Dr. Melissa is a member of the Clinical TMS Society and opened a new Transcranial Magnetic Stimulation (TMS) specialty clinic in direct response to the need for increased access to care.
As you will see from our video’s ,TMS is a great option for clients who do not want to take medication, are not responding to medication or those who cannot tolerate medication side effects. Combined with TMS, we also offer wellness coaching and programs centered around nutrition, sleep and exercise.
What is TMS?
TMS, or transcranial magnetic stimulation, is an innovative and non-invasive procedure that works by using magnetic fields to stimulate the brain’s nerve cells in the regions of the brain that are involved in mood, anxiety, and addiction, just to name a few. TMS has been cleared by the Food and Drug Administration (FDA) for treatment-resistant depression since 2013. It was initially developed for patients who have tried multiple other treatments for depression with no success. Over the years, the clinical utility of TMS has grown and is now FDA approved in the treatment of Obsessive-Compulsive Disorder (OCD) and addiction issues such as nicotine addiction. Furthermore, off-label TMS uses include Post-Traumatic Stress Disorder, chronic pain, Tinnitus, and many others.
TMS is an outpatient procedure that is safe, non-invasive, and with minimal mild side effects. Patients can drive themselves to and from their appointments without any difficulty. Patients will relax in a dentist-like chair and a large figure-eight magnetic coil is placed over the targeted region of the brain. When the machine starts, patients will feel a sensation similar to a pencil tapping on the skull. Depending on the protocols used, the TMS treatments can last 5 to 45 minutes and occur 4 to 5 times per week for approximately 6 weeks. This may seem like a long time, but this is to insure the brain changes are long-lasting.
How Does TMS Work?
As with most things dealing with the brain, the exact mechanism is unknown. However, what is known is that when a magnetic pulse is applied to the head, it is able to directly stimulate underlying brain neurons. As one brain region is stimulated, other connected brain regions are also stimulated in a domino-like effect reaching other interconnected brain regions. Why is this important? When we trigger a region of the brain believed to play a role in depression, like the dorsolateral prefrontal cortex, we are, in effect, stimulating not just the prefrontal cortex but also other neuronal connections downstream that are also associated with depression. Furthermore, repetitive stimulation of the same brain area overtime is thought to strengthen (long-term potentiation) or weaken (long-term depression) the neuron synapse depending on the type of stimulation given. For depression, we use a stimulation protocol that enhances or strengthens connections in the brain that have been implicated in the pathophysiology of depression. With repetitive treatments, the brain regions in the “depression network” are thought to increase in synaptic strength and neuronal plasticity which allows long-lasting changes to the brain that can result in improvements in depressive symptoms.
Is TMS right for me and do I qualify?
At TMS elevated, you will see Dr. Melissa, MD, a psychiatrist who will carefully evaluate you to make sure you qualify for TMS. In our office, we mostly commonly treat depression, PTSD, and OCD, but we will also work with those struggling with other issues such as attention deficit-hyperactivity disorder (ADHD), addiction, and pain and neurological issues such as tinnitus.
Transcranial magnetic stimulation is a great treatment option for those who:
- Are not achieving full remission from depression despite trying many medications
- Have not responded to any medications or therapy
- Cannot tolerate medications due to side effects
- Do not want to take medications
- Mothers who are Breast-feeding
- Or those individuals considering a more holistic approach to treatment.
So, who would not qualify? The main issues that would prevent someone from having TMS is a history of a seizure disorder or the presence of metal in the brain that is close to the stimulation site. In addition, stimulator implants in or near the head, or people with active or inactive implants such as deep brain stimulators, cochlear implants, and vagus nerve stimulators are also not good candidates for TMS. Individuals who have suffered a large stroke or had a severe brain injury may also not be good candidates for TMS. TMS Elevated does not perform TMS on children or adolescents under the age of 16 for now, as we are awaiting FDA clearance before treating children and younger adolescents.
What are the side-effects of TMS?
The side effects from TMS are mild and can include a headache, particularly at the treatment site, and some facial pain or twitching during the procedure. If the latter occurs, the intensity of the stimulus will be reduced, or the coil will be repositioned for maximum comfort. Both of these side effects usually improve over time with treatment. Less common side effects include possible worsening of mood, anxiety, or irritability. There is also a very rare risk of causing a seizure during the procedure which occurs in less than 0.1% of people undergoing TMS.
Why is TMS Elevated different and “elevated” from the rest?
We believe in an all-inclusive and holistic approach to care. From the beginning, you will be assessed by our psychiatrist and medical director, Dr. Melissa Lopez-Larson. Dr. Melissa is an integrative psychiatrist with over 15 years of experience treating patients in a variety of inpatient, outpatient, and residential settings. She will not only put a plan in place for TMS but also your medications, sleep, nutrition and exercise. She will meet with you throughout your treatment process to ensure progress is being made and to help troubleshoot if necessary. In addition, our technicians will be with you every step of the way to make sure you are safe and comfortable during each treatment. TMS Elevated has developed specific protocols that are performed while undergoing treatment, such as specific brain games to help improve outcomes as well. Finally, we do have wellness coaching packages available on request to give individuals the extra support they need to achieve life-long health and happiness.
Still not sure if TMS is right for you or still have questions? Please call our office or fill out the form below for a free consultation to decide if TMS would be a good option for you. Let’s get you started on your path to health and happiness today.