Everything You Need to Know About TMS Therapy


North End Psychiatry in Boise, Idaho offers a plethora of psychiatric services, including being one of the few first in Southwest Idaho that perform Transcranial Magnetic Stimulation (TMS) Therapy. This treatment course is a safe non-invasive option for those who haven’t responded to previous treatment courses.

What is Transcranial Magnetic Stimulation (TMS) Therapy?

Transcranial magnetic stimulation (TMS) is a noninvasive form of brain stimulation in which a changing magnetic field delivers an electric current at a specific area of the brain. This current is conducted by a changing magnetic field and delivered via electromagnetic induction. TMS therapy has shown diagnostic and therapeutic potential in the central nervous system and thought to treat a wide variety of mental health and neurological diseases.

Is TMS Therapy Safe?

NeuroStar TMS Therapy is a new treatment that was cleared by the US Food and Drug Administration on August 17, 2018. While research is still evolving, TMS Therapy is designed for patients suffering from depression who have had unsatisfactory results with prior antidepressant treatment.

As the treatment is non-invasive, recipients don't require surgery, and remain awake and alert during therapy sessions. TMS Therapy can be performed in a psychiatrist's office, and is non-systemic, which means treatment is not administered by mouth or intravenously.

Patients who have implanted metallic devices or non-removable metallic objects in or around their head shouldn’t use TMS Therapy, nor those who employ pacemakers, implantable cardioverter defibrillators or ICDs, and vagus nerve stimulators (VNS).

Treatment courses typically consist of 5 treatments per week over a 4-6 week period, and each session lasts approximately 19-37 minutes. If you have any additional questions, feel free to contact us.

How TMS Therapy Treats Depression

TMS Therapy uses a targeted pulsed magnetic field, similar to an MRI (magnetic resonance imaging) machine. The treatment coil is placed on the head over the left prefrontal cortex. This part of the brain is involved with mood regulation, and is underactive during depression. Delivery of very small electrical currents activate cells which are thought to release neurotransmitters like serotonin, norepinephrine, and dopamine.

Depression is thought to be the result of an imbalance of these feel-good chemicals, and TMS Therapy seeks to restore their natural balance, thus relieving the symptoms of depression.

Is TMS Therapy Effective?

An independent, randomized, controlled trial funded by the National Institute of Mental Health treated 307 patients with the NeuroStar TMS System over a 4-6 week period of time.

These patients were divided into two groups: low treatment resistance (those who failed to improve depression symptoms after a single antidepressant treatment), and high treatment resistance (those who failed to improve depression symptoms after multiple antidepressant treatments). 

Here are the results of that study:

  • Patients who had received NeuroStar TMS Therapy were four times more likely to achieve remission compared to patients receiving a sham treatment.

  • 1 in 2 patients experienced significant improvement in their depression symptoms.

  • 1 in 3 experienced complete remission.

  • Patients also experienced significant improvement in anxiety and physical symptoms, such as appetite changes, aches and pains, and lack of energy.

Given these findings, there’s an increased likelihood that TMS Therapy will relieve, if not permanently eradicate, the symptoms of depression.

What to Expect on Your First TMS Therapy Visit

Your first session could last up to an hour and a half, as the physician needs to determine how to most effectively administer treatment. As the system emits a tapping sound, you will be provided and asked to wear protective earplugs.

Before treatment begins, the physician will perform a test to determine your motor threshold. This threshold is the amount of magnetic field strength that results in movement of your right thumb, and is different for everyone. Once this threshold is established, the location where optimal treatment will be administered is determined by the physician.

TMS Therapy is then administered over a 19-37 minute period, where rapid pulses are delivered in 30-second intervals, which feels like tapping on the scalp. If you find this tapping uncomfortable, the physician may be able to make adjustments.

Once the treatment session is completed, you may return to your normal daily routine, including driving. You may experience a headache or discomfort at the treatment site. These symptoms should lessen as treatment continues, and an over-the counter analgesic can be used to reduce symptoms. 

Does Your Insurance Cover TMS Therapy?

Since the FDA’s clearance of TMS in 2008, insurance coverage for eligible patients has increased significantly, with over 60 coverage policies, including most Medicare contractors. If you’re not responding to or cannot otherwise tolerate medications, TMS Therapy may be right for you. Talk to your North End care provider regarding any specific insurance questions.

Click here for a list of insurance companies that cover TMS Therapy.

How North End Psychiatry Can Help

The staff at North End Psychiatry are fully equipped to administer treatments and answer any questions or concerns that you may have about TMS Therapy. We also have an on-site laboratory patient service center, a self-pay sliding fee scale, and provide the only ECT treatment in Southwest Idaho by licensed psychiatrists. 

Click here for a full list of our available services.

Feel free to contact us here at North End Psychiatry if you have any additional questions about TMS Therapy or to set up an appointment. Our office is conveniently located just outside of downtown Boise near 15th and State Street.

Colin Eggleston