TMS Therapy FAQs

Do you have questions about Transcranial Magnetic Stimulation (TMS) therapy, a safe and proven cutting-edge treatment for people suffering from depression? Here are some responses to frequently asked questions about TMS therapy. Please, call us (361) 582-5678 if you have any other questions or if you would like to schedule a Psychiatric Consultation with Dr. Bouras.

How does TMS therapy work?

The non-invasive therapy uses highly focused, pulsed magetic fields to stimulate nerve cells in the area of the brain responsible for mood regulation. Through a treatment coil, the NeuroStar TMS Therapy© system generates highly concentrated, magnetic fields which turn on and off rapidly. These magnetic fields are the same type and strength as those produced by a magnetic resonance imaging (MRI) machine. Read more about TMS therapy and how it works.

Am I a good candidate for TMS therapy?

You may be a good candidate for TMS therapy if you suffer from depression, but are not benefiting from antidepressants, or wish to seek an alternative to antidepressants. This treatment is clinically proven to treat the symptoms of depression for patients who have not responded to previous antidepressant treatment.

Not all patients are appropriate candidates for NeuroStar TMS Therapy. Contact us to determine if TMS therapy is right for you. TMS Therapy should not be used in patients with implanted metallic devices or non-removable metallic objects in or around the head. It also should not be used in patients with implanted devices that are controlled by physiological signals such as pacemakers.

Are their side effects to TMS therapy?

The most common side effect is brief and mild to moderate scalp discomfort or pain at the treatment area during active treatments. The incidence of this side effect will likely decline after the first week of treatment. Fewer than 5% of patients during clinical trails discontinued the study due to any negative side effect.

More than 10,000 active treatments were safely performed with NeuroStar TMS Therapy during the clinical trials. No side effects such as weight gain, sexual problems, stomach problems, sleepiness, or dry mouth were seen during trials. There were no negative effects on memory or ability to concentrate.

Is TMS therapy like electroconvulsive therapy (ECT)?

The two procedures are very different. However, TMS therapy could be a good alternative to treating depression for those who have undergone ECT.

• ECT intentionally causes a seizure;
• TMS therapy does not.

• Patients receiving ECT must be sedated with general anesthesia and paralyzed with muscle relaxants
• Patients undergoing TMS therapy do not. During the TMS therapy procedure, the patient sits in a chair and is awake and alert throughout the entire procedure. No sedation is used with TMS Therapy.

• Recovery from an ECT treatment session occurs slowly, and patients are usually closely monitored for minutes or a few hours after a treatment. Short-term confusion and memory loss are common, and long-term disruptions in memory have been shown to occur and may persist indefinitely in some people.
• In studies completed to date, TMS therapy was shown to have no negative effects on memory function.

How long is TMS therapy?

Treatment involves a series of short outpatient visits to our office, where you will be under the supervision of one of our psychiatrists. A typical course of treatment consists of five treatments per week over four to six weeks. Each treament lasts approximately 40 minutes.

What are the benefits to TMS therapy?

TMS therapy is a non-invasive alternative to depression without the side effects, such as weight gain, sexual dysfunction, nausea, sedation, and dry mouth, which can be associated with antidepressant treatment.

In clinical trials, one in two patients had significant improvement in symptoms and one in three had complete symptom resolution.

Does TMS therapy hurt?

TMS therapy uses the same type and strength of magnetic fields as MRIs, which have not been shown to have side effects. The amount of magnetic field exposure for a full course of TMS therapy is a small fraction of just one brain scan with an MRI.

How effective is TMS therapy compared with drugs?

NeuroStar TMS therapy was not compared in head-to-head studies with antidepressant medications. It is difficult to compare NeuroStar vs. drugs, because they have been studied in different patient populations. The patients for which NeuroStar has been FDA-cleared had failed multiple treatment attempts, one of which achieved an adequate dose and duration. Almost all antidepressant medications have been studied and approved for 1st-line treatment. In the NeuroStar randomized controlled trial, almost 3x the number of NeuroStar-treated patients had a significant improvement in symptoms compared to placebo.

Is TMS therapy covered by insurance and/or Medicare?

Your pre-treatment psychiatric consultation with Dr. Bouras may be covered by your insurance. NeuroStar TMS therapy is reimbursed on a case-by-case basis. Patients can work with their provider and the NeuroStar Care Connection (NCC) program to seek coverage.

Does NeuroStar TMS Therapy work in other disorders?

There are lots of studies in the literature suggesting it works in other areas. While NeuroStar TMS therapy has only been approved for use in patients with unipolar, non-psychotic major depression, it is currently also being used in Bipolar depression, PTSD, OCD, Auditory Hallucinations, Chronic Pain, Fibromyalgia, and Tinnitus.

While there is promising data in these disorders, these data are preliminary and require systematic evaluation in controlled clinical trials. Please, visit our links to research articles or  clinicaltrials.gov to search for current clinical research currently being conducted.

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See Also: Depression FAQs | Video FAQs

Depression FAQs

Major depressive disorder affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older in a given year. Here are some commonly asked questions about depression. Please, call us (361) 582-5678 if you have any other questions or if you would like to schedule a Psychiatric Consultation with Dr. Bouras.

What is major depression?

Depression is a serious medical illness affecting more than 14 million Americans each year. It is a condition which lasts two or more weeks and interferes with a person’s ability to carry out daily tasks and enjoyed activities that previously brought pleasure.

What causes major depression?

The exact cause of depression is not known, but the leading scientific theory is that depression is caused by an imbalance in the brain’s neurotransmitters. Neurotransmitters are chemical messengers that send signals between brain cells. A person’s genetic make-up and life history may also determine a person’s tendency to become depressed.

How prevalent is depression?

From 2001-2003, a study conducted by the Department of Health Care Policy at Harvard Medical School, reported that major depressive disorder will affect approximately 14.8 million American adults (about 6.7 percent of the US population) in a given year.

Is depression a serious disease?

The National Institute of Mental Health maintains that, "Depressive illness can often interfere with normal functioning and cause pain and suffering not only to those who have the disorder, but to those who care about them. Serious depression can destroy family life as well as the life of the ill person."

In 2000, the economic burden of depression was estimated at $83.1 billion in the US and researchers estimate that by the year 2020, depression will be the second leading cause of disability worldwide. Depression can also be a lethal disease. Each year in the US, over 30,000 people die by suicide, 60% of whom suffer from depression.

Is there a depression cure?

There is no known cure for depression but with effective treatment, many patients can remain symptom free.

Are some people more likely to become depressed than others?

Yes, depression is known to be hereditary so depression may occur in some people who have a particular genetic makeup that make them more likely to develop depression. However, the exact nature of these genetic characteristics is not known. Other factors may contribute to an individual’s likelihood of experiencing depression.

Some of these risk factors include:

• Individuals suffering from certain medical illnesses such as stroke, heart attack, cancer, Parkinson’s disease, and hormonal disorders
• Individuals experiencing a serious loss, difficult relationship, financial problem, or any stressful change in life pattern
• Individuals taking certain medications that may increase vulnerability to depression

What are the symptoms of depression?

According to the standard diagnosis guide (DSM-IV-TR) published by the American Psychiatric Association, depression is diagnosed when an individual is experiencing either a depressed mood or a loss of interest or pleasure plus four or more of the following depression symptoms during the same two-week period:

• Significant weight loss (when not dieting) or weight gain (a change of more than five percent of body weight in a month)
• Significant increase or decrease in appetite
• Excessive sleepiness or insomnia
• Agitation and restlessness
• Fatigue or loss of energy nearly every day
• Feelings of worthlessness or excessive and inappropriate guilt nearly every day
• Diminished ability to think, concentrate, or make decisions
• Recurrent thoughts of death or suicide

If you feel you are experiencing any of these depression symptoms, contact your doctor and speak with them about your depression treatment options.

What are the current approved treatments for depression?

Depression is most often treated with psychotherapy (talk-therapy) and antidepressant medications administered together. Although antidepressants can be effective for many patients, they do not work for everybody. Additionally, since antidepressants are typically taken by mouth, they circulate in the bloodstream throughout the body, often resulting in unwanted side effects.

More than 4 million patients do not receive adequate benefit from antidepressant medications and/or cannot tolerate the side effects caused by them. For these patients, alternative treatments are available which usually involve the use of a medical device. These treatments include: transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT) and vagus nerve stimulation (VNS).

What is transcranial magnetic stimulation?

Transcranial magnetic stimulation uses short pulses of magnetic fields to stimulate nerve cells in the area of the brain thought to control mood. These pulsed magnetic fields may have a positive effect on the brain’s neurotransmitters levels. Treating depression with transcranial magnetic stimulation, also referred to as TMS Therapy, may provide an alternative depression treatment for those who have not benefitted from prior antidepressant medication.*

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See Also: TMS Therapy FAQs | Video FAQs

Patient FAQs

Here are some responses to frequently asked questions that we get from patients inquiring about undegoing TMS therapy. Call us, (361) 582-5678 if you have any additional questions, or if you'd like to schedule a Psychiatric Consultation with Dr. Bouras.

I am not sure if TMS Therapy is right for me. Can you help me?

Whenever one is considering pursuing new treatment options, it is normal to feel a little apprehensive. We try to include as much information as possible about TMS Therapy on our website. We will be happy to schedule a Psychiatric Consultation (usually covered by your health insurance) with Dr. Bouras to review your treatment history and to see how TMS Therapy can help you in your recovery from depression.  You can call us at (361) 582-5678 or email us for more information.

I am currently seeing another psychiatrist. Can I still see them if I pursue TMS Therapy?

Absolutely! TMS Therapy is another treatment modality, like psychotherapy and pharmacotherapy (medication management). We act as the consultant offering the TMS Therapy modality. You will continue seeing your psychiatrist (and therapist, if you have one) who will be your primary psychiatric provider. We will act as consultants, keeping in touch with your psychiatrist and update them of your progress during TMS Therapy.

I am currently taking medications. What will happen with the medications once I start TMS Therapy?

We encourage patients to continue taking their current medications during the course of TMS therapy and continue seeing their psychiatrist or primary care provider for monitoring and refills. We normally recommend gradual decrease and tapering off of medications after TMS Therapy has started. The goal will be to get you off some (or all) of your medications. We will be in touch with your current provider and update them on your progress.

Why my insurance does not reimburse for TMS Therapy right away?

NeuroStar TMS therapy was approved by the FDA in October 2008. Like many relatively new treatments and therapies, it takes some time for the health insurance companies to include TMS Therapy as a covered benefit (there are 3 health insurances in the US that have already added TMS Therapy in their health policies). Since TMS Therapy is not a covered benefit, any claims filed will initially be denied. We do provide a "letter of medical necessity" and with the assistance of NeuroStar Care Connection, the appeal process begins. The success rate of the appeal process is about 75%, which means that 3 out of 4 patients who undergo TMS Therapy will be reimbursed by their health insurance. There are a lot more TMS Centers in California, having filed a lot more claims for TMS Therapy, that for some health policies reimbursement happens without having to go to the appeal process! We are confident that as more and more insurances see the benefit of using TMS Therapy in the treatment of depression, it is a matter of time to see TMS Therapy as a covered benefit in the near future.

What is the process of getting reimbursement from my insurance?

Because TMS therapy is not a covered benefit at most health insurance plans, it will more likely be denied in the beginning, but reimbursement can occur upon appeal of that denial. Currently, the success rate of reimbursement upon appeal is 75% or 3 out of 4 patients. We cannot start any appeal process without having claims denied. Patients usually start and pay for the TMS Therapy treatment first, claims are subsequently filed, and the appeal process begins once those claims are denied.

Once I finish TMS Therapy, do I need to come back for more sessions?

Some patients can benefit from maintenance TMS Therapy or “booster” TMS Treatment sessions. This is assessed on an individual basis and we can discuss this possibility with you upon completion of the acute phase of TMS Therapy. You are encouraged to contact us, should depressive symptoms return in the future. Please, call your psychiatrist or primary care provider to facilitate continued care and treatment.

Is it true that Victoria TMS Center put Victoria on the map?

Yes! We even include the map to prove it! On a serious note, we are the first and only TMS Center south of I-10, serving the Crossroads Area and South Texas. What this means for the residents of Victoria and surrounding counties is that they do not need to go to a "big city" in order to get this latest, cutting-edge, proven and safe treatment for depression. That in itself is a tremendous convenience, where people do not need to take too much time off work or school, and it provides savings in travel and lodging. For people who need to travel to come to Victoria, they get to enjoy our city and its hospitality.

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See Also: TMS Therapy FAQs | Depression FAQs | Video FAQs