FAQs – Frequently Asked Questions

Transcranial Magnetic Stimulation (TMS)

Treatment for depression, OCD, addiction, anxiety and more

Find out more about Repetitive Transcranial Magnetic Stimulation treatment.

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Questions About Treatment

Here are our answers to some of the most commonly asked questions about this treatment.

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Questions & Answers

Transcranial Magnetic Stimulation is a neuro-modulation technique which emits electromagnetic pulses to stimulate the brain.

In depression treatment, the left dorsolateral prefrontal cortex is treated. High frequency magnetic stimulation excites the neural pathways in this particular brain area. Repetitive stimulation of the left prefrontal cortex results in improved mood, increased motivation and positive cognitions.

A standard course of treatment for depression and anxiety is comprised of one 30 minute session per day, 5 times per week for 2-6 weeks. Accelerated treatment where a patient undergoes more than one session per day is also an option, if the treating clinician permits this. The overall duration of treatment depends on whether a patient is responding, and at what pace they are responding at.

Patients usually require 20-30 sessions of rTMS to experience a significant reduction in symptoms or enter remission.

TMS treatment is suitable for any individual over the age of 18, experiencing major depressive disorder.

TMS is an alternative avenue of treatment for depression to consider if antidepressants or talking therapies have not helped to alleviate depressive symptoms.

While rTMS is generally very well tolerated, there are some individuals who may not be suitable for treatment.

A person with a history of seizures or who have metal implants in their brain are not suitable for TMS therapy. Individuals with Bi-Polar disorder who are currently experiencing a manic phase are also not permitted to undergo TMS treatment.

During the assessment our treating clinician screens all potential patients for any contraindications to TMS treatment.

If you are deemed unsuitable for rTMS therapy, you will continue to receive care from your GP or local mental health clinic for depression. This may involve being referred to a psychiatrist/psychologist.

Patients are strongly advised to continue taking their antidepressant/ any currently prescribed medication. This is to ensure that if improvements occur during treatment, they can be accredited solely to the rTMS treatment.

Patients usually respond between 12-15 sessions or two and a half to three weeks. While some individuals respond in less time, others may be in a late-responding category. Improvements are generally subtle and gradual.

In clinical rTMS trials, 1 in 2 patients experienced a significant reduction in symptoms after four weeks. 1 in 3 participants entered complete remission after six weeks of treatment. Smart TMS’ clinical experience of response rates is considerably higher than the published research.

Yes, TMS is safely administered to patients who are taking antidepressant medication in conjunction with the treatment.

Stopping or altering prescribed medication is not advised for the duration of treatment.

Some medications such as Clozapine, or consuming large amounts of alcohol lowers an individual’s seizure threshold and so in not advised. During assessment, your treating clinician will inform you about any unsuitable medications and also speak about healthy lifestyle factors to consider during treatment. Adopting these healthy lifestyle factors such as limiting alcohol intake, not only ensure better safety and tolerance of rTMS but also help to derive the greatest benefits of TMS therapy.

It is well established among medical professionals and psychologists that rTMS is an effective alternative treatment to antidepressant medication.

Some individuals do not respond to anti-depressants or find their side effects difficult to tolerate.

Transcranial Magnetic Stimulation is non-systemic, meaning that nothings enters your body or bloodstream. The TMS is localised to the specific brain area that is being treated. This also means that patients can immediately return to regular daily activities after rTMS sessions.

Antidepressants are a systemic method of treatment for depression which focus on regulating chemical neurotransmitters that effect mood and emotions. A course of antidepressants can take several weeks to feel the effects and often carry with them serious side effects such as weight gain, nausea, emotional numbness, sexual dysfunction and insomnia.

Transcranial Magnetic Stimulation is a non-invasive treatment for depression which focuses on the regulation of neural activity in the brain. As rTMS is non-systemic, it has very few side effects and patients usually can see benefits within two and a half to three weeks of treatment.

TMS is usually considered if an individual is unresponsive to antidepressants or is unable to tolerate their side effects.

While both TMS and ECT treatments use electrical output to modify cortical circuitry and activity in the treatment of depression, their similarities end there.

ECT is a more intense and invasive procedure designed to stimulate a controlled convulsion. Anesthesia is required while undergoing ECT treatment.

TMS is a non-invasive therapy which treats a specific brain area. Patients are awake during treatment and usually tolerate it quite well.

While ECT is associated with memory loss, TMS does not effect cognition and carries few side effects.

Each patient’s experience of TMS treatment is high individual. approximately 75% of patients experience a significant reduction in symptoms while 60% enter remission.

In some cases, patients feel a slight relapse where some of their previous symptoms return. However, TMS offer maintenance sessions of continuous care to ensure that the benefits of rTMS therapy are sustained and remission can be achieved again.

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Unfortunately, as rTMS therapy is still a new modern treatment for depression, it is not yet covered by the Irish HSE public health service.

As Transcranial Magnetic Stimulation is becoming more and more popular, more private medical insurers (PMIs) are now starting to cover TMS treatment.

Please follow the link for latest information.

Claims are generally considered on a case by case basis, so always check with your insurer.

Insurance companies do respond to feedback from their customers, so it is always worth enquiring about rTMS cover from your insurance provider so that they become more aware of the alternative effective treatments for depression and mental health conditions and consider covering treatment in the future.

Where a patient has a combination of conditions including Depression/Anxiety, initially we would treat the Depression/Anxiety symptoms with the standard treatment of 10-15 sessions. We would then review patient improvement. This would typically be followed by 5-10 sessions for the other conditions the patient presents.

We can tailor treatment plans for patients’ by condensing their sessions into an Accelerated Treatment Programme (5 sessions/day x 5 days).

However, research has shown that a patient’s’ improvement continues over a 2 week period following their last treatment session and therefore, it is advisable for treatment to occur over a 6 week period, where practical.

Patients should be at least 18 years old. However, we may agree to treat patients nearing their 18th birthday.

We do not recommend you to stop or change any current medication you may be taking whilst receiving TMS treatment.

Patients are not required to have short hair or shave their head for the treatment.