F.A.Q.

Frequently Ask Questions

Discover answers from Dr. Lindsay Israel to the most popular TMS related questions below.

• What are the side effects of TMS?
  TMS therapy is a well-tolerated treatment for most patients, although it does not work for everyone. Side effects, while infrequent, can include headaches and neck pain.
• How long is an individual sessions and how many are required?
  At SuccessTMS, a typical TMS session lasts approximately 20 minutes. The sessions continue for five days a week over a duration of four to six weeks. Occasionally, a two-week tapering period may follow consisting of just a few sessions a week.
• Is TMS Safe?
  Yes. TMS is an FDA-approved treatment, which means it’s completely safe to administer to patients. It’s also non-invasive and virtually pain-free.
• What are some results of TMS?
  Many TMS patients experience an increase in mood, energy, and appetite, while also experiencing a reduction in anxiety. In clinical practice, nearly 70% of all patients respond to the treatment, and over 45% report remission of their depressive symptoms.
• Can TMS cause brain damage?
  In short, no, TMS cannot cause brain damage. It cannot cause brain damage because there is no physical impact on the brain. TMS uses electromagnetic pulsed energy to trigger the neurons to cause a reaction. That reaction sends signals in the brain to appropriately modulate various neurotransmitters that have a role to play in psychiatric symptoms. In various psychiatric conditions, these neurons are either hyper or hypoactive, therefore there is a mismatch of the ratio of these neurotransmitters. TMS trains the neurons how to fire appropriately and therefore bring balance back to the neurotransmitters.
• Can TMS be reused?
  Yes, a person can have additional courses of TMS. In fact, patients who respond well to TMS initially, are more likely to continue to respond positively to TMS if needed again in the future.
• Can TMS help with anxiety?
  Yes, there is lots of data to support the benefits of TMS for anxiety. In fact, there is a separate treatment protocol for anxiety, though it is not FDA approved at this time.
• Can TMS worsen depression?
  It is very unlikely for TMS to worsen symptoms, but there is a remote possibility for some patients that their symptoms can seem to get worse before they get better?
• Can TMS cause seizures?
  Yes, however, there is a less than 0.1% risk of seizure associated with TMS. If a patient has a history of seizures, or if they could be withdrawing from alcohol or a benzodiazepine, the risk could be higher and the TMS provider should be notified of any increased risk potential prior to starting TMS treatment.
• Can TMS cure OCD?
  Currently, only deep TMS has the FDA approval for its use in treating OCD, but there currently is no ‘cure” for OCD but it can minimize and treat the symptoms.
• Can TMS make you smarter?
  TMS can be used to help enhance cognition which can improve one’s ability to learn new information.
• Can TMS cure depression?
  Depression is considered in terms of “remission” and “recurrence.” TMS can put depression into remission for an extended period of time but there is a possibility, depending on the nature of the patient’s depression, symptoms can recur down the road. If this does occur, then patients are even more likely to respond positively to repeated TMS treatments.
• Can TMS cause brain cancer?
  There is no evidence that shows TMS can at all cause cancer. It uses the same technology as an MRI.
• Does TMS cause brain damage?
  To date, there is no evidence that TMS causes any kind of long term damage to the brain. TMS does carry a very minor risk or seizure during treatment, specifically less than 0.1%. This risk seems to be more associated with those who are already at risk of seizure, whether due to a medication, a chronic condition such as epilepsy, or secondary to drug and alcohol use. However, this potential for the treatment to induce a seizure reaction has not been seen to be a long term issue, only specifically during the TMS treatment.

• Is there training necessary to administer TMS?
  Training is provided by manufacturers of the device, as well as ongoing support. Many medical centers offer advanced courses on the treatment.
• Who are candidates for TMS?
  Patients who have failed to respond to antidepressants or psychotherapy are the ideal candidates for TMS. People who are not a good fit for TMS are those with metallic implants in ears or eyes, stents in the neck or brain, and other metal devices implanted in or near the head should refrain from undergoing TMS therapy.
• Is TMS the same as ECT?
  No. While TMS is safe, painless, and has little-to-no side effects, ETC or electroconvulsive therapy requires general anesthesia which can carry some risk. And unlike TMS, whose patients can immediately resume activities like driving and physical exercise, electroconvulsive therapy (ECT) patients require an extended recovery period and heightened risk of seizure and memory loss.
• How does TMS work?
  TMS has been shown to produce changes in the activity of neurons of the limbic system, which is linked to mood regulation. The procedure consists of magnetic pulses inducing brain activity in the cells of that region. These pulses activate the limbic system cells to improve symptoms of depression. TMS is most often prescribed when other treatments for depression have not been effective.
• Can TMS cause anxiety?
  It is very unlikely for TMS to ever cause anxiety, in fact, it is used to treat anxiety off-label. However, there is a remote possibility for TMS to unmask anxiety symptoms that were underlying a severe depression.
• Can TMS cause memory loss?
  No, in fact, recent studies have shown TMS, when targeted at the Parietal lobe, can help with age-related memory loss as well as possible Alzheimer’s dementia-related memory loss.
• Can TMS be used for bipolar?
  TMS is currently under investigation for its use in treating Bipolar disorder. It is currently not FDA-approved for Bipolar Depression, but the ongoing studies are showing some positive results
• Can TMS make you tired?
  Yes, mild fatigue is not uncommon after the first few treatments of TMS, as it is like a “work-out” for the brain. However, for many patients, this is a very welcomed effect and can be a benefit for many patients who experience insomnia due to their depression.
• Can TMS cause headaches?
  TMS can cause scalp tenderness during the treatment pulses but typically does not cause a lasting headache. For patients who are prone to headaches, they can premedicate with ibuprofen or acetaminophen prior to treatments to prevent a headache.
• Can TMS treat OCD?
  Yes, deep TMS has the FDA approval as a treatment for OCD.
• Can TMS help with PTSD?
  Yes, TMS has been used off-label to help treat PTSD, but it should always be used in conjunction with trauma therapy to prevent exacerbation of memories that can trigger symptoms.
• Can TMS improve memory?
  Yes, TMS has been shown to help improve long term memory in older adults.
• What’s the success rate of TMS?
  68% of people experience improvements, 45% achieve complete remission from their depression.
• When does TMS start working
  The basic answer to this question is that the time to respond to TMS therapy varies. Patients can see improvement in their depression symptoms any time within the first third, middle third or end, and even as far out as 3-4 weeks. It is highly recommended that patients complete the TMS course to give them the best chance possible of achieving optimal results from the treatment.