Transcranial Magnetic Stimulation

Frequently Asked Questions

We understand you may have many questions about TMS (Transcranial Magnetic Stimulation). Here are common questions we are asked with regards to the process of TMS and our assessment program.

  • Does rTMS work?
  • What is different about neuroCare’s approach to TMS?
  • Can I just get rTMS without cognitive therapy?
  • How many sessions do I need?
  • How often do I need to come in for sessions?
  • What if I have planned time away for (e.g.) a holiday coming up?
  • Are there any side-effects in TMS treatment?
  • Is TMS painful?
  • Does TMS really have a long term effect?
  • How is TMS different from Electroconvulsive Therapy (ECT)?
  • What is the difference between TMS and Neurofeedback?
  • Can anxiety also be treated with TMS?
  • Can I drive myself home after treatment?
  • Can I stop taking antidepressants while undergoing a TMS therapy program?
  • Why is a QEEG assessment required?
  • Who qualifies for TMS?
  • Would I be eligible for reimbursement via a private or public insurance provider?
  • Do I need a referral?
Does rTMS work?

Our scientific results show that after an average of 21 sessions recovery can be achieved in 78% of clients (see Arns et al. 2012).   These results are based on a combined treatment of rTMS and psychotherapy.

What is different about neuroCare’s approach to TMS?

Therapists trained by neuroCare’s highly experienced and global team of researchers and practitioners, are taught to combine any type of Psychotherapy concurrent to TMS treatment.  neuroCare’s research shows that a combined approach is more effective than monotherapy (see Arns et al. 2012).

Can I just get rTMS without cognitive therapy?

Studies show that rTMS without counselling has a lower efficacy, so we do not recommend this.

How many sessions do I need?

On average our clients need about 20 TMS treatment sessions. For the best results treatment sessions should be held 2 or 3 times a week. Usually the client notices an effect within 8 to 12 sessions. .

How often do I need to come in for sessions?

For TMS to have the best effect sessions need to be frequent, this is why we recommend two times per week at minimum.

What if I have planned time away for (e.g.) a holiday coming up?

If you know you have a holiday or time away coming in the two to three months from starting treatment, just let the patient manager know and they can discuss with you what your best options are. We might decide it is best to wait until you get back from any planned time away. Or if it is just a short trip we can either work around your schedule, or fit in more sessions before you go.

Are there any side-effects in TMS treatment?

There are some side-effects in rTMS treatment. Some patients experience a transient mild headache which is often easily remedied with a light painkiller. During discharge of the coil you will hear a ‘click’ sound and the volume depends on the strength of the stimulation. This may have a temporary effect on hearing so patients can choose to wear earplugs.

Extensive trials in TMS have ensured its safety as a treatment method. During the research phase in TMS there was one instance of a patient having a seizure. The risk of a seizure is dependent on many individual characteristics.  People with a history of epilepsy have an increased risk of experiencing a seizure during TMS.  A QEEG test is a means to assess this risk.

We comply with the internationally established safety guidelines and the risk of a seizure for people with no medical history of epilepsy or other condition is very limited.

Is TMS painful?

People undergoing TMS describe the ‘magnetic taps’ as irritating, but not painful. After a few sessions clients often get use to this feeling.

Does TMS really have a long term effect?

We tentatively conclude that the effects of rTMS in combination with psychotherapy lasts at least six months for the majority of clients. However, a number of clients opt to return for follow-up treatment once a month or once every 2 to 3 months to maintain the effects or to prevent relapse.

Research shows that after six months depressive symptoms are significantly lower than at intake.

How is TMS different from Electroconvulsive Therapy (ECT)?

Research has shown that in the treatment of unipolar depression, rTMS is as effective as Electroshock therapy or Electroconvulsive therapy (ECT). However, unlike Electroshock therapy or ECT clients do not require hospitalization and the side-effects are not as severe.

In ECT electric currents are distributed across the brain and there is a heightened risk of memory loss, rTMS on the other hand targets a specific area of the brain.

What is the difference between TMS and Neurofeedback?

Neurofeedback is a method that has been extensively studied in the treatment of ADHD, sleep and epilepsy. However, there is very little controlled research done on the effects of neurofeedback on depression. For this reason Neurofeedback cannot be seen as an evidence-based approach to treat depression. rTMS is extensively studied in the treatment of depression and therefore has a greater chance of treatment success.

Can anxiety also be treated with TMS?

Anxiety is an illness which is common in people with depression and is often treated with psychotherapy. rTMS in combination with psychotherapy may be a recommended treatment to help patients with anxiety disorders.

Can I drive myself home after treatment?

Unlike some medications, TMS does not affect your ability to drive. The experience of intensive treatment, however, can be tiring. If you would not feel comfortable driving after this experience you would be advised to ask a friend to drive you home after a treatment session.

Can I stop taking antidepressants while undergoing a TMS therapy program?

If you are considering phasing out your intake of antidepressant medication TMS is a recommended treatment for this period in order to avoid relapse. It is not necessary to entirely eliminate medication before the treatment starts and antidepressant medication can still be taken throughout the treatment period. Any changes to your medication should be made in consultation with your prescribing doctor or psychiatrist.

Why is a QEEG assessment required?

This is for two reasons. The first is safety. We review the QEEG to decide whether you are eligible for treatment. Certain brain activity is found in about 5% of the population which does not make treatment with rTMS possible. This activity increases the possibility of seizure and in such cases we would first seek the approval of a neurologist if treatment were to start.

The second reason we conduct a QEEG assessment is so we are better able to personalise the treatment , to identify if there are any other factors which may explain depressive symptoms (e.g. a sleep disorder).

Who qualifies for TMS?

A diagnosis of depression may qualify an individual to undergo rTMS. Furthermore, in Australia rTMS is a recommended treatment option for people who do not respond to antidepressant medication (according to RANZCP Guidelines).

Before you can start with rTMS, we would need to conduct a thorough intake assessment.

Would I be eligible for reimbursement via a private or public insurance provider?

TMS is not an item that is covered by Medicare. Other aspects of the therapy program may be reimbursed (e.g. Psychotherapy with a Psychologist, Consultations with a Psychiatrist) You may be eligible for reimbursement from Private Insurers, however this is not done within the clinic.

Do I need a referral?

Before starting rTMS we will need to conduct an intake assessment with a Psychologist or Psychiatrist. To be able to claim Medicare benefits you will need a referral from a GP.

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Personalising Mental Healthcare since 2001, using state-of-the-art neuromodulation to help children, adults and their families achieve lasting mental wellness.

www.neurocareclinics.com.au

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