Overview of Service
The procedure (TMS)
TMS uses focused pulsed magnetic fields to non-invasively stimulate the brain. TMS has proven effectiveness as a treatment for depression and obsessive-compulsive disorder (OCD) and it is approved by the US Food and Drug Administration (FDA).
TMS is a relatively safe procedure that lacks side effects seen with some psychopharmacologic agents such as weight gain, sedation, and sexual dysfunction and with other interventional psychiatry techniques such as transient cognitive effects, transient dissociative symptoms, and need for surgery. TMS sessions are usually well tolerated. Scalp discomfort and mild / transient headache are the most common side effects, both usually limited to the first week of treatment.
Initial Assessment
Patients are initially seen by a psychiatrist with expertise in mood / anxiety disorders and interventional psychiatry. The initial assessment includes a diagnostic and treatment evaluation focusing on determining the appropriateness of TMS as the next step in your treatment, as well as its risks, benefits, and other available treatments for your condition. Patients are carefully screened for the presence of conditions (seizure disorder or epilepsy) or underlying risk factors (implantable devices or presence of metal within the head) that might make the administration of TMS clinically unsafe. If TMS is deemed to be safe and appropriate for your case, you will be scheduled to commence a course of TMS treatment. Scheduling is contingent upon insurance approval / coverage.
TMS delivery
Sessions are administered on an outpatient basis and last from 15 to 60 minutes depending on the dose and protocol being use. You will be fully conscious and aware throughout the procedure and no post-session recovery period is needed. A symptom provocation protocol (i.e., exposure to triggering thoughts or images) may be used when treating obsessive-compulsive disorder. You will be able to resume your normal activities like work or driving immediately after your TMS session.
TMS is administered daily from Monday to Friday. An adequate initial course of TMS requires 20 to 30 sessions depending on the diagnosis and its severity.
Patients are reassessed for clinical progress and need for dose optimization by an experienced psychiatrist every 2 - 3weeks (10 - 15 sessions) of treatment. Additionally, patients are assessed for side effects and other changing conditions before each TMS session.
If you do benefit from TMS, we will discuss with you how this improvement can be best sustained, including the possibility of intermittent maintenance TMS sessions with a frequency that can range from 1 per week to 1 per month or longer. If no clinical benefit is achieved after an adequate trial of TMS, we will discuss other treatment options and suggest appropriate referrals or course of action.
Resources for Patients
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