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About TMS

Are you or a loved one suffering from depression, anxiety, or PTSD even after trying numerous medications? In some cases, these conditions may be resistant to pharmacological intervention, and fortunately, due to new medical technologies, TMS therapy is effective in treating depression. Other psychiatric disorders, such as PTSD and anxiety, can benefit from TMS therapy since depression is often present in these conditions. 

What is TMS?

Transcranial Magnetic Stimulation (TMS) is an FDA-approved, non-invasive, non-medication, interventional therapy that uses magnetic pulses to reverse the changes in the brain that occur from depression. 

How is TMS different from taking medication?

 

Unlike traditional pharmacological antidepressant therapy, TMS allows for the treatment of depression, without the associated unpleasant side effects, such as decreased libido, weight gain, and emotional blunting (inability to experience the full range of human emotions such as joy and happiness).

What are the side effects of TMS?

TMS typically has minimal side effects, such as minor headaches, dizziness, scalp tenderness at the site of stimulation, tingling, spasm of the facial muscles, and lightheadedness. Individuals suffering from bipolar disorder are more likely to experience a manic episode and in extremely rare instances seizures have been reported. TMS has no observable effects on cognition or cognitive function. As concentration deficits are often a symptom of depression many individuals report improvement in concentration after TMS treatment.

What are the symptoms or conditions that can make TMS risky?

If you think you may have a history of epilepsy, bipolar disorder, or head injury, please consult your physician prior to trying TMS.

What are the symptoms or conditions that can make TMS risky?

If you think you may have a history of epilepsy, bipolar disorder, or head injury, please consult your physician prior to trying TMS.

Does TMS cure depression?

In certain cases, TMS can be used alone to treat depression. If TMS is successful, many individuals are able to come off some or all of their medications.  TMS can work concurrently with therapy or by itself.

What are the symptoms or conditions that can make TMS risky?

If you think you may have a history of epilepsy, bipolar disorder, or head injury, please consult your physician prior to trying TMS.

How does TMS work?

TMS therapy stimulates the part of the brain that is underactive in people with depression. The TMS Therapy system generates highly concentrated magnetic fields that rapidly switch on and off. These magnetic fields do not directly impact the entire brain, reaching only a few centimeters inward, directly beneath the treatment coil. By stimulating this part of the brain, the neurons in effect, “learn” to be more active, which is associated with the resumption of functioning and improvement from depression symptoms.

Which type of TMS Therapy system does Pristine Mental Health use?

How is TMS different from taking medication?

Unlike traditional pharmacological antidepressant therapy, TMS allows for the treatment of depression without the associated unpleasant side effects such as decreased libido, weight gain, and emotional blunting. 

What are the side effects of TMS?

TMS typically has minimal side effects, such as minor headaches, dizziness, scalp tenderness at the site of stimulation, tingling, spasm of the facial muscles, and lightheadedness. Individuals suffering from bipolar disorder are more likely to experience a manic episode and in extremely rare instances seizures have been reported. TMS has no observable effects on cognition or cognitive function. As concentration deficits are often a symptom of depression many individuals report improvement in concentration after TMS treatment.

What are the symptoms or conditions that can make TMS risky?

TMS typically has minimal side effects, including minor headaches, scalp tenderness at the stimulation site, and tingling. During treatment, spasms of the facial muscles may occur. Individuals who have bipolar disorder are more likely to experience a manic episode, and in infrequent instances, seizures have been reported. TMS has no observable effects on cognition or cognitive function. As concentration deficits are often a symptom of depression, many individuals report improvement in concentration after TMS treatment.

Does TMS cure depression?

In some instances, TMS can be used alone to treat depression. If TMS is successful, many individuals can come off some or all of their medications, and TMS can work concurrently with therapy or on its own.

How does TMS work?

TMS therapy stimulates the part of the brain underactive in people with depression. The TMS Therapy system generates highly concentrated magnetic fields that rapidly switch on and off. These magnetic fields do not directly impact the entire brain, reaching only a few centimeters inward directly beneath the treatment coil. By stimulating this part of the brain, the neurons, in effect, “learn” to be more active, which is associated with the resumption of functioning and improvement from depression symptoms.

Which type of TMS Therapy system does Pristine Mental Health use?

Dr. Penner will do several measurements and fit an individual for a cap.  Using these measurements he calculates the location of the brain that is being treated, called the dorsolateral prefrontal cortex.  Markings on the cap are made to ensure that every treatment is calibrated and placed identically between sessions. 

 

Next, Dr. Penner determines the ideal stimulation intensity by using a smaller magnet to stimulate the motor cortex to determine the minimum strength needed to produce a response (hand or thumb twitch). The patient then sits in the treatment chair and the treatment coil is placed. Dr. Penner will start the first treatment at a low intensity and increase as tolerated. Therapy may be conducted with supplied earplugs if the rapid “woodpecker-like” tapping noise is too loud. Most patients choose not to use earplugs.

TMS therapy typically occurs 5 days a week for 6 weeks, followed by a 3 week taper period. Each session typically lasts 19 minutes but can be as short as 3 minutes and 26 seconds. Upon arrival, patients will briefly check-in at the front desk. After checking in, one of our TMS technicians will greet the patient and escort them to a private suite for treatment.

 

We offer flexible scheduling, tailored to the lives of our patients. The front desk reception is available to make scheduling arrangements.

There is no altered consciousness or confusion so patients may operate a motor vehicle and go back about their day as normal. Many individuals receive treatment before work or on their lunch break.

Upon the initial session, the patient may notice subtle changes, such as increased focus and motivation. However, improvements widely vary per patient.  Some individuals experience symptom improvement rapidly, occasionally within the first week and not uncommonly by the end of the second week. Others are slow and gradual responders throughout treatment and others only towards the end of treatment or even after treatment has concluded.

According to the National Library of Medicine, data shows a 63% remission rate and an 82% response rate.

The current use of electromagnetic induction for transcranial stimulation dates back to 1985. Dr. Tony Barker and his colleagues invented the initial type of TMS in Sheffield, UK. Moreover, Barker scientifically proved the influence of magnetic stimulation on the motor cortex of the human brain in 1985.

 

In 2002, the Canadian Association of Health, which is an official institution, approved the medical results and benefits of rTMS. Moreover, other countries like the US, the UK, Germany, and Japan have been working on this method for 20 years. At present, many different types of devices are being used for repetitive electromagnetic stimulation. The Food and Drug Administration of the United States granted approval to this method on October 8th, 2008.

Nearly all insurers cover TMS Therapy, however, coverage varies based on whether or not the provider is credentialed with a prospective patient’s insurance plan. Currently, Dr. Penner is credentialed with Regence Blue Shield, Premera Blue Cross (and nearly all out of state Blue Cross/Blue Shield plans), Tricare, US Family Health Plan, Kaiser Permanente, United Healthcare Commercial, Providence Behavioral Health, First Choice Health Network, Cigna, Aetna, Beacon Health Strategies, Molina Medicaid, Medicare and the US Department of Veteran Affairs. 

 

During the pre-screening process, Pristine Mental Health will rule out potential barriers for insurance reimbursement and identify any contraindications that can prohibit safe treatment.

If a patient qualifies for treatment and insurance coverage is not available, Pristine Mental Health offers a discounted cash-pay rate and flexible repayment options on a case-by-case basis. We believe finances should not deter prospective patients from receiving the treatment they deserve.

Typically, insurers do not cover patients under the age of 18. However, Dr. Penner has worked with some insurers to obtain a “single case agreement” or exception to this age group.  Dr. Penner is a child and adolescent psychiatrist and has experience treating adolescent depression with TMS. If insurance reimbursement is not available, Pristine Mental Health offers cash payment options on a case-by-case basis. To learn more about these options, please contact our billing department.

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