QUESTIONS AND ANSWERS
TMS stands for Transcranial Magnetic Stimulation, a safe and non-invasive treatment for Treatment Resistant Major Depressive Disorder (TRMDD) and Obsessive Compulsive Disorder (OCD).
TMS, when utilized for major depressive disorder has a good chance to work for you. Results in our clinic have shown that about 75% of our patients have had a response (a response is a reduction in symptoms of at least 50%) to TMS and about 50% have gone into full remission of their depressive symptoms. There are some individuals that TMS will not work for. TMS for OCD has varied results.
Because of the large number of individuals benefiting from TMS, most insurance companies including Medicare are providing coverage. We can help you find out whether your insurance will cover treatment. TMS costs are more affordable than you may think or have heard.
TMS for OCD is not a widely covered treatment option. Call our office today to discuss further.
TMS treatment is beneficial for those suffering from TRMDD. Those who wish to avoid the side effects of antidepressants can also be helped.
You will be seated comfortably in our private treatment room. A TMS device will be positioned onto your head and you will begin to feel a tapping sensation every few seconds. You may watch TV, read, or use your phone during treatment. A TMS technician will remain in the room to ensure your comfort and care. After the 20-minute session, you will be able to resume daily activities without limitations.
Yes. TMS was cleared by the FDA in 2008 and is only contraindicated in patients with implanted metallic devices or non-removable metallic objects in or around the head (except for standard amalgam dental fillings).
Generally, TMS is well tolerated. A few patients have reported slight headaches, toothaches, or some discomfort at the treatment site which goes away at the end of each treatment session.
A treatment session takes approximately 20 minutes a day, 5 days a week for 36 total treatment sessions or about 6-8 weeks.
Antidepressants work for some individuals. About 30% of the depressed population are resistant to antidepressant medications and others cannot tolerate the side effects of medication. This is where TMS becomes an option for you.
Both treatments have been found to be helpful for treatment resistant depression. ECT is the preferred treatment for depression associated with psychotic features, catatonia or active suicidal thoughts; however, ECT is very invasive as it requires anesthesia, electrodes, and electric shocks, and often results in memory loss. TMS uses safe, non-invasive magnetic pulses and has been shown most “treatment resistant” patients respond to TMS.
Patients usually stay on their current medication regimen throughout the TMS treatment.
TMS was first widely used in the USA after receiving FDA clearance starting in 2008. It was in 2015 that insurance companies first realized how effective TMS treatment can be and thus started providing coverage for this treatment.
Benefits of treatment vary person to person. While some individuals may notice a benefit within the first week, for a majority of individuals, the benefits aren’t realized until at least session number 20. There are however a small number of individuals for which TMS unfortunately is not effective.
If you are utilizing the NueroStar Advanced Therapy device, it is uncommon for this to occur. However, if you are utilizing the Brainsway Deep TMS, the magnetic field may be broad enough to elicit an involuntary movement in your hand. This movement only occurs during the 2 seconds that you are receiving the magnetic pulses.
While it is recommended that treatments occur 5x a day for the first six weeks, we understand that it may be unavoidable to miss a day here and there. It is ok, and the efficacy of the treatment should not be impacted.
No, a referral is not necessary. If you would like us to, we can collaborate with your existing health care providers.
Prior to your consultation, you will be emailed an intake packet. It is important that the intake packet be filled out. Particularly, please focus on the medication trials (names of medication, approximate dosages and dates started and stopped). You will then have a complete psychiatric examination completed by a Board Certified Psychiatrist. The Doctor will also explain what TMS is, how it works, examine the risks and benefits and answer all your questions.
Our office staff will also collect your insurance information and provide you with an estimate of your out of pocket cost, if any, and present to you, flexible payment arrangements.
If you meet the criteria to receive treatment, we will submit the necessary information to your insurance company for prior authorization of TMS. We have significant experience in collaborating with the insurance industry. We try only to present strong cases for consideration. About a week or so after your initial consultation, we should have an answer from your insurance company on if TMS treatment will be authorized. Once authorized, we can begin your course of treatment soon thereafter.
When is your office open? How late or early can I schedule an appointment?
Our hours are flexible. We understand the time commitment that TMS therapy involves. Therefore, we operate by appointment and are able to accommodate times as early as 6:30am- 6:00pm.
If this occurs, please let us know right away. We would need to speak with your new insurance provider and attempt to gain prior authorization.
Yes, we offer a few different options for you. Contact us directly for details.
If you have not tried the necessary number of medications to meet the insurance company guidelines for treatment, call our office and talk to our staff about your options.
No, this is not recommended. If necessary, medications can change during treatment, but we must be informed of any changes.
This is not recommended but could be a conversation that you and the Doctor could have.
Yes. If after your first course of TMS treatments, you have experienced a 50% reduction or greater in symptoms and have a recurrent episode of your major depression, your insurance company may authorize an additional course of treatment. Typically, insurance companies like to see 6 months of sustained results before they will authorize another treatment course.
While research suggests that maintenance therapy is beneficial, insurance companies are reluctant to provide benefit coverage. A recommended maintenance schedule for those who have achieved a response from TMS would be: 2 treatments per month for the first two months, then 1 treatment per month thereafter.
A recommended maintenance schedule if remission is achieved would be: 1 treatment per month. It is worth reiterating, insurance companies have not been known to authorize maintenance sessions and this would be an out of pocket expense.