Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation treatment for patients with psychiatric or neurological disorders whose symptoms have not improved with routine care. Get answers to common questions about TMS therapy treatment.
TMS is cleared by the Food and Drug Administration (FDA) for major depressive disorder, obsessive compulsive disorder (OCD), and nicotine use disorder.
TMS can help with some forms of anxiety that are linked to depression. However, TMS has limited data for helping anxiety alone.
TMS is not FDA cleared for bipolar disorder, mania, or bipolar depression. Some patients with a diagnosis of bipolar disorder seek a TMS evaluation for a second opinion on their diagnosis.
TMS is FDA cleared for migraine headaches, but this treatment protocol is not one that we offer.
No, TMS therapy is different from ECT. TMS requires no medications, no anesthetics, and no seizures. There are also fewer serious risks and side effects with TMS.
Some patients find TMS pulses to be uncomfortable or even painful. However, studies show that the discomfort of TMS decreases as the treatment course proceeds. Our TMS technicians will work with you to maximize your comfort as you get used to the treatment. It is not uncommon for patients to have mild headaches after the first few treatments, but these typically resolve by the end of the first week.
Yes, TMS has been studied alone and in combination with medications and therapy.
We do not prescribe medications or offer psychotherapy. Instead, we work with your outpatient psychiatrist to ensure that you get quality care before, during, and after TMS.
TMS therapy treatment ranges from 3-37 minutes per day depending on which protocol is prescribed. Each protocol currently involves daily weekday treatments for up to 36 treatments.
Most patients receive 30-36 daily weekday (Monday through Friday) treatments.
Appointments are booked 7:30 a.m.- 4:30 p.m. Monday through Friday.
We understand that sickness and emergencies happen. Missing an occasional treatment is not a problem. Treatments are often cancelled for major holidays. Patients are advised to not miss several consecutive days at once. Patients who miss a full week of treatment are often advised to discontinue treatment as there are limited data on how large treatment gaps affect TMS benefits.
Referrals must come from a primary clinician who is responsible for a psychiatric treatment plan before, during, and after TMS. Referrals can be made through our electronic medical record (Epic) or through the form listed on our website. Patients cannot self-refer, even if they are medical personnel or clinicians.
Nearly all insurance companies cover TMS for depression that has not improved with routine therapy and medications. Only one local company currently covers TMS for obsessive compulsive disorder (OCD), and no insurance companies cover TMS for nicotine use disorder.
Please check with your insurance company on whether you have a co-pay for TMS. We are often unable to obtain this information for you in advance because of privacy laws. Please note that co-pays may apply to each of the 36 TMS treatments, not the entire treatment course.
We offer a 15-minute grace period in accordance with Brigham and Women’s Hospital policy. After 15 minutes, we cannot offer treatment as it would be unfair to other patients.
We pay for up to 2 hours of parking in the Hale Building for Transformative Medicine (60 Fenwood Road) parking garage, which is below the clinic. We cannot reimburse for the costs of ride services or public transit. The administrator at the Neurosciences Testing and Procedures Desk (Ground Floor of Hale, just outside TMS treatment rooms) will provide a parking pass.
From the parking garage, enter the elevator and go to the ground floor. Exit the elevator and turn right to enter the lobby. Next, turn left and walk to the end of the building. You will see a sign for Neurosciences Testing and Procedures on your left. Enter the glass door.
There are limited data on the safety of combining ketamine and TMS. We recommend that patients pursue one treatment at a time.
SAINT was cleared by the FDA in September 2022. All SAINT studies have been conducted with the Magnus Medical SAINT Neuromodulation System, which is not yet widely available. SAINT cannot be replicated without structural and functional MRI, neuronavigation equipment, and the proprietary algorithm necessary to target treatment based on functional MRI connectivity. Whether similar results can be obtained with other systems or with standard scalp-based measurements is unclear. We are working on being able to offer SAINT once these issues are resolved.
