We partner with Enlighten TMS to provide Express TMS, which uses theta burst technology to reduce the total session time to only 3 minutes per treatment. Express TMS has been proven to be just as effective as traditional TMS protocols, which can require up to 20 minutes per treatment. It also requires a less intense magnetic pulse to achieve the same efficacy, which can result in a reduction in side effects.
How Does TMS Work?
A depressed brain does not operate at full strength in the areas responsible for mood and emotional control. The reduction in activity in these areas means fewer and less healthy communications being sent from the brain to the rest of our nervous system, which is experienced as distorted and negative thought patterns, fatigue, avoidance behaviors, changes in sleep and appetite, and poor motivation. A depressed brain is less able to decode and respond productively to what is happening in the environment.
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TMS is a safe, FDA-approved, non-invasive treatment that uses short magnetic pulses to target the exact areas of the brain affected by depression Over time, the repetitive stimulation results in improved cellular metabolism and functioning. Connections improve between the nerve cells and they begin firing properly again, restoring the emotional control center.
What Does TMS Treatment Look Like?
Standard Express TMS Treatment Protocol:
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You will have an initial visit with the psychiatrist to determine whether you are a candidate for treatment.​ We will discuss the risks, expected benefits, and alternative approaches available to you so that you can make an informed decision about whether to proceed.
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Treatment begins with "brain mapping" which is the process whereby we determine the precise location for the coil placement during treatment. And, in the same visit, we also determine the "motor threshold" which indicates the appropriate intensity of the signal to be delivered. We will repeat brain mapping and motor threshold determination at least one additional time during the treatment protocol.
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You will receive your first Express TMS treatment on the same day that we perform brain mapping and motor threshold determination.
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Standard protocols for depression call for a total of 36 sessions, which are typically delivered once daily, 5 days per week, for a total of 7-8 weeks of treatment.
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You will follow-up with your psychiatrist around the mid-point of your treatment and again once your protocol has been completed.
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Treatment does not require sedation, and you are able to drive yourself to and from the appointment.
Can I Accelerate My Treatment?
Yes, you can.
The once-daily approach to rTMS (repetitive TMS) is based on FDA approval and is what insurance companies are willing to reimburse. However, good data exists for reducing the total length of the treatment by stacking multiple sessions per day, with at least a 40 minute rest period between sessions. This provides a compelling alternative option for patients who may struggle to be physically present at the office for 36 consecutive work days, especially since missing more than one session in a row requires us to begin your protocol anew.
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Because there is no prohibition against driving immediately after treatment, you can explore local shops and restaurants between same-day sessions, or you may choose to stay in one of our comfortable relaxation rooms with a book or your Guest WiFi connected device.
What are the Side Effects?
During the treatment you will feel a tapping sensation on your head, which some people describe as uncomfortable. Headaches can occur, which are typically mild and temporary.
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Less common side effects include: fatigue, dizziness, tinnitus, nausea, vomiting, insomnia, worsening of anxiety or depression, back or neck pain, migraine aura, odd sensations, or seizures.
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Some patients are not candidates for rTMS, due to risk of significant harm with magnetic stimulation:
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Patients with implanted electronic devices in or near the head (cochlear implants, deep brain stimulators, vagus nerve stimulators, etc.)
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Patient with other non-removable metal objects in or near the head.
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A major benefit of rTMS treatment is that it does not pose a risk of weight gain or sexual side effects, as with many antidepressants.
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What are the Costs?
Brain Mapping and Motor Threshold Determination $400
TMS Session $300
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Total Package Cost for Depression Treatment = $11,600
Includes 2 Motor Threshold Determinations, and 36 TMS sessions.
(Does not include visits with the psychiatrist for intake or follow-up, which typically totals $1000 for new patients, for 3 standard scheduled appointments.)
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Additional considerations regarding the cost of treatment:
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Insurance will typically reimburse one TMS session per day for patients who qualify.
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We will obtain prior approval from your insurance company to provide you with an estimate of what they will reimburse for our out-of-network services.
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You will pay us for your treatment each day that you have a session. However, we can file directly with your insurance company to support you in recouping your out-of-pocket costs.
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We provide treatment for anxious depression (stimulation of the right-side of the brain) at no additional cost, for all patients who are receiving the rTMS depression protocol.
Contact Us
If you would like to speak directly with our partner, Enlighten TMS, about this technology and our approach to treatment, please reach out!
"This practice is going to help a lot of people. The amazing ladies who run it are experienced in a wide array of medicine...this includes promotion of gut health, lab testing to discover sensitivities, balancing diet, etc. What was once considered new age is now essential in our daily health."
-Brian