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Transcranial Magnetic Stimulation

TMS Therapy

TMS therapy uses repetitive magnetic pulses delivered to the brain via an electromagnetic coil. These pulses stimulate nerve cells in the brain area that controls mood changes. Because of the repeated stimulation, it is also known as repetitive TMS or rTMS.

A TMS physician or technician uses TMS therapy to relieve the symptoms of major depressive disorder (MDD), General Anxiety Disorder (GAD) and Obsessive-Compulsive Disorder (OCD), among other mental illnesses. Physicians typically prescribe TMS for patients who have had no success with medication and psychotherapy.

If you are considering TMS therapy, you may first want to the answer to these questions:

  • What is TMS therapy?
  • What should you expect during TMS treatments?
  • What are the side effects of TMS?

Transcranial Magnetic Stimulation (TMS)

Cranial bones are the skull bones that house and protect your brain. Collectively these bones make up the cranium. So, Transcranial Magnetic Stimulation involves emitting magnetic pulses across the skull into the brain.

TMS works by targeting the parts of the brain underactive in depression and anxiety patients. The stimulation “wakes up” these brain parts to ease the symptoms. Depending on the patient’s reaction, the amount of magnetic stimulation can be increased or reduced during the procedure.

Unlike electroconvulsive therapy (ECT), TMS doesn’t require sedation. It is a painless, non-invasive procedure that lasts approximately  20 minutes per session. There is often no downtime and many people return to work or go about their day after daily treatment.

TMS Self Assessment Tool

What is TMS Therapy?

TMS is not a one-time treatment process. More like psychotherapy (talk therapy) sessions, you will need to visit the office 4-5 times a week for 6 weeks or a total of 36 treatments.. Some patients start to see results sooner than others but it is important to finish all 36 treatments to remain symptom free.

The multiple visits to the office may deter some patients. But the sessions are short and can be done before or after work. No recovery time is required because you remain completely conscious during the process. You can go to work or drive yourself home after a session.

TMS therapy is entirely outpatient and can be done at an office.

TMS Treatment

TMS has been FDA approved for treating depression for over ten years. There is a number of conditions and illnesses that can be treated using transcranial magnetic stimulation. This treatment is primarily used for adults (18 and older) who suffer from mental illnesses, including:

  • Depression
  • Generalized anxiety disorder
  • PTSD
  • Obsessive-compulsive disorder

Before starting TMS treatments, your psychiatrist will conduct a physical exam and a psychiatric evaluation to decide if you are a good candidate. Although TMS treatment is safe, it may not be suitable for you if:

  • Metal implants in your head
  • Cochlear implants
  • Facial or cranial tattoos with ink that contains metals
  • Neck or brain stents
  • Aneurysm clips or soils
  • Have a history of epilepsy or seizures
  • Suffer from medical conditions that increase your likelihood of suffering from a seizure

It is essential to have a productive consultation visit before you start treatments. The physician will explain the procedure. During the evaluation, you can help by giving your medical history. Before treatments begin, let the doctor know if:

  • You are pregnant or are planning a pregnancy
  • Have any of the implants mentioned above or tattoos
  • Have had previous TMS treatments
  • Struggle with headaches
  • You are currently using any medications

Aside from the medical exam, you need to be 18 years or older, have a specific mental illness diagnosis, and in most cases, fail to respond to traditional treatments.

If the doctor determines that you qualify, you can immediately work out a treatment schedule that works for you. Your psychiatrist can help create a therapy schedule around your other responsibilities.

What to Expect During TMS Treatment

  • The first TMS session usually lasts longer than the subsequent ones. The physician (or TMS technician) will measure your motor threshold during the first session. Your motor threshold is the amount of stimulation it takes for your thumb or hand to twitch. It helps doctors personalize treatments to your specific needs.
  • Motor threshold tests are unnecessary at every session, but the doctor may decide to test again if changes occur and stimulation needs to be adjusted.
  • During each treatment session, the TMS technician stays with you. You will be alert and able to tell them how you are feeling and if you want the treatment to pause or stop for whatever reason.
  • You should expect to hear a loud noise when the machine turns on. For this reason, you should wear earplugs to protect your hearing. During the session, you will hear a clicking or tapping on the forehead where the coil is placed. It is the machine releasing magnetic pulses into your brain.
  • During all sessions, you will be seated in a relaxing chair.
Patient undergoing TMS therapy

What to Expect After Each Session

  • Explain to the technician how you feel and any significant sensations you experience.
  • TMS treatments are brief, with no recovery period necessary so that you can go home immediately after a TMS treatment session.
  • Although you can drive yourself home, some patients prefer to bring a driver for the first few sessions for good measure until they know what to expect.

Always consult with your doctor before undergoing Transcranial magnetic stimulation to ensure this treatment is right for you.

TMS Side Effects

TMS is FDA approved for OCD and depression treatment. The approval means that the treatment is safe, secure, and efficient. Some patients report short-term side effects following therapy sessions.

The most common side effects include:

  • Headaches
  • Lightheadedness
  • Discomfort in the area of stimulation on the scalp
  • Tingling of facial muscles

The more severe but rarely reported side effects include seizures and mania. Some patients also report hearing loss that often goes away with time. At this time, scientists have not discovered chronic side effects following rTMS. We keep up to date with such discoveries and make them available to our patients as soon as they come out.

About Neurostar TMS

At Arcara Personalized Psychiatry, we use NeuroStar’s TMS. Their machine is considered one of the industry’s best. It is non-invasive and easy to use. Patient’s will not have to worry about wearing a helmet, as NeuroStar uses a smaller more manageable handheld device. The doctor uses this device to administer the electromagnetic pulses for this treatment. No helmet reduces the discomfort patients would experience from other TMS machines. NeuroStar TMS treatments are quick and easy for patients.

TMS has relieved many patients who have had to live under the crippling ups and downs of depression and anxiety. Antidepressant medication and talk therapy are the standard treatments for mental illnesses. However, TMS has produced better results for patients intolerant to medication or who have not seen significant improvement after prolonged use. Here are a few pointers about TMS:

  1. A thorough medical examination and psychiatric evaluation are necessary to decide if you qualify as a TMS candidate.
  2. TMS treatments are repetitive and take 36 sessions to complete. Good planning with your psychiatrist can help you make a schedule that suits your needs.
  3. Treatments are painless and non-invasive, and the patient stays awake and conscious through the sessions.
  4. TMS is FDA-approved making it safe, secure, and efficient.
  5. The mild side effects of TMS like headaches, lightheadedness and scalp discomfort do not last long.
  6. TMS treatment is outpatient and doesn’t have to interfere with your routine.
  7. Some insurance companies cover TMS. Others prefer that you first try the more traditional treatment methods before they approve payment for TMS. Check with your insurance before starting treatment if you can’t pay off-pocket.

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To get started

If you have had unsuccessful experiences with antidepressants or other forms of behavioral and psychological therapy, TMS could be the next step. If other medications have failed to relieve your symptoms or if you have been unable to tolerate the side-effects of such treatments, transcranial magnetic stimulation may be an alternative.

If you would like to see if you qualify for this therapy fill out this form.

If You Have Questions Or Concerns, The Professionals At Arcara Psychiatry Will Provide An In-Depth Consultation To Determine If Transcranial Magnetic Stimulation Is The Right Treatment Option For You.


We have offices in Westborough, MA and Boston, MA. Fill out our online intake form or call us directly.