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transcranial magnetic stimulation (TMS) for depression

safe, insurance based, medication free alternative

• Sweetgrass Psychiatry has invested in the top of the line TMS device: Apollo due to its safety and efficacy profile.

• TMS is a non-invasive method of brain stimulation that uses magnetic technology targeted towards the area of the brain involved in mood regulation. TMS treatment has been approved by FDA since 2008 for patients with depression who have failed to achieve satisfactory improvement from one prior antidepressant medication at or above the minimal effective dose and duration in the current episode. It has also more recently been approved for obsessive compulsive disorder (OCD).

• TMS has been demonstrated to be safe, well tolerated, and more effective than medications. It does not involve surgery. During treatment, patients remain awake and alert. Patients can resume their normal activities immediately after treatment.

• Treatments are typically five days per week on weekdays and last about 19 minutes. A course of TMS treatments is usually between 6-7 weeks, depending on the individual’s condition and response.

• Controlled clinical studies¹ applying TMS on patients for major depression showed that:

  • Approximately 1 out of 2 patients experience significant improvement in depression symptoms.

  • Approximately 1 out of 3 patients experienced complete symptom relief after the full TMS therapy.

    • 1) Carpenter LL, et al. (2012). Transcranial magnetic stimulation (TMS) for major depression: a multisite, naturalistic, observational study of acute treatment outcomes in clinical practice. Depression and Anxiety, 29(7):587-596. www.ncbi.nlm.nih.gov/pubmed/22689344.

    • 2) Rossi S, et al. (2009). Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol, 120(12):2008-39. www.ncbi.nlm.nih.gov/pubmed/19833552.

• It is currently covered by BCBS, Medicare, Aetna, United, Tricare, Humana, and Cigna.

• To start treatment, give the office a call and specifically request for a TMS intake appointment with Dr. Das or have your psychiatrist/therapist/primary care doctor fax us a referral to (888)316-7716.

• Providers who are interesting in referring patients to TMS, refer to our Sweetgrass Psychiatry TMS Referral Guide.

• TMS treatment location: 710 Johnnie Dodds, Suite 200, Mount Pleasant SC 29464 - wheelchair accessible and ample parking

Patient Information About tms

According to the World Health Organization, depression is the leading cause of disability worldwide, with an estimated 350 million people suffering from this serious disorder (http://www.who.int/mediacentre/factsheets/fs369/en/). Although many different forms of medication therapies exist, these may be unsatisfactory due to a lack of effectiveness or undesirable side effects.

Transcranial Magnetic Stimulation, or TMS in short, can help achieve remission in major depressive disorder as an alternative, FDA approved treatment for patients that did not benefit from prior antidepressant medications. TMS is an approach which uses magnetic pulses to accurately stimulate neural activity.

TMS treatment is:

• Non-invasive, meaning it does not involve surgery, anesthesia or sedation of any kind. -

• Non-systemic, meaning it is not a pill that has to be swallowed and does not circulate the blood stream.

The technology is similar to that of MRI scanners – short magnetic pulses are emitted from a butterfly-like coil, which can painlessly pass through the intact skull and to the outer regions of the brain. Here, very short and very small electric fields are induced, which in turn can influence neural activity. By stimulating with several pulses over several treatment sessions, TMS can have lasting effects on the brain. As such the therapeutic approach with TMS is to inhibit over-active areas in the brain or, as is the case in a depression treatment, excite under-active regions. TMS is a proven and safe treatment method with very few side-effects. The most common side-effect is transient pain, transient headaches, discomfort at the treatment-site or short uneasiness or dizziness. In extremely rare cases, epileptic seizures may be induced (although no seizures were observed during TMS FDA clinical trials that included over 10,000 treatment sessions.). TMS is free of most side-effects which are typically associated with antidepressant medications such as weight gain, sexual problems or upset stomach

Each TMS treatment session takes approximately 19 minutes. Before and right after treatment, the patient can directly come and go from their normal everyday activities. In total, the patient receives 5 therapy sessions for approximately 6 weeks. Patients are alert and awake during treatment.

Controlled clinical trials applying TMS on patients who had failed to achieve satisfactory improvement from one prior antidepressant medications showed that:

• - Approximately 1 out of 2 patients experienced significant improvement in depression symptoms.

• - Approximately 1 out of 3 patients experienced complete symptom relief after the full TMS therapy.

Please ask your doctor if TMS is right for you. You should not apply TMS if any of the following conditions apply:

• - You have implants such as cochlear implants, internal pulse generators, medication pumps, pacemakers or other implanted devices. - You have metal of any kind in the head or brain area.

• - You have a history of epilepsy.

• - You have had a vascular, traumatic, tumoral, infectious, or metabolic lesion of the brain.

• - You are pregnant.

TMS is a safe form of treatment that has been cleared by FDA since 2008 for patients with depression who have failed to achieve satisfactory improvement from one prior antidepressant medication at or above the minimal effective dose and duration in the current episode.

For additional information, read about TMS from the Mayo Clinic.

If you are unsatisfied with your current depression medication or worry about its side effects and are looking for a proven, drug-free alternative, call Sweetgrass Psychiatry for a TMS evaluation.