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TMS for Resistant Depression: Long-term Results Are In!

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Transcranial Magnetic Stimulation (TMS) is a non-invasive treatment for severe depression offered by the Comprehensive Behavioral Health Program, at CMPS. TMS uses magnetic stimulation of the brain to help control mood in adults with major depression. The procedure was approved by the U.S. Food and Drug Administration in October 2008 after more than 10 years of clinical investigation in patients who failed to achieve satisfactory improvement from one course of pharmacotherapy (medication). For this reason, TMS is particularly helpful for people who have not experienced significant relief from antidepressant medications or have difficulty with their side effects.

HOW DOES TMS WORK?
TMS uses focused magnetic impulses to non-invasively stimulate the brain in the prefrontal cortex (the region of the brain associated with mood regulation). During a TMS treatment, a clinician gently places a magnetic coil against one side of a patient’s scalp. The magnetic fields penetrate approximately two to three centimeters beneath the coil directly into the brain to produce brain cell nerve activation. This brain cell activation is thought to release neurotransmitters, which play a role in mood regulation. Since depression is believed to be caused by an imbalance of chemicals in the brain, TMS helps restore balance and relieve the symptoms of depression.

THE ADVANTAGES OF TMS
TMS requires no anesthesia or sedation and patients are awake and alert during the procedure. Because no medications are administered, there are no systemic effects or cognitive after-effects (memory loss and ability to concentrate); since no electrical current is administered (as in ECT/shock treatment), there are no neurological or cognitive complications and patients can return immediately to regular activity.

TREATMENT
Patients typically receive 20 to 30 treatments over four to six weeks, five times per week, with each treatment lasting approximately one hour. The course of treatment varies according to each individual. There also may be a taper phase. An initial assessment will determine the appropriate dose of the magnetic pulse and the exact area of the brain the coil should target. As treatment progresses, the clinician will conduct periodic re-evaluations of the dose level and coil placement.

During a treatment session, the patient sits in a comfortable reclining chair similar to that found in a dentist’s office. A headset is applied to deliver the magnetic stimulation. Ear plugs are provided to decrease the loud clicks associated with each magnetic pulse and the patient is given the option of watching TV. During the procedure, the patient is monitored continuously to ensure correct positioning and comfort level.

ARE THERE RISKS AND SIDE EFFECTS WITH TMS?
More than 10,000 treatments were safely performed during clinical trials. Patients reported no side effects like those associated with antidepressant medication (weight gain, dry mouth, drowsiness, etc.), seizures, and no cognitive side effects. Scalp discomfort during the procedure is the most common side effect. TMS should not be used for patients with implanted metallic devices that include metal plates in the skull or aneurysm coils, clips or stents. Special precautions are recommended for individuals with implants, such as pacemakers and implantable cardioverter defibrillators.

IS TMS COVERED BY INSURANCE?
TMS coverage is now provided by Medicare (Florida and many other states), Blue Cross Blue Shield of Florida, Blue Cross Blue Shield Federal, and United Healthcare. Other insurance companies may also pay for TMS on an individual authorization basis. For any insurance company which does offer insurance coverage, there are strict criteria which apply and must be met before authorization or treatment is allowed. Please consult one of our TMS physicians at CMPS for more information.

CMPS COMPREHENSIVE BEHAVIORAL HEALTH PROGRAM
TMS is part of CMPS’ Comprehensive Behavioral Health Program, which is dedicated to improving the quality of life for individuals with a broad range of psychiatric illnesses. Its collaborative team approach is aimed at maximizing the effectiveness of psychotherapy, medication management and psychosocial treatments with emerging techniques, technologies and interventions.

OTHER FACILITIES USING TMS
McLean Hospital – Harvard Medical Center
University of Florida
University of South Florida
Mayo Clinic
James A Haley Veterans Hospital
Stanford Hospital
Brown University

cohen-interview
Dr. Rebecca Cohen Interview about TMS with Heidi Godman, Host of Health IQ on WSRQ Radio June 26th, 2013. (Click here to play interview).

Research Articles

NeuroStar TMS Links

Other Related Links

Contact
For further information or a referral for consultation, please call 941-363-0878 or e-mail info@medpsych.net.

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