Transcranial Magnetic Stimulation (TMS)
Frequently Asked Questions:
TMS (transcranial magnetic stimulation) Therapy is a new treatment cleared by the FDA for patients suffering from depression who have not achieved satisfactory improvement from prior antidepressant medications. Using pulsed magnetic fields, TMS Therapy stimulates the part of the brain thought to be involved with mood regulation. Performed [in our clinic] as an outpatient procedure NeuroStar TMS Therapy is:
- Non-invasive, meaning that it does not involve surgery. It does not require any anesthesia or sedation, as the patient remains awake and alert during the treatment.
- Non-systemic, meaning that it is not taken by mouth and does not circulate in the bloodstream throughout the body.
The typical treatment course consists of 5 treatments per week over a 4-6 week period (20-30 treatments). Each treatment session lasts approximately 37 minutes.
TMS Therapy® is a short outpatient procedure performed right in our clinic. The treating clinician uses a treatment coil to send pulsed magnetic fields, similar in type and strength to those produced by a magnetic resonance imaging (MRI) machine, to the part of your brain thought to control mood.
TMS Therapy is a highly targeted treatment reaching 2-3 centimeters into the brain, directly beneath the treatment coil. The nature of the magnetic fields allows them to pass through a patient’s hair, skin and skull and into the mood-regulating area without being distorted in any way. This method allows for a very accurate type of stimulation, minimizing the stimulation of brain tissue not involved in mood.
These magnetic pulses produce very small electrical currents. The amount of electricity created in the brain is very small and cannot be felt by a patient. These small electric currents can cause the neurons (brain cells) to fire or become active and lead to the release of neurotransmitters (the brain’s chemical messengers).
Is NeuroStar TMS Therapy® a good alternative for patients who cannot tolerate the side effects associated with antidepressant medications?
TMS Therapy® is non-systemic (does not circulate in the blood throughout the body), so it does not have side effects such as weight gain, sexual dysfunction, nausea, dry mouth, sedation, etc. The most common side effects reported during clinical trials were headache and scalp discomfort – generally mild to moderate – occurring less frequently after the first week of treatment.
NeuroStar TMS Therapy has been cleared by the U.S. Food and Drug Administration (FDA) for the treatment of patients with depression who have failed to achieve satisfactory improvement from prior antidepressant medication at or above the minimal effective dose and duration in the current episode. Like any treatment option, you and your doctor should work together to find the most appropriate treatment option for you.
Is NeuroStar TMS Therapy like electroconvulsive therapy (ECT)?
No, the two procedures are very different. While both are effective in the treatment of depression, there are many differences in safety and tolerability. During the TMS Therapy procedure, patients sit in a chair and are awake and alert throughout the entire 37-minute procedure – no sedation is used with TMS Therapy. Patients can transport themselves to and from treatment.
In over 10,000 active treatments with NeuroStar TMS Therapy in clinical trials, no seizures were observed. TMS Therapy was also shown to have no negative effects on memory function in these studies.
In contrast, patients undergoing electroconvulsive therapy (ECT) are provided a light and brief general anesthesia and then an electrical stimulus is used to produce a brief seizure lasting from 30-60 seconds. Recovery is monitored for up to a few hours and patients are then released, but will need someone to drive them home, which is typical for an outpatient procedure requiring anesthesia. After ECT, short-term confusion and memory loss are common, and long-term disruptions in memory have been shown to occur and may persist indefinitely in some people.
What are the potential risks of NeuroStar TMS Therapy?
NeuroStar TMS Therapy is well tolerated and has been proven to be safe in clinical trials. Throughout over 10,000 active treatments performed in clinical trials, the most commonly reported side effect related to treatment was scalp discomfort during treatment sessions. This side effect was generally mild to moderate, and occurred less frequently after the first week of treatment. Less than 5% of patients treated with NeuroStar TMS Therapy discontinued treatment due to side effects.
In NeuroStar clinical trials, over 10,000 TMS treatments demonstrated its safety, with no occurrence of seizures. However, there is a small risk of a seizure occurring during treatment. This risk is no greater than what has been observed with oral antidepressant medications.
While NeuroStar TMS Therapy has been proven effective, not all patients will benefit from it. Patients should be carefully monitored for worsening symptoms, signs or symptoms of suicidal behavior, and/or unusual behavior. Families and caregivers should also be aware of the need to observe patients and notify their treatment provider if symptoms worsen.
Does NeuroStar TMS Therapy cause memory loss?
No, TMS Therapy was systematically evaluated for its effects on memory. Clinical trials demonstrated that NeuroStar TMS Therapy does not result in any negative effects on memory or concentration.
Is TMS Therapy uncomfortable?
The most common side effect related to treatment was scalp discomfort during treatment sessions. This side effect was generally mild to moderate, and occurred less frequently after the first week of treatment. If necessary, you can treat this discomfort with an over-the-counter analgesic. If these side effects persist, your doctor can temporarily reduce the strength of the magnetic field pulses being administered in order to make treatment more comfortable. Less than 5% of patients treated with NeuroStar TMS Therapy discontinued treatment due to side effects.
For more information regarding TMS Therapy, please visit the Neuro Star TMS website.
For more information or to make an appointment, please call (863) 291-5915
Winter Haven Hospital
Center for Behavioral Health
1201 First Street South
Winter Haven, Florida 33880
Clinic hours are Monday through Friday from 8am-4:30 pm. For more information, or to schedule an appointment please call (863) 294-7062.
Takkallapelli Rao, MD is Board Certified in Adult Psychiatry, Geriatric Psychiatry, Addiction Psychiatry and Psychopharmacology. He graduated from Kakatiya Medical College and completed his Psychiatric Residency at Danvers State Hospital affiliated with the Massachusetts General Hospital in Boston, MA. Dr. Rao completed a visiting fellowship in Transcranial Magnetic Stimulation Therapy (TMS) at Columbia University, and leads the Center for Behavioral Health TMS Team. He is recognized as a Life Fellow by the American Psychiatric Association. Dr. Rao provides outpatient psychiatric services at the Center for Behavioral Health and inpatient psychiatric services at the Center for Psychiatry.
top to bottom, left to right are: Linda Norris, Elizabeth Martin, ARNP, George Winny, MD, Takkallapelli Rao, MD, Laura Stanley, LPN, Tiffany Justice, BS
| TMS Providers
top to bottom, left to right are: Elizabeth Martin, ARNP, George Winny, MD., Takkallapelli Rao, MD., Laura Stanley, LPN