Transcranial Magnetic Stimulation (TMS)

A good candidate for Transcranial Magnetic Stimulation (rTMS) is typically someone who meets several of the criteria below. 

You may be a good candidate for rTMS if you:

✔ Have major depressive disorder (MDD) or obsessive compulsive disorder (OCD)

rTMS is FDA-cleared for 15 -75 year olds with either MDD or OCD, especially when symptoms are moderate to severe.

✔ Have not had enough relief from antidepressant medications
Many people who pursue rTMS have tried two or more antidepressants without adequate improvement or have had side effects that made medications hard to tolerate.

✔ Are looking for a non-medication treatment option
rTMS does not involve daily medication, sedation, or anesthesia.

✔ Can attend regular treatment sessions
rTMS is usually given 5 days per week for 6 weeks, so the ability to attend scheduled visits is important.

rTMS may also be appropriate if you:

• Are hoping to avoid potential medication side effects like weight gain, fatigue, or sexual dysfunction
• Want to stay alert and resume normal activities immediately after treatment
• Have depression with anxiety symptoms (many patients experience improvement in both)

Who may not be a good candidate?

rTMS may not be recommended for individuals who:

• Have a history of seizure disorder 
• Have certain implanted medical devices or metal in the head, including cochlear implants
• Are unable to sit comfortably for treatment sessions

Transcranial Magnetic Stimulation (TMS) is the umbrella term for a non-invasive treatment that uses magnetic pulses to stimulate specific areas of the brain. rTMS stands for Repetitive Transcranial Magnetic Stimulation and is a specific type of TMS that uses repeated pulses. It is the most common type of TMS used in clinical practice.  

• Insurance coverage varies by individual health plan. We encourage you to check your insurance benefits for TMS coverage, including co-pays and deductibles. The RCBM TMS Program does not participate with TriCare, Carelon Behavioral Health, UMR, Beaumont UMR, Blue Care Network, Humana, or Medicaid. If you have one of these health plans, please visit NeuroStar to find an rTMS center that takes your insurance.
• All insurance plans require pre-authorization and ongoing authorization for TMS treatment, and each insurer has different authorization criteria. This includes a history of inadequate response to a stipulated number of classes of antidepressant medications or medications for OCD by your insurance company, with a trial of a minimum of 4 - 8 weeks each, along with augmentation strategies such as psychotherapy based on your specific insurance company criteria.
• Your psychiatrist must refer you for rTMS treatment and document the medical necessity of rTMS in accordance with the required criteria.

How does rTMS work?

Certain parts of your brain help control your mood. When the connections in these areas aren’t working as well as they should, communication between brain cells slows down, which can lead to depression. rTMS helps reactivate these connections, allowing the brain to communicate more normally again.

What is involved in the initial mapping session of my rTMS treatment?

An rTMS mapping session is an appointment that helps your care team find the exact spot on your head to treat—and the right treatment strength for you.

During the session, you’ll sit comfortably in a chair while a small magnetic coil is placed against your scalp. The provider sends brief magnetic pulses and watches for a small movement in your hand or fingers. This movement allows them to observe how your brain responds and helps determine the minimum stimulation required to work safely and effectively.

Using this information, they carefully measure and mark the treatment location on your head so each session is consistent. The mapping session is not painful, does not involve needles or surgery, and usually takes 30 - 45 minutes, followed by your first treatment session, which takes 20-30 minutes. It’s an important step to personalize your rTMS treatment and make sure it’s both safe and effective.

Do I still take my psychotropic medications during rTMS treatment?

There are some medications that are contraindicated with TMS. However, for any medications that are not contraindicated, you will continue to take them as prescribed.

When will I start to feel better?

Individuals' experiences with NeuroStar® rTMS vary. The timing of when you feel improvement in your depressive symptoms may not be the same as that of other individuals. Some individuals may begin to experience positive effects within the first week, whereas others may not notice them until the end. It is important to trust the process and stay committed to all 36 treatments. Some of the positive changes include increased energy, improved sleep quality, elevated mood, better concentration, improved eating habits, restored interest in hobbies, and improved social disposition. 

As this is a new program at RCBM, we will process referrals in the order received. Thank you

TMS Department Contact Information:

Email: tms@rcbm.net

Phone: (586) 684-1915

Fax: (947) 230-0565