TMS Therapy FAQ’s
TMS stands for transcranial magnetic stimulation. It is used to treat depression by stimulating the brain non-invasively using electromagnetic fields, similar to those produced by an MRI machine. During TMS Therapy, a magnetic field is administered in very short pulses to the part of your brain that research has demonstrated to be associated with depression. The typical initial course of treatment is about 37 minutes daily over 4-6 weeks.
The NeuroStar TMS Therapy system uses short pulses of magnetic fields to stimulate the area of the brain that is thought to function abnormally in patients with depression. The magnetic field produces an electric current in the brain that stimulates the brain cells (neurons). This results in changes that are thought to be beneficial in the treatment of depression.
An ever-growing number of TMS cases are receiving reimbursement from a wide range of insurance companies. However, it typically takes time for most healthcare insurers to establish coverage policies for newly-approved treatments like TMS Therapy. Thus, TMS might not be covered currently by your health insurance plan. Calabasas Behavioral Health will work with you and your insurance provider to seek reimbursement.
Is TMS Therapy a good alternative for patients who cannot tolerate the side effects associated with antidepressant medications?
Transcranial magnetic stimulation therapy is non-systemic (does not circulate in the blood throughout the body), so it does not have side effects such as weight gain, sexual dysfunction, nausea, dry mouth, sedation, etc. The most common side effects reported during clinical trials were headache and scalp discomfort – generally mild to moderate – occurring less frequently after the first week of treatment.
No. TMS Therapy involves a unique method of using pulsed magnetic fields for potential therapeutic benefit. The intensity of the magnetic field is similar to that of the magnetic fields used in magnetic resonance imaging, or MRI. These techniques differ radically from the popular use of low intensity, static magnetic fields. These products deliver weak and undirected static fields that are not capable of activating brain cells.
No, the two procedures are very different. While both are effective in the treatment of depression, there are many differences in safety and tolerability.
During the TMS Therapy procedure, patients relax comfortably in a chair and are awake and alert throughout the entire 37-minute procedure – no sedation is used with TMS Therapy. Patients can transport themselves to and from treatment.
In over 10,000 active treatments with NeuroStar TMS Therapy in clinical trials, no seizures were observed. TMS Therapy was also shown to have no negative effects on memory function in these studies.
In contrast, “shock therapy,” or electroconvulsive therapy (ECT), intentionally causes a seizure. 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 few hours after a treatment.
In ECT, short-term confusion and memory loss are very common, and long-term disruptions in memory have been shown to occur and may persist indefinitely in some people. Because of the side effects associated with ECT, a significant amount of caregiver support is required.
In clinical trials, patients received NeuroStar TMS Therapy 5 times per week for 37 minutes sessions over 4-6 weeks. We have had best results in patients that are treated for six weeks. Patients treated with NeuroStar TMS Therapy should receive treatment for a minimum of four weeks with additional treatments based on clinical judgment and individual outcomes.
NeuroStar TMS Therapy is well tolerated and has been demonstrated to be safe in clinical trials. Throughout over 10,000 active treatments performed in clinical trials, the most commonly reported side effect related to treatment was scalp discomfort during treatment sessions. This side effect was generally mild to moderate, and occurred less frequently after the first week of treatment. Less than 5% of patients treated with NeuroStar TMS Therapy discontinued treatment due to side effects.
In NeuroStar clinical trials, over 10,000 TMS treatments demonstrated its safety, with no occurrence of seizures. However, there is a small risk of a seizure occurring during treatment. This risk is no greater than what has been observed with oral antidepressant medications.
While NeuroStar TMS Therapy has been demonstrated effective, not all patients will benefit from it. We carefully monitor our patients for worsening symptoms, signs or symptoms of suicidal behavior, and/or unusual behavior. Families and caregivers should also be aware of the need to observe patients and notify their treatment provider if symptoms worsen. Worsening symptoms are not a side effect of TMS, however they may occur as a part of the progression of depression that does not get better with treatment.
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.
No, NeuroStar TMS Therapy was systematically evaluated for its effects on memory. Clinical trials demonstrated that NeuroStar TMS Therapy does not result in any negative effects on memory or concentration.
The most common side effect related to treatment is scalp discomfort during treatment sessions and occasional headaches. This side effect is generally mild to moderate, and occurs less frequently after the first week of treatment.
If necessary, you can treat this discomfort with whatever pain reliever you routinely use. If these side effects persist, Dr. Werner-Crohn may recommend temporarily reducing the strength of the magnetic field pulses being administered in order to make treatment more comfortable.
How long does the antidepressant effect last? Will I need any therapy beyond the first treatment regimen?
In most patients, the clinical benefit of NeuroStar TMS Therapy was maintained through 6 months of follow-up study. Throughout your treatment Dr. Werner-Crohn will discuss options for your long-term treatment plan.
Yes. In clinical trials, NeuroStar TMS Therapy was safely administered with and without other antidepressant medications. During your initial consultation we will discuss with you how TMS can help to make some antidepressants perform more optimally.
Does FDA-clearance of the NeuroStar TMS Therapy system mean that all TMS devices are cleared for use in major depression within the United States?
No, the NeuroStar TMS Therapy system is the first and only TMS device to be cleared by the U.S. Food and Drug Administration (FDA) for the treatment of major depression. The NeuroStar TMS Therapy system is also the first and only TMS device to have been evaluated in a large, multicenter, controlled clinical trial. No other TMS device can claim to be “FDA-cleared” for the treatment of depression. These devices have not been demonstrated to be safe and effective for treating depression.