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What Does a Typical TMS Treatment Entail?

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Transcranial magnetic stimulation (TMS) is designed to treat MDD and in some cases can treat OCD. It targets neural activity deep within the brain. It is a completely non-invasive procedure. 

How TMS Treatments Work 

TMS, transcranial magnetic stimulation,  is an FDA approved treatment regimen for MDD (major depressive disorder). There are also two TMS devices, including BrainsWay, which are FDA-cleared to treat OCD (Obsessive-Compulsive Disorder). This procedure utilises magnetic fields to stimulate neural activity, deep within the brain. Patients undergo repetitive transcranial magnetic stimulation, rTMS, to successfully treat symptoms of depression. 

An electromagnetic coil inside of a head-covering device is placed against the scalp. The resultant magnetic pulses are designed to target specific areas of the brain, thereby alleviating symptoms of depression. TMS is a non-invasive treatment regimen; no incisions, intubations, implantations, or infusions are needed. The magnetic pulses simply stimulate the appropriate nerve cells in parts of the brain responsible for controlling mood.

During depressive episodes, it is believed that these areas of the brain are under-stimulated. The TMS treatment regimen is designed to ‘kickstart’ the nerve cells, to gradually improve mood and disposition. Though FDA approved, the biology of this treatment is not completely understood. Transcranial Magnetic Stimulation is safe, with only limited side-effects. These may include symptoms like dizziness, twitching or tingling, scalp discomfort, or a mild headache. Fortunately, the symptoms can be controlled by making requisite adjustments to the prescribed level of TMS stimulation.

While generally well tolerated by patients with only mild side-effects, there have been rare instances of more serious side effects such as mania or hearing issues if patients do not use the correct ear protective devices. The treatment program is generally well tolerated by patients across the board. There is no pain in administering the treatment. It is simply like wearing a helmet that targets magnetic waves towards specific areas of the brain. Patients do not need to be sedated prior to the procedure, no fasting is necessary, and there is no post-procedure recovery period.

Duration of TMS treatments

The duration of TMS treatment depends upon the severity of the disorder and the treatment facility’s recommendations. Generally, patients will undergo a lengthy first appointment, followed by much shorter treatment sessions for 5 days a week, between 4 and 6 weeks. That means a total of 20 – 30 TMS treatment sessions are required to be successful. The initial TMS session is the most important session since this one determines which areas of the brain the treatment regimen will target. During the initial appointment, the doctor will carefully assess where the magnets should be placed, to guarantee the best possible results.

The actual procedure takes place in a private room. Patients will be seated in reclining chairs with muffling devices, such as earplugs, to eliminate the sound of the TMS machinery. The TMS pulses are generated by turning the electromagnetic coil on/off repeatedly. Patients may hear what sounds like a tapping noise for a couple of seconds and then there will be a pause with no sound. A tapping sensation will be felt on the patient’s forehead, for mapping purposes. 

The prescribed dose of magnetic energy 

The next part of the procedure is important since it determines how much magnetic energy is required to successfully treat the disorder.  This part of the process is referred to as the ‘motor threshold’. The TMS test dose continues until your fingers or hands twitch. The prescribed TMS treatment plan can be modified accordingly, based on how well a patient responds to the therapy. The actual process of getting treated is comfortable and relaxing. 

The only thing that gives away the fact that you’re being treated is the sound of the TMS machine. That’s why earplugs must be worn, to protect against damage. All in all, the entire process – per session – lasts between 40–50 minutes. Throughout the entire process, patients remain awake. Once your Deep TMS treatment is over, you’ll be able to drive home, walk home, or ride home as you see fit. The beauty of Deep TMS is that you can expect incredibly successful results. TMS is typically prescribed when other treatments for depression fail. It can also be combined with therapy and medication for maximum efficacy. 

Provided you have healthcare coverage, the costs of your treatment should be covered in your plan. TMS treatments can be repeated, if necessary.

Tommy Williamson did his degree in psychology at the University of Edinburgh. He has an ongoing interest in mental health and well-being.

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