Initial Intake and Phone Screen
When we first speak with you, we will need to gather information about your psychiatric history including diagnoses, medications tried, psychotherapy/counseling history, health care professionals you have seen. We will need to secure HIPAA-compliant releases of information to other doctors and health care professionals for your records. We will also gather demographic and insurance information. Upon coming to our offices to sign releases we will furnish more information packets to you and if available you may meet with our coordinator or one of our other technicians and see the MagVita system (unless it is in use which it typically is). After gathering information which generally takes 1-2 weeks, we will decide whether to go forward with the next step.
An initial consultation will be scheduled to discuss what is troubling you and whether TMS is an appropriate treatment. At that time, you and Dr. Cook will review your symptoms, treatment history, and possible treatment options.
If TMS is the right treatment for you, treatment sessions can be scheduled to begin immediately.
TMS Therapy is a short outpatient procedure, performed in office under Dr. Cook's supervision while you remain awake and alert. During treatment, you can relax in the treatment chair. Keep in mind that TMS Therapy is:
- Non-invasive, meaning that it does not involve surgery. It does not require any anesthesia or sedation, as the patient remains awake and alert during the treatment.
- Non-systemic, meaning that it is not taken by mouth and does not circulate in the bloodstream throughout the body.
The First Treatment Session
At the first treatment appointment, Dr. Cook and staff need to determine how to most effectively administer treatment and your first session could last up to an hour and a half. You will be provided and asked to wear protective earplugs—the system's magnetic pulses make a loud clicking sound and feel like a tapping on the scalp, but do not result in more than mild discomfort.
Dr. Cook will first perform a test to identify your motor threshold (the amount of magnetic field strength that results in a movement of the fingers of your right hand). This test is important because it identifies the magnetic field strength that will be used in your treatment. This field strength is customized for each patient to deliver the correct treatment dose.
Next, Dr. Cook will determine the place on the head where the TMS treatment will be applied and the magnetic coil will be moved to that location. This will allow you to receive optimal treatment.
The TMS team will then administer TMS Therapy over an approximately 19-minute period. In 30-second intervals, the device will deliver rapid "pulses" of the magnetic fields. These will feel like tapping on your scalp. Everyone refers to this as "the woodpecker." If you find this tapping uncomfortable, your physician or technician may be able to make adjustments to reduce this discomfort. We always recommend taking an over-the-counter pain reliever such as Tylenol, ibuprofen, or Aleve 1 hour prior to your first 5 treatments to minimize headaches. This is rarely necessary after the first few sessions.
Each subsequent treatment will last 19 minutes during which you will be awake and alert. If you wish, you can listen to music with an iPod or mp3 player or speak with our TMS Specialists during the TMS session.
After Treatment Sessions
After the treatment you can drive and resume your normal activity. TMS is non-invasive, meaning it does not involve surgery, and has no systemic effects. Typical TMS side effects are transient and mild irritation or discomfort at the treatment site and headache during or after treatment. These are common side effects that often improve as further treatment sessions are administered.
If necessary, you can treat this discomfort with an over-the-counter analgesic. If these side effects persist, your TMS physician can temporarily reduce the strength of the magnetic field pulses being administered in order to make treatment more comfortable.
TMS Treatment Plan Length
A usual course of treatment for depression involves sessions 5 days a week for 6 weeks, although this can vary depending on your response. As you progress through your treatment, we will regularly assess and share with you your status and determine with you the eventual number of treatments. We utilize standard depression rating scales weekly to aid in your care. We perform weekly depression testing to assess your progress.
TMS & The FDA
TMS Therapy is FDA cleared for patients who have not benefited from prior antidepressant treatment. TMS Therapy is indicated for the treatment of Major Depressive Disorder in adult patients who have failed to achieve satisfactory improvement from prior antidepressant medication at or above the minimal effective dose and duration in the current episode.
TMS+YOU is an online community and national patient advocacy site for TMS Therapy. Those considering Transcranial Magnetic Stimulation can connect with patients who have had the treatment to answer questions, share insights, and get the latest information.