Transcranial magnetic stimulation (TMS) is a relatively new addition to the field of psychiatry. However, this non-invasive form of electromagnetic therapy continues to show its potential as a viable alternative for sufferers of MDD (Major Depression Disorder). Importantly, this therapy represents an element of hope for individuals who do not respond well to antidepressants or psychotherapy.
Who Is Eligible For TMS Therapy?
As a starting point, TMS is exclusively designed for patients with a confirmed diagnosis of major depression disorders. The next major distinction involves each patient’s history with depression treatments. A cycle of TMS therapy is only applicable to those who have previously tried yet failed to gain a meaningful reaction to antidepressant medications and psychotherapy.
Eligibility then begins with patients over the age of 18. Beyond children and teenagers, other ineligible groups include anyone with a history of psychosis, schizophrenia, bipolar, seizures, and serious substance abuse. Finally, individuals with any tattoos or non-removable metal in their cranium cannot receive a TMS treatment.
What Does A TMS Session Entail?
Each TMS session revolves around the activation of targeted electromagnetic pulses that are designed to stimulate specific nerve cells in the frontal cortex area. The frontal area is chosen because it is directly linked to the regulation of our mood and emotions. Once the necessary measurements are taken, the patient is seated in a comfortable chair, the coil is carefully placed on their head and finally, pulses are delivered in an ongoing cycle.
How Long Will Each Session Be?
The average session time typically falls between 30 to 60 minutes. From the first appointment, follow up therapy occurs five times a week over an overall period of between four to six weeks. Maintaining this consistency is crucial to achieving the treatment’s desired effect.
What Are The Core Benefits?
Transcranial Magnetic Stimulation is based upon a fundamental link between depression disorders and our brain’s regulation of mood and emotion. Therefore, the ability to target and stimulate specific areas of the brain is designed to relieve a patient’s ongoing depressive symptoms. While research into its effects continues, TMS therapies are emerging as a viable alternative for individuals that do not react to antidepressant medications or psychotherapy.
How Does Tms Technology Work?
TMS therapy technology involves several key components that operate together to offer safe and non-invasive treatment. These major components are
- A magnetic coil (placed on the head to deliver targeted magnetic pulses to the brain)
- The flexible arm (connects the magnetic coil to the computer)
- The monitor/computer (regulates the speed of the pulse and records critical data)
- A comfortable chair (ensures maximum comfort and wellbeing of the patient)
How Does the Coil Work?
A magnetic coil is fundamental to TMS therapy. Within each coil is the ability to generate electromagnetic fields that mimic those produced by standard magnetic resonance imaging (MRI) machines. The electrical currents produced by the coil then stimulate specific nerves and cells in the brain’s prefrontal cortex.
Are There Any Side Effects?
As an invasive outpatient treatment, side effects associated with rTMS therapies are mild and slight in their severity. Of course, the proper precautions and screening process must occur prior to the first session. Contact between metallic objects and the magnetic coil, for example, has grave consequences.
Therefore, determining suitability is the most crucial factor during any preliminary meetings. Taking the necessary due diligence will limit any potential side effects during treatment.
Are TMS Treatments Covered Under Medicare?
Yes. In November 2021 rTMS treatments were officially added to the Australian Medicare Benefits Scheme. This announcement followed an official recognition of the therapy by the Royal Australian & New Zealand College of Psychiatrists in 2018. So, what does the 2021 TMS legislation mean? An initial period of 35 therapy sessions and 15 follow up sessions now come with a Medicare rebate to ease the burden of medical costs. Of course, those with comprehensive private insurance will also be covered.
Is The Treatment Invasive?
No. TMS Therapy is a non-invasive treatment. This means that no anaesthetic is required, and patients can leave feely on their own accord after each session. Patients can also resume normal activities, such as driving or work, with no need to stay the night at a medical facility. Overall, TMS is a departure from invasive treatments such as electroconvulsive therapy (ECT).
Is TMS Exclusive to Patients Over 18?
Yes. Under current Australian guidelines, TMS therapy is only available for patients of adult age. Further research is still required to determine the safety and viability of rTMS for individuals under the age of 18. At the current stage, no one below legal adult age is eligible for TMS therapies.
When Can I Expect TMS to Show Results?
Unfortunately, there is no blanket rule and timeline for TMS effectiveness. Across the board, however, patients normally note minor changes to depression symptoms between week 2 and 4 (for individuals that respond well to the therapy).
For context, antidepressant medications typically take anywhere between 6 to 8 weeks before a change is noted. Unlike these medications, patients are not required to continue with TMS past the initial phase of treatment.
If TMS Therapy is Successful, How Long Will the Effects Last?
Success rates vary depending upon the individual. Some may enter remission for a period of months, while others experience a drop in symptoms for years at a time. If TMS proves successful yet your symptoms reappear, a follow up course of treatment is entirely normal.
What About Follow Up Appointments?
If a course of rTMS therapy proved successful yet their depressions symptoms return down the line, another round of treatment is an option. Under the Australian Medicare scheme, for instance, rebates are available for certain amount of follow up TMS appointments. When finances are a concern, we advise that you check the estimated costs before the next round of treatments begin.
Keep in mind that any follow up treatments only apply to patients that responded well to the therapy on the first go round.