS can be used to help enhance cognition which can improve one's ability to learn new information.

Depression is considered in terms of "remission" and" recurrence." TMS can put depression into remission for an extended period of time but there is a possibility, depending on the nature of the patient's depression, symptoms can recur down the road. If this does occur, then patients are even more likely to respond positively to repeated TMS treatments.

The basic answer to this question is that the time to respond to TMS therapy varies. Patients can see improvement in their depression symptoms any time within the first third, middle third or end, and even as far out as 34 weeks. It is highly recommended that patients complete the TMS course to give them the best chance possible of achieving optimal results from the treatment.

How much do the benefits outweigh the disadvantages when it comes to TMS and depression medications?

Pros & Cons of Medications

- covered by almost all insurance plans

- taken every day without requiring a daily office visit 

- systemic side effects

- severe withdrawal when stopped

Pros & Cons of TMS

- covered by almost all insurance plans

- daily treatment for 30 consecutive treatments (Followed by Taper)

- no systemic side effects

- no withdrawal when treatment ends

As you can see, both medications and TMS have their own set of pros and cons.

Both medications and TMS are covered by almost all insurance plans, however, currently, insurance companies require some type of attempt to try medication before TMS can be approved and covered.