Department of Psychiatry

Penn Behavioral Health

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 has been approved by the FDA in the US since 2008.

TMS is a safe procedure that lacks side effects that are seen with some medications such as weight gain, sedation, and sexual dysfunction. 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 board certified psychiatrist with expertise in mood disorders and neuromodulation. 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 medical 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.

TMS delivery

Sessions are administered on an outpatient basis and last from 20 to 60 minutes depending on the dose. You will be fully conscious and aware throughout the procedure and no post-session recovery period is needed. 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 weeks (10 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 with you the next best treatment options in your case and make appropriate referrals.

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