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What is TMS and how does it work?TMS is an effective, non-invasive alternative for a large number of patients not responding to traditional treatments such as medication and therapy. It is a non-invasive magnetic stimulation of the brain, similar to the magnetic field produced by an MRI machine. The TMS system delivers magnetic pulses to stimulate nerve cells (neurons) in the areas of the brain which affect mood and cognition. TMS does not require anesthesia and is not to be confused with ECT (Electro Convulsive Therapy).
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Who and What does TMS treat?Transcranial Magnetic Stimulation is FDA approved for individuals diagnosed with treatment-resistant depression. Our equipment has also been FDA cleared to treat individuals diagnosed with Obsessive-Compulsive Disorder.
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Does TMS work for conditions other than Depression?There is a great deal of research being conducted on the use of TMS for a wide range of psychiatric and neurologic disorders. More studies are urgently needed. In early studies, TMS may be effective for the following conditions: Depression in pregnant women Obsessive Compulsive Disorder (OCD) Post Traumatic Stress Disorder (PTSD) Chronic neuropathic pain Adolescent mania Dysarthria after subacute stroke Spasticity after stroke Migraine Smoking cessation: in combination with nicotine replacement Tinnitus Regional Pain Syndrome Communication and linguistic deficits in Parkinson disorder Alzheimer dementia Mild TBI-related headaches In Schizophrenia, TMS has been shown to improve working memory In Canada TMS is also used to treat Bipolar Disorder Before beginning TMS therapy, our psychiatrist will see you for a comprehensive psychiatric evaluation to determine if you will benefit from TMS.
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What are the side effects?TMS is generally a safe procedure and does not have many side effects. Common side effects include mild headache and scalp pain or discomfort, muscle twitching, skin irritation on the scalp where the muscle electrode sensors are placed, and temporary hearing changes (no problems with hearing due to TMS have occurred when earplugs have been properly worn).
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What are the possible risks of TMS ?While cortical magnetic stimulation is generally considered a very safe procedure, there are, of course, risks. Patients should be carefully observed for worsening symptoms or signs of suicidal thinking, and/or unusual behavior. Families and caregivers should also be aware of the need to observe patients and notify their treating doctor if symptoms worsen. Serious side effects are rare. This may include seizures (under ordinary clinical use, the estimated risk of seizure is approximately 1 in 30,000 treatments (0.003%) or 1 in 1000 patients (0.1%).
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Who should not be given TMS Therapy?Patients with non-removable conductive, ferromagnetic, or other magnetic-sensitive metal anywhere in the head or within 12 in (30cm) of the stimulation coil. Examples include cochlear implants, implanted electrodes or stimulators, aneurysm clips or coils, stents, bullet fragments, ocular implants, and stents. Patients who have an active or inactive implanted device (including device leads), including deep brain stimulators, cochlear implants, cardiac pacemakers, and vagus nerve stimulators. Contraindicated use could result in serious injury or death. Patients with increased intracranial pressure or patients with intracardiac lines, intravenous pumps, or dose calculators.
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What is the cost of TMS and will my insurance pay for it?Our staff will work with you and your insurance company to determine if insurance will cover all or part of the cost of TMS. Many insurance companies will cover a significant portion of TMS treatment for FDA approved diagnoses. In many instances insurance requires authorization and our staff will submit all necessary documents on your behalf. Medicare does not require any authorization and TMS is typically always be covered under this plan. We offer a sliding fee scale for patients without insurance coverage and will work with you on the cost.
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Is TMS a painful procedure?TMS is not considered to be painful and can be described as a tapping or knocking sensation on the head. You may feel some discomfort at first but many of our patients grow accustomed to the sensation fairly quickly. The TMS technician administering the treatment will always work with you and evaluate your comfort levels to ensure that the treatment is tolerable. Some also experience eyebrow or jaw twitching depending on the placement of the coil and is not considered unusual.
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How often do I need to come in for treatment?There are a total of 36 treatment sessions for each course of TMS and typically each session lasts between 20-35 minutes. It is recommended that you come in for at least 4-5 sessions per week, however if you are unable to commit to such a schedule, you may discuss your treatment plan with your clinician to see if there is benefit in attending 2-3 times a week or less when possible. Our TMS operating hours are typically 9 AM to 5 PM Monday through Friday.
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Can I continue taking medications during TMS therapy?Yes. You do not need to stop your medications for TMS therapy.
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Is TMS an option for patients who cannot tolerate the side effects associated with antidepressant medications?TMS therapy does not have side effects commonly seen with medications such as weight gain, sexual dysfunction and sedation. The most common side effects reported with TMS are headache and scalp pain or discomfort. These are generally mild to moderate and rapidly diminish with time. As with all indications, the use of TMS for patients who can not tolerate side effects will be carefully evaluated and discussed in detail with you.
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Will I be able to go to work after the procedure?Yes. You will come for a session that is about 20-35 minutes long, sometimes shorter. You will be awake during the procedure. You can listen to music, watch TV, or just rest while you receive TMS therapy.
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Does it cause memory impairment?It has not been shown to impair memory.
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Can I receive therapy during TMS?Yes. In some cases this may improve the results of TMS treatment.
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