What is Transcranial Magnetic Stimulation Therapy?

April 29th, 2024

The lifetime prevalence rate for major depression is around 17.1%. This means that 17.1% of the population will experience a major depressive episode at some point in their life. Depression is not an uncommon occurrence, and patients have the right to evidence-based treatment to help with the symptoms they are experiencing. Seeking treatment for depression can be an extremely hard step to make. There are many variables at play, and one may begin to feel they are out of options for treatment.

When it comes to treating depression, there are many different modalities that one can take – psychotherapy (think: talk therapy) and pharmacology (think: SSRIs, SNRIs, etc.), for example. In addition to those first-line agents, noninvasive neuromodulation procedures can be utilized in treatment-resistant depression. These include electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS). Clarity Clinic offers leading TMS therapy to qualifying patients in Chicago.

What is TMS Therapy?

Transcranial magnetic stimulation or TMS, is utilized throughout the world for varying psychiatric disorders and brain-related disorders. TMS is a non-invasive therapy used to improve symptoms of psychiatric disorders, which uses magnetic fields to stimulate nerve cells in the brain. TMS therapy involves using these magnetic fields to induce an electrical current at specific areas within the brain to aid in the treatment of different psychiatric conditions.

There are different types of TMS which differ based on stimulation target, pulse patterns, magnet strength, and pulse frequency. Regarding stimulation targets, TMS devices may administer surface cortical stimulation, theta burst stimulation, and deep stimulation. Surface cortical stimulation is standard practice, while deep stimulation aims to stimulate nerve cells deeper within the cortex. Theta burst stimulation involves shorter, more frequent bursts of stimulation.

What Does Transcranial Magnetic Stimulation Treat?

The US Food and Drug Administration approved TMS for treating treatment-resistant depression in 2008. With this FDA approval, TMS therapy is most utilized in patients who have major depressive disorder and have not found successful treatment with pharmacotherapy or psychotherapy. This therapy is typically reserved for patients who have failed at a minimum of one antidepressant medication. While TMS is primarily used in treatment-resistant depression, it has also been used in the following psychiatric disorders:

Bipolar Disorder: A mental health condition characterized by extreme mood swings, including emotional highs (mania or hypomania) and lows (depression).

Generalized Anxiety Disorder (GAD): A chronic disorder marked by excessive, long-lasting anxiety and worry about nonspecific life events, objects, and situations.

Obsessive-Compulsive Disorder (OCD): A mental health disorder characterized by unwanted and intrusive thoughts (obsessions) that lead to repetitive behaviors (compulsions) performed to alleviate the stress.

Chronic Pain: A persistent pain that lasts weeks to years, which may be caused by inflammation or dysfunctional nerves and significantly affects one’s quality of life.

Post-Traumatic Stress Disorder (PTSD): A psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event, characterized by severe anxiety, flashbacks, and uncontrollable thoughts about the event.

Schizophrenia: A serious mental disorder in which people interpret reality abnormally, potentially leading to combinations of hallucinations, delusions, and extremely disordered thinking and behavior that impairs daily functioning.

Depersonalization/Derealization Disorder: A dissociative disorder where individuals experience persistent or recurrent feelings of being detached from one’s body or thoughts (depersonalization) and/or a sense of unreality about the external world (derealization).

Parkinson Disease: A progressive neurological disorder that affects movement, causing symptoms such as tremors, stiffness, and slowness of movement.

TMS Therapy for Depression

Transcranial Magnetic Stimulation (TMS) therapy for depression involves the use of magnetic fields to stimulate nerve cells in the brain. It specifically targets areas of the brain that are underactive in people with depression.

TMS Therapy for Anxiety

TMS therapy for anxiety targets similar neural circuits involved in anxiety disorders by modulating the activity in specific areas of the brain known to be involved in anxiety, stress, and emotional regulation.

How Does TMS Therapy Work?

TMS works to treat different psychiatric diagnoses by modulating activity in cortical regions and the associated neural circuits. In layman's terms, TMS uses magnetic fields to pulse electrical currents into certain areas of the brain.

This stimulates different neurons in the brain, which has been shown to alleviate depressive symptoms (sleep disturbance, lack of interest, feelings of guilt, lack of energy, lack of concentration, lessened/heightened appetite, increased/decreased psychomotor activity, and suicidal ideation).

The magnetic fields utilized with TMS therapy are comparable to those used in magnetic resonance imaging (MRI). With an MRI, the magnetic fields cast a wide net as opposed to TMS, which casts a small net.

TMS focuses the magnetic fields on one area of the brain. With this in mind, preparing for TMS is quite similar to preparing for an MRI. This will look like removing any metal from one’s body – jewelry, glasses, etc. In addition to this, ear protection is to be worn as the magnets used can cause ear damage without protection.

In practice, when undergoing this therapy, one will wear a device on their head that will pass alternating electrical currents in pulses through a metal coil into specific brain areas. During the procedure, one should feel no discomfort as TMS is a painless procedure.

In addition to this, TMS does not require anesthesia, unlike another type of neuromodulation procedure – electroconvulsive therapy. TMS therapy can last anywhere between a couple of minutes to about half an hour, and your provider would be the best resource to find out exactly how long the session will last. TMS is rarely a one-time therapeutic exercise, with most patients having multiple sessions over weeks’ time.

What is The Success Rate of TMS Therapy?

The success rate of TMS has been supported through many different research studies throughout the years. Multiple reviews based on randomized trials have repeatedly demonstrated that TMS is a safe and effective therapy for patients who are facing treatment-resistant depression.

A meta-analysis of 11 different trials of TMS vs. placebo (treatment designed to have no therapeutic effect) with patients who displayed symptoms of treatment-resistant depression demonstrated that patients were eight times more likely to have improvement of symptoms with TMS than the placebo treatment.

This provides ample support for the use of TMS in treatment-resistant depression. Additionally, studies have not only shown the efficacy of TMS, but they have provided support that TMS is well tolerated by patients. In fact, on average TMS therapy has a success rate ranging from 70 to 80 percent.

Is TMS Therapy Covered by Insurance and Medicare?

Transcranial Magnetic Stimulation (TMS) therapy is covered by certain Medicare and insurance policies, it is an increasingly recognized and effective treatment for certain medical conditions such as depression and anxiety. Here’s what you need to know:

Insurance Coverage: Many private insurance companies now cover TMS therapy for depression, especially when it is deemed medically necessary and other treatments have failed to provide adequate relief. Coverage can vary significantly between insurers and plans, so it's important to check with your specific provider for details on coverage, copays, and pre-authorization requirements. Clarity Clinic partners with Aetna, Blue Cross Blue Shield, Cigna, and UnitedHealthCare.

Medicare Coverage: Medicare typically covers TMS therapy for patients with depression who have not responded to traditional treatments. Coverage details may vary by location, and beneficiaries are often required to meet specific conditions to qualify, such as undergoing a certain number of treatment failures with other modalities.

Pre-authorization: Both private insurance and Medicare may require pre-authorization. This means your doctor must prove the medical necessity of TMS therapy for your condition before you can begin treatment.

Out-of-Pocket Costs: Depending on your insurance plan, there may be out-of-pocket costs such as copays or deductibles. It’s advisable to understand these costs upfront to manage your financial planning effectively.

What Are The Side Effects of TMS Therapy?

TMS therapy has limited side effects compared to other treatment options. As with any type of medical treatment or procedures, there may be side effects. For TMS, side effects can include:

Headaches
Scalp Discomfort
Loss of Appetite
Agitation
Insomnia Issues

Best TMS Therapy Near You

Are you seeking effective solutions for depression, anxiety, or other mental health challenges? Our mental health clinic provides state-of-the-art TMS therapy, along with a comprehensive range of therapy and psychiatric services, designed to support your journey to better mental health.

Expert Care: Our team consists of highly trained professionals who specialize in TMS therapy, an innovative treatment proven to be effective for those who have not found relief through traditional methods.

Comprehensive Services: Beyond TMS, we offer a variety of therapeutic options including individual therapy, couples counseling, and medication management, ensuring a holistic approach to mental health care.

Personalized Treatment Plans: We believe that each individual’s needs are unique. That’s why we tailor our treatments to fit your specific conditions and health goals.

Supportive Environment: From your first consultation to your treatment sessions, our clinic provides a warm, welcoming environment that promotes healing and well-being.

Don’t let depression or anxiety dictate your life. Visit us to discover why we are considered the best provider of TMS therapy and other psychiatric services in Chicago. With mental health clinics located in the Loop, River North, Lakeview Broadway, Lakeview Belmont, Evanston, Arlington Heights, and Mokena, IL, you can start your path to recovery today.

If you can’t make it to one of our clinic locations, not to worry! We also provide online mental health services. Our dedicated team of psychiatrists and therapists is here to support you every step of the way. Book an appointment to improve your mental health at Clarity Clinic, the best mental health clinic near you.

Transcranial Magnetic Stimulation Commonly Asked Questions

How long does a TMS therapy session last?

A TMS therapy session typically lasts between 20 to 40 minutes.

How often do you have to have the procedure done?

TMS therapy is usually conducted five times a week over a period of four to six weeks, but the schedule can vary based on individual needs.

What are the most common side effects of TMS therapy?

The most common side effects of TMS are mild and transient – headaches and scalp irritation.

How much does TMS therapy cost?

The cost of TMS therapy can vary widely depending on the treatment plan, but typically ranges from $6,000 to $12,000 for a full course.

Does Medicaid cover TMS therapy?

Medicaid coverage for TMS therapy can vary by state and individual circumstances. It's best to contact your local Medicaid office to determine if TMS therapy is covered under your plan.

What does TMS mean?

TMS therapy stands for transcranial magnetic stimulation, a type of non-invasive therapy used to treat psychiatric disorders.

Is TMS therapy safe?

Yes, TMS therapy is safe.

References:

Schatzberg AF, DeBattista C. Schatzberg’s Manual of Clinical Psychopharmacology. 9th ed. American Psychiatric Association Publishing; 2019.

Holtzheimer PE. Unipolar depression in adults: Indications, efficacy, and safety of transcranial magnetic stimulation (TMS). In: Roy-Byrne PP, ed. UpToDate.