Transcranial Magnetic Stimulation (TMS)

TMS therapy is a safe, non-invasive treatment for depression, especially when other treatments have not been effective. It uses magnetic fields to stimulate electric activity in nerve cells in the brain, specifically targeting areas thought to be associated with mood control.

Our Capabilities

Our Mood Disorders Center, where TMS is done, is a member of the National Institutes of Health “Mood Disorders Centers of Excellence” with clinicians who are experts in the field of treatment resistant depression. 

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Our team of subspecialists offer hope to patients with mood disorders through innovative treatments and compassionate care. We know that diagnosing mood disorders early is crucial to managing your condition and offering you the best quality of life. At UC Health, we focus on identifying predictors of mood disorders, as well as studying new interventions backed by leading research to bring you the best possible care.

To schedule an appointment, please call the UC Health Mood Disorders team at 513-558-MOOD (6663).

ABOUT THIS TREATMENT OPTION

Understanding TMS Therapy

What is Transcranial Magnetic Stimulation (TMS)?

Transcranial Magnetic Stimulation (TMS) is a safe, non-invasive therapy that helps treat depressive disorders, especially when other treatments have not been effective. TMS therapy uses electromagnetic fields to stimulate electrical activity in nerve cells in the brain, specifically targeting areas believed to be associated with mood.

How Does TMS Work?

During TMS treatments, an electromagnet is placed against the scalp, near the forehead, above the region of the brain called the prefrontal cortex.  The electromagnetic field created passes easily through the skull to stimulate the activity of this brain region, which has been found to have decreased activity in people suffering from depression.  By returning the brain to a higher and more stable level of activity, TMS helps to alleviate symptoms of depression and improve overall mental well-being.

TMS can be especially beneficial for treatment-resistant depression, which includes those individuals who have not responded to other treatments, such as antidepressants and psychotherapy. It offers hope for patients who struggle with persistent symptoms of depression, providing a pathway to recovery without the systemic side effects often associated with medications.

If you have tried various depression treatments with little success, TMS might be the next step to consider.

The Benefits of TMS Treatment

Effectiveness of TMS Therapy

TMS therapy has been proven to effectively manage symptoms of depression in cases where other treatments have failed. Clinical studies and patient reports consistently demonstrate significant improvements in mood and function after undergoing TMS. These benefits often manifest after the first four weeks of treatment, with 75% of patients experiencing at least a 50% reduction in symptom severity when treatment is completed.

Advantages Over Other Treatments

TMS is a non-invasive treatment. Unlike electroconvulsive therapy, which requires anesthesia and can cause temporary memory issues, TMS sessions are conducted while you are fully awake and alert, and they do not have the same risks of cognitive side effects. Each session lasts about 15 to 45 minutes, and you can return to daily activities immediately afterward, making it a convenient option for those with active lifestyles. Further, TMS is a targeted treatment without the systemic side effects experienced with antidepressant medications, including weight gain, fatigue, and sexual dysfunction.

Long-term Benefits

Patients who respond well to TMS often experience lasting relief. More than 60% of people who respond to this treatment maintain improved mood and increased functioning for more than 1 year.  Additionally, for those whose symptoms return, repeat treatment is effective for most patients.

TMS is more than just a treatment; it's a gateway to improved quality of life, offering hope and renewal to those who have felt trapped by their depression. If you're looking for a treatment that brings reliable change without significant side effects, TMS might be the answer.

 

Is TMS Right for You?

Eligibility for TMS Therapy

Not everyone is a candidate for TMS therapy. It is specifically designed for individuals with treatment-resistant depression. This means that if you have tried at least two antidepressants without success, you might consider TMS as a potential treatment. A thorough evaluation by a healthcare professional, which includes a detailed psychiatric assessment, is necessary to determine if TMS is appropriate for you.

Assessment and Consultation

Starting the process typically involves a consultation with a psychiatrist who specializes in mood disorders. During this consultation, your mental health history is reviewed, and a physical examination may be conducted to ensure there are no contraindications to the treatment. This step is crucial to tailor the treatment to your specific needs and to maximize its effectiveness.

What to Expect

If you qualify for TMS, you'll be guided on what to expect before, during, and after the treatment. TMS sessions are conducted five days a week for seven weeks (36 total treatments). During each session, you will sit in a comfortable chair, and a nurse will position the electromagnet on your head. During treatment, you will hear the click of pulses and feel a tapping sensation on your scalp.  Some patients experience an initial discomfort that usually resolves within the first week.

It's important to commit to the full course of treatment to achieve the best results. Weekly assessments by a psychiatrist will occur to monitor your progress and make any necessary adjustments.

Making an Informed Decision

Choosing to undergo TMS is an important health decision and should be made based on a comprehensive understanding of the benefits and considerations. It’s vital to discuss all your options with a medical professional who can provide insights based on the latest research and your unique health profile.

TMS Treatment Process

Overview of the Treatment Session

Understanding what happens during a TMS session can help alleviate any anxieties you might have about the treatment. Each session involves sitting in a specially designed chair, while a psychiatrist or nurse places an electromagnet over a specific area of your scalp. The device generates focused electromagnetic pulses that stimulate brain cells involved in mood regulation.

Detailed Step-by-Step Process

  1. Preparation: Upon arrival at the clinic, you'll be seated in the treatment chair. The clinician will adjust the electromagnet to fit your head properly and ensure optimal alignment with the target brain regions.
  2. Session Start: The machine is then activated to deliver electromagnetic pulses in short bursts of 10 pulses per second. This is part of what is known as repetitive transcranial magnetic stimulation (rTMS), which involves repeated application of these pulses to effectively stimulate the brain. During treatment, you will hear the click of pulses and feel a tapping sensation on your scalp.  Some patients experience an initial discomfort that usually resolves within the first week.  These sensations are normal and indicate that the stimulation is being applied correctly.
  3. Monitoring: Throughout the session, the technician monitors the machine's settings and your response to the treatment. Adjustments may be made to enhance comfort and efficacy.
  4. Duration: Each session typically lasts between 15 to 30 minutes. During this time, you can relax, listen to music, or watch TV, provided by the clinic for your comfort.
  5. Post-Session: After the session, there is no recovery time needed. You can immediately resume your normal daily activities, including driving.

Frequency and Duration of Treatment

A typical TMS treatment course consists of daily sessions, Monday through Friday, for 36 treatments over 7 weeks. Regular assessments with your psychiatrist will help track your progress and adjust treatment as needed.

Safety and Side Effects

TMS is considered safe and well-tolerated. The most common side effect is temporary discomfort at the treatment site during the session. Other side effects are rare but can include mild headaches or brief lightheadedness, which typically resolve soon after the session.

Continuous Support and Evaluation

During your treatment course, you will have regular check-ins with your treatment team to discuss your progress and any concerns. This ongoing support is crucial to ensure the effectiveness of your treatment and to make adjustments as needed for the best outcomes.

UC Health’s Unique Approach to TMS

Expertise and Innovation in TMS Therapy

At UC Health, our approach to Transcranial Magnetic Stimulation (TMS) therapy is grounded in deep clinical expertise and a commitment to advancing mental health treatment. Our team includes leading psychiatrists who are also faculty members at the University of Cincinnati College of Medicine. This unique positioning allows us to combine cutting-edge research with practical, evidence-based treatment strategies.

Tailored Treatment Plans

Understanding that each patient's journey with depression is unique, we customize every TMS treatment plan. Before starting treatment, our specialists conduct comprehensive assessments to tailor the therapy to each patient’s specific needs. This personalized approach helps optimize treatment outcomes and patient satisfaction.

Educational Resources and Support

We believe in empowering our patients through education. UC Health provides extensive resources and support systems to help patients and their families understand their conditions and treatment options. From initial consultations to post-treatment follow-ups, we ensure that our patients are well-informed and supported every step of the way.

Community and Advocacy

Beyond individual treatment, UC Health is committed to destigmatizing mental health issues and advocating for better mental health services. We engage with the community through workshops, seminars, and public speaking events to raise awareness about the benefits of innovative treatments like TMS.

Financial Considerations and Insurance

Understanding Costs and Coverage

Navigating the financial aspects of TMS therapy can be straightforward with the right information. At UC Health, we are committed to transparency about the costs associated with TMS treatment and the insurance coverage options available.

Insurance Coverage

Most health insurance plans cover TMS therapy for patients who meet specific criteria for treatment-resistant depression. Before starting treatment, our financial coordinators work with you to verify your coverage and explain any out-of-pocket costs you may be responsible for. This process includes checking your benefits, obtaining necessary pre-authorizations, and ensuring that all paperwork is handled efficiently.

Out-of-Pocket Costs

For patients without insurance coverage or those who prefer not to use insurance, UC Health offers options for out-of-pocket payment. We strive to make TMS therapy accessible to everyone who needs it and can provide information on potential financing plans and payment schedules.

Office Co-pays and Additional Fees

Any co-pays or additional fees associated with office visits or treatment sessions will be clearly outlined during your initial financial consultation. Our goal is to ensure that there are no surprises when it comes to the cost of your care.

Questions and Support

If you have any questions about insurance, billing, or financial options, our dedicated billing team is here to help. We encourage you to reach out with any concerns so we can assist you in making informed financial decisions about your treatment.

For more detailed financial information and support: uchealth.com/financial/

Help Along the Way

Answers to Your Questions about TMS Therapy

The duration of the effects from transcranial magnetic stimulation (TMS) can vary widely among patients. Most patients who experience relief from depression symptoms report the benefits lasting from several months to years up to a year after a course of TMS treatment. Ongoing maintenance sessions may be recommended to sustain these effects.

TMS is not approved by the FDA for the treatment of bipolar depression, but studies have shown promise in improving symptoms of depression, in patients with bipolar disorder who do not respond well to medications for depression. It's used as an adjunct treatment and should be managed by a specialist to carefully monitor bipolar symptoms due to the risk of inducing mania.

The risk of stroke from TMS is extremely low. TMS is a non-invasive procedure that focuses on specific areas of the brain, and there's no evidence suggesting it increases the risk of stroke. Patients are screened for any contraindications to treatment before starting TMS therapy.

TMS is less invasive than electroconvulsive therapy (ECT) and doesn't require anesthesia. While both are effective for major depression, TMS typically has fewer side effects and doesn't involve the same level of cognitive risks, such as memory loss, that are sometimes associated with ECT.

Yes, contraindications for TMS include having metallic implants or medical devices implanted in or near the head (excluding dental fillings).  Because this treatment has a risk of inducing seizures, a history of seizures can be a contraindication though not always. A thorough medical evaluation is necessary to determine suitability for TMS treatment.

Clinical studies have shown that about 70-75% of individuals with treatment-resistant depression who undergo TMS will experience a clinically significant response, with 30-40% of individuals achieving full remission of their depression symptoms.

TMS has been explored as a treatment for chronic pain, with some studies indicating it may reduce pain levels, particularly in conditions like fibromyalgia and neuropathic pain. However, it is not as commonly used for pain management as it is for depression, and more research is needed in this area.

During a TMS therapy session, patients often report feeling a tapping sensation on the scalp. While this can produce some discomfort or mild pain, most individuals report that the severity of this side-effect diminishes after the first 5 treatments. 

TMS therapy is typically considered a short-term treatment, with a course consisting of daily sessions for 7 weeks. While the benefits can be long-lasting, some patients might require repeated treatment if symptoms return.

TMS therapy does not typically cause cognitive impairment. In fact, some patients report improvements in concentration and cognitive function following TMS. Unlike electroconvulsive therapy, TMS does not cause memory loss and is considered a brain stimulation treatment with minimal cognitive risks.

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Referring Physicians

We are committed to providing optimal care to your patient and open communication with you. We understand that as a referring physician, you need to be kept informed on your patient’s progress. You will receive as report detailing the patient’s treatment and response to treatment, once completed.  Additionally, our clinicians are available at any time during the treatment to discuss your patient’s progress.  

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