TMS Therapy

About

TMS Therapy

What is TMS therapy?

Transcranial magnetic stimulation (TMS) is a painless, non-invasive brain stimulation therapy used to treat depression. It is approved by the Food and Drug Administration (FDA) for the treatment of depression when antidepressant medication or psychotherapy has been unsuccessful.

What are the different types of TMS therapy available?

There are two different types of TMS therapy currently available. They include:

  • Repetitive Transcranial Magnetic Stimulation (rTMS) has been around for over 20 years and can be used for anxiety, depression, and other mental illnesses. It was approved for medication-resistant depression in 2008. The sessions are usually 40 minutes, but there is a newer version, theta-burst stimulation, that can be performed in as quickly as 3 minutes.
  • Deep Transcranial Magnetic Stimulation (dTMS) is used to penetrate larger, deeper sections of the brain. It uses special H coils that have the capability of reaching 4cm beneath the scalp. A special helmet is used, but no anesthesia is required. These sessions are 20 minutes long.

When is TMS therapy used?

Although depression is very treatable, sometimes traditional treatments may not be effective for all. When psychotherapy and pharmaceutical medications fail, TMS therapy may be considered.

What else should you know about TMS therapy?

TMS therapy can be used in conjunction with psychotherapy. However, there is currently no research that confirms combination therapy is more beneficial than stand-alone TMS therapy for the treatment of depression.

Is TMS therapy successful?

TMS therapy has shown great success in the treatment of major depression, with 60% of patients showing improvement.

What other conditions can TMS therapy treat?

Although approved by the FDA for major depression, TMS has also been shown to be beneficial with other conditions such as:

  • Pediatric depression
  • Bipolar disorder
  • Obsessive-compulsive disorder
  • Smoking cessation
  • Post-traumatic stress disorder.

Mechanism of action

How does TMS therapy work?

The technology around TMS is that it uses repetitive electrical impulses to stimulate nerve cells- also referred to as repetitive transcranial magnetic stimulation (rTMS). The electrical impulses go through the scalp, and no anesthesia is required. Although approved for depression, TMS can also help treat post-traumatic stress disorder, obsessive-compulsive disorder, anxiety, and Parkinson's disease.

Administration

How is TMS therapy administered?

TMS therapy is administered by having an electromagnetic coil placed on the scalp, where the brain regulates mood. It is recommended that TMS therapy is provided 4-5 times a week for at least 4-6 weeks to get the best results. Typical sessions last about 40 minutes; however, a newly FDA-approved TMS therapy called theta-burst stimulation only requires 10 minutes of treatment for depression. It has even shorter treatment times for other mental illnesses. This faster treatment option still requires several weeks of treatment to be effective. 

Where can you receive TMS therapy?

TMS therapy is performed on an outpatient basis. There are no restrictions for this therapy and patients can drive themselves to and from their appointments for administration. 

How long does TMS therapy last?

With TMS therapy, many people experience a decrease in depression, or the symptoms may go away altogether. It usually takes a few weeks before improvement is noticeable, but some research has shown that it may last for as long as a year.  Remission is always a possibility- as with most mental health illnesses. There is still ongoing research regarding if maintenance treatments are needed to prevent depression from recurring after successful TMS therapy. However, if symptoms return, retreatment can always be administered.

Candidates for TMS therapy

Who should use TMS therapy?

Currently, TMS therapy is recommended when first-line treatments for depression or other mental illnesses fail.

Who should avoid using TMS therapy?

TMS therapy has many benefits but may not be suitable for the following patients:

  • Patients with metal implanted in their body. 
  • Patients who may be pregnant.
  • Patients who want to become pregnant in the near future.
  • Patients who have a history of seizures.
  • Patients who have a history of chronic headaches or migraines.
  • Patients who have a history or brain injuries.

Is TMS therapy safe?

What are the potential side effects of TMS therapy?

TMS therapy is well tolerated and relatively safe. Still, it does pose some potential side effects that should be addressed. Some common side effects include:

  • Seizures
  • Loss of consciousness
  • Headaches
  • Scalp irritation
  • Spasms of facial muscles

Less common side effects include:

  • Seizures
  • Mania
  • Hearing loss


Cost

How much does TMS therapy cost?

TMS therapy may be an expensive form of treatment for most people. The average cost of a TMS session is $500. This means the complete treatment for at least the 30 sessions that are recommended would run about $15,000.

Does insurance cover TMS therapy?

Most insurances cover TMS therapy when a licensed healthcare professional states it is a medical necessity. Therefore, TMS therapy is usually pretty affordable due to insurance coverage. Our trained staff at TeleMed2U are very familiar with what is needed to have this therapy approved by your insurance provider. Receiving the appropriate treatment and not having to stress about medical coverage or costs is always our goal.

Summary

Are you or someone you know struggling to get relief from your depression symptoms? Then you may benefit from TMS therapy. The benefits of starting this medication include relief of symptoms, possibly for an extended amount of time. Speaking with a healthcare provider at TeleMed2U may be the first step in learning if this safe, FDA approved treatment may work for you.

References

Anxiety & Depression Association of America. (2021, April). Transcranial Magnetic Stimulation (TMS)https://adaa.org/finding-help/transcranial-magnetic-stimulation
Mayo Clinic. (2018, November). Transcranial magnetic stimulationhttps://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625 
Porter, R. (2021, February). How Much Does TMS Therapy Cost? Betterhelphttps://www.betterhelp.com/advice/therapy/how-much-does-tms-therapy-cost/ 
Stern, A. (2018, February). Transcranial magnetic stimulation (TMS): Hope for stubborn depression. Harvard Health Publishing. https://www.health.harvard.edu/blog/transcranial-magnetic-stimulation-for-depression-2018022313335

With Insurance

Behavioral Health

Your copay
Depending on insurance

Without Insurance

Behavioral Health

$240

Initial Visit

$99

Follow Up

Information

Medically reviewed by:

Dr Roy Kedem, MD

Dr Roy Kedem started his premedical studies at Harvard, and research in genetics and gene sequencing at Harvard, Beth Israel. He attended medical school in the UK at the Cambridge Overseas Medical Program in 1998. Dr Kedem then completed his residency in Internal Medicine at Columbia College of Physicians and Surgeons in Stamford, Connecticut and his fellowship in Hospital Medicine at the Cleveland Clinic in Cleveland, Ohio.

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TM2U Curve inverted

Affordable –
with or without insurance

With Insurance

Behavioral Health

Your copay
Depending on insurance

Without Insurance

Behavioral Health

$240

Initial Visit

$99

Follow Up