Transcranial Magnetic Stimulation (TMS) Therapy

When might TMS be appropriate?

Our MagVenture TMS Therapy system is FDA-approved for the treatment of major depressive disorder in adults (18-years of age and older) who have failed at least one previous antidepressant medication. TMS has also been approved for the treatment of OCD in combination with medication, however that service is not offered through our clinic.

What is a typical course of TMS?

TMS is performed as an outpatient. A course of TMS typically involves sessions 5 days a week for 4-6 weeks total followed by a 3-week taper. Depending on which protocol is chosen, the daily treatment session can last between 3 to 40 minutes. Because there is no need for anesthesia or other medications during the session, patients are able drive and go about their daily activities immediately following the appointment.

What are the benefits and risks of TMS?

TMS has been found to be an effective option for depression that has failed to respond to previous medications and therapy. While side effects may occur, TMS does not cause weight-gain, sedation or sexual side effects that are common with antidepressant medications. TMS also has not been found to cause cognitive side effects or memory impairment which can be seen with ECT.

The most common side effects associated with TMS therapy are scalp pain or muscle twitching, generally reported as mild to moderately uncomfortable.  TMS may increase the risk of seizure, however the estimated rate of seizures with TMS is <0.01%. A personal or family history of seizures should be discussed with the consulting provider.

Who would not be appropriate for TMS?

Patients with a history of seizures may still be appropriate for TMS, however this would need to be discussed with their treating neurologist. TMS is contraindicated in patients with non-removable metal objects in the head and neck. Examples include aneurysm clips, cochlear implants, deep brain stimulators, and metal fragments. Patients with braces and metal dental fillings or appliances may be able to receive TMS, however this should be discussed with the consulting provider.

Does insurance cover TMS?

Currently most major insurance providers cover TMS except for NC Medicaid. Insurance companies typically require at least two failed antidepressants and a trial of outpatient therapy before approving TMS.

TMS is offered on a fee-for-service basis for patients whose treatment is not covered by insurance.