Trans-cranial Magnetic Stimulation (TMS)

What is TMS?

Repetitive Trans-cranial Magnetic Stimulation (TMS) is a treatment option for depression and possibly other psychiatric disorders.

Since the mid-1990s, Depression Studies have proven TMS is more effective in patients who have not responded well to anti-depressant medication treatment. TMS is a mild form of brain stimulation whereby a small coil is placed onto the scalp and magnetic energy is administered to stimulate a small area of the brain.

TMS works by modifying activity levels in the brain of depressed patients: either increasing brain activity in areas that are under active or reducing activity in areas that are over-active. Qualified Psychiatrists prescribe the treatment protocol and it is administered by a Registered Nurse trained to perform TMS.

There is no anaesthetic involved and a person’s memory is not affected by the use of TMS.

What happens when you have TMS?

Throughout each TMS session, you are awake and sitting in a reclining chair.  

Before the initial treatment course begins:

  • The TMS Psychiatrist will determine the area of the brain to stimulate using the TMS coil
  • You may experience sensations such as a twitching in the hand. This procedure is done to establish the correct intensity required for your individual treatment.

During the treatment:

  1. A coil is placed on your scalp towards the front region of your brain. The coil is connected to a machine that generates a magnetic pulse. 
  2. The machine produces a clicking sound. The sound of water may also be heard, as the water keeps the coil cool.
  3. You will need to wear ear protection to prevent discomfort from the sound during the course of TMS. 
  4. You may feel a tapping sensation under the coil. 
  5. The magnetic field produced can also stimulate small nerves around your head and face, producing a muscle twitch in the forehead, face or eye region. The stimulation process routinely takes 30-45 minutes over a consecutive 5 day period (with a break of 2 days). A usual course treatment consists of 20 sessions.

Exclusion Criteria

Patients not suitable for TMS include those who have:

  • A diagnosis of epilepsy
  • An active brain illness such as a recent stroke
  • An insertion of anything that may be affected by the magnetic field (such as metal implants in the head, surgical clips, cardiac pacemakers, implanted medication pumps or electrodes)
  • An unstable medical condition (for example; heart disease) that could be exacerbated if they were to suffer a seizure
  • Or may be pregnant

If any of these conditions are relevant to you, it is very important to inform your treating doctor at the time of assessment.

Other Treatments whilst undertaking TMS

It is important to notify your treating doctor and the TMS team about any treatments or medications you may be currently taking. This includes:

  • Non-prescription medications and/or herbal remedies
  • Any changes to non-prescription medications and/or herbal remedies during your participation with TMS

By not informing of your other treatments or medications, it is likely to confuse the understanding of therapeutic benefits this treatment might have produced.

Side Effects:

TMS is generally well tolerated with minimal side effects. A headache or neck-ache can occur, and can be relieved with simple pain relief medication.

Those who initially find it uncomfortable, do adapt to the sensation over a few days. In the meantime, the strength of the stimulation pulse can be lowered.

The main concern associated with TMS is its potential to cause seizures.

A Registered Nurse will be observing you throughout the session and is trained to manage these infrequent situations.

The vast majority of research conducted to date suggests that TMS is safe and without long-term side effects.

Here are some of the frequently asked questions about TMS:

Q: What will it feel like?

A Everyone’s experience is unique, but most patients describe it as a tapping sensation. It may be initially uncomfortable, however most patients do adapt to the sensation after a few treatments.

Q I have had a number of session treatments and I haven’t noticed any improvement, is that normal?

A It can take about 10-15 treatments before one notices a response to TMS. The response time may vary from one patient to another and for some, the response may not be evident until after the completion of the course of TMS.

Q Can I use my phone/device or read during the treatment?

A We strongly recommend avoiding the use of electronic devices during the treatment. Devices brought too close to the coil during stimulation may be damaged by the strong magnetic field. It is okay to read a book during the treatment.

Q I’m thinking about starting/coming off (antidepressant) medication, is that ok?

A Any changes in your medications should always be discussed with your treating doctor. Any changes after the discussion with your doctor should be relayed to the TMS team.

Q I have to miss a treatment, will it affect my chances of getting better?

A For an optimal response, consistent attendance is required. However, missing an occasional treatment should not affect the chances of a good response.

 

Please contact Delmont Private Hospital at 03 9805 7333 or email delmont@delmonthospital.com.au for more information.

 

 

 

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