Transcranial Magnetic Stimulation (TMS)

• Non-invasive treatment
• Out-patient treatment
• Statistically and clinically significant improvement in depression symptoms (in open-label trial, 54% of patients responded and 33% remitted)
• No interruption to daily schedule
• No anesthesia
• No adverse effects on cognition
• Few or no side effects (most severe side effect is a mild headache, scalp discomfort). Less than 5% of patients discontinued treatment due to side effects.
• Safe and tolerable. More than 10,000 active treatments have been safely performed.
• Patients do NOT have to stop taking medication in order to receive TMS
• FDA approved

The first step in determining if you are a candidate for TMS therapy is to schedule a consultation with Dr Rachel. The Initial Consultation is a face to face consultation where your previous psychiatric history and medical history will be discussed and evaluated.

Please contact Kay Kraisa, TMS Nurse Manager, at 701-364-9723 or email drrachel@mydrrachel.com to discuss scheduling. In preparation for consultation, we will require all of your past psychiatric records from your treating physician(s).

Scheduling TMS therapy:
If you are an appropriate candidate for TMS, we will schedule a block of 20-30 treatment sessions initially. Treatment will be provided daily (M-F) for a 4-6 week period. Payment is due prior to scheduling.

The best way for you to determine if TMS is right for you, is by speaking with Dr Rachel. Proper pre-procedural screening ensures that therapy is administered only when it is medically advisable.

Eligibility:
In order to ensure your safety, the following general requirements will need to be met prior to receiving TMS therapy:

• Currently diagnosed with treatment resistant depression by a psychiatrist, physician or qualified health care professional. Treatment resistance is defined as one antidepressant failure at or above the minimal effective dose in the current episode.
• No implanted ferromagnetic items (i.e. pacemaker)
• No previous history of epilepsy
• No foreign metal cranial bodies or metallic/magnetic implants

Generally, the initial course (acute phase) of treatment will involve 20-30 consecutive treatment sessions over a 4-6 week period (usually a 45-minute treatment session each day from Monday to Friday.

Maintenance treatment
Maintenance treatment may be required in the future depending upon your individual needs. You or your treating provider can contact us if maintenance treatment is required.

WECT News Coverage

Watch the Neurostar Video

APA: Lasting Benefit Seen for TMS in Depression

What is NeuroStar TMS Therapy?
Transcranial magnetic stimulation (TMS) therapy is used to treat depression by stimulating the brain non-invasively using electromagnetic fields similar to those produced by an MRI machine. During NeuroStar TMS Therapy, a magnetic field is administered in very short pulses to the part of your brain that research has demonstrated to be associated with depression.

How does it work?
TMS uses short pulses of magnetic fields to stimulate the area of the brain that is thought to function abnormally in patients with depression. The magnetic fields produce very small electrical currents that activate cells within the brain. These cells are thought to release neurotransmitters. It is believed that the symptoms of depression can be alleviated by increasing the levels of these neurotransmitters.

Are there side effects?
NeuroStar TMS Therapy is non-systemic. It is not a medication, so it does not circulate throughout the patient's body in the bloodstream. It does not have unwanted side effects such as weight gain, sexual problems, upset stomach, sleepiness and dry mouth. The most common side effects reported during clinical trials were headache and scalp discomfort (generally mild to moderate) occurring less frequently after the first week of treatment.

Is it safe and appropriate?
NeuroStar TMS Therapy, approved in October 2008 by the US Food and Drug Administration (FDA) as a safe and effective alternative to antidepressant medication for treating depression.* Like any treatment option, you and your doctor should work together to find the most appropriate treatment option for you.

How long does it take?
The typical initial course of treatment is about 37 minutes daily over four to six weeks. In clinical trials, patients received NeuroStar TMS Therapy five times per week for 37-minute sessions over four to six weeks. Patients treated with NeuroStar TMS Therapy typically receive treatment for four weeks with additional treatments based on clinical judgment, followed by a three-week tapering period.

What are the potential risks?
NeuroStar TMS Therapy is well tolerated and has been proven to be safe in clinical trials. Throughout over 10,000 active treatments performed in clinical trials, the most commonly reported side effect related to treatment was scalp discomfort during treatment sessions. This side effect was generally mild to moderate, and occurred less frequently after the first week of treatment. Less than five percent of patients treated with NeuroStar TMS Therapy discontinued treatment due to side effects.

In NeuroStar clinical trials, more than 10,000 TMS treatments demonstrated its safety with no occurrence of seizures. However, there is a small risk of a seizure occurring during treatment. This risk is no greater than what has been observed with oral antidepressant medications.

While NeuroStar TMS Therapy has been proven effective, not all patients will benefit from it. Patients should be carefully monitored for worsening symptoms, signs or symptoms of suicidal behavior, and/or unusual behavior. Families and caregivers should also be aware of the need to observe patients and notify their treatment provider if symptoms worsen.

Does it cause memory loss?
No. NeuroStar TMS Therapy was systematically evaluated for its effects on memory. Clinical trials demonstrated that NeuroStar TMS Therapy does not result in any negative effects on memory or concentration.

Is TMS Therapy uncomfortable?
The most common side effect related to treatment was scalp discomfort during treatment sessions. This side effect was generally mild to moderate, and occurred less frequently after the first week of treatment.

If necessary, you can treat this discomfort with an over-the-counter analgesic such as ibuprofen or acetominophen. If these side effects persist, your doctor can make treatment more comfortable by reducing the strength of the magnetic field pulses temporarily, or by adjusting the position of the magnet.

Less than five percent of patients treated with NeuroStar TMS Therapy discontinued treatment due to side effects.

How long does the antidepressant effect of TMS therapy last?
In most patients, the clinical benefit of NeuroStar TMS Therapy was maintained through six months of follow-up study. Talk to your doctor about your long-term treatment path.

Can I take antidepressants if I am receiving NeuroStar TMS Therapy?
Yes. In clinical trials, NeuroStar TMS Therapy was safely administered with and without other antidepressant medications.

Will NeuroStar TMS Therapy be covered by my insurance and/or Medicare?
NeuroStar TMS Therapy may be covered on a case-by-case basis. You can work with your doctor and the NeuroStar Care Connection (NCC) program to seek case-by-case coverage. The NCC staff is made up of trained case managers that can help you and your doctor with the reimbursement process. Learn more about the NeuroStar Care Connection.