rTMS is a procedure during which magnetic fields are used to stimulate the area of the brain which is under functioning in depression. Magnetic energy generated by a coil placed on the head is used to stimulate a small area on the surface of the brain. The coil is connected to a machine that generates magnetic pulses while patient lies comfortably and awake in a recliner chair.
A session of rTMS typically takes 20-30 minutes and is given on consecutive weekdays on an outpatient basis. There is no need for any anaesthetic or sedation and there are no adverse effects on memory and thinking ability.
rTMS is used to treat depression and can be offered when patients have not responded to antidepressant medication, prefer to try an alternative to medication, or cannot tolerate antidepressant medications due to side effects. It is important that a thorough psychiatric evaluation is undertaken for each patient to determine if TMS is a suitable treatment.
A large body of research conducted worldwide and Australia indicates that rTMS has antidepressant effects. It is understood that TMS works by modifying and rebalancing activity across brain networks, which has become altered in depression. TMS is now an approved treatment for depression in countries including Australia, the United States, Canada, Israel and the United Kingdom.
Generally, rTMS has few side effects that might be experienced during the procedure only. These include headache, scalp discomfort and facial muscle twitching. These side effects are mild and generally resolve soon after a treatment session. Most patients find side effects reduce in intensity and frequency as the course of TMS progresses. Also, the rTMS machine at our centre allows stimulation at lower intensity in the initial phases to help patients acclimatise to any side effects.
The main risk associated with rTMS is its potential to cause seizure. In clinical practice, very few seizures have occurred. rTMS delivered within published guidelines to individuals without risk factors appears to cause fewer than 1 seizure per 60,000 sessions.
The initial appointment with the psychiatrist identifies risk factors like an underlying epilepsy or concurrent brain condition that could increase the risk of seizure.
You will be awake through the whole session. A staff member will be with you to guide you through the treatment process. If you have any concerns during the treatment, the treatment can be stopped immediately.
A session involves lying in a comfortable recliner chair and wearing either ear muffs or plugs for hearing protection. A small magnetic coil is then precisely placed on your forehead, touching your scalp. When the treatment starts you may hear a soft clicking noise and feel a tapping sensation on your scalp. The treatment will take 10-30 minutes and then you should be able to resume your normal activities including driving home after the session.
A course of 20 to 30 sessions given over consecutive weekdays is recommended for therapeutic results. Some patients may notice changes after several days.
A thorough psychiatric assessment and physical examination need to be done before treatment is commenced. After assessment our psychiatrist can discuss the individual factors that may affect the likelihood of benefit for you. If you do respond to TMS it may take days to weeks to have a good response to treatment.
Treatment is provided on a fee for service basis. Before the first session an additional test is done to establish the right magnetic field dose for effective treatment. This takes about 30 minutes. At present, Medicare does not cover the cost of TMS treatment and this needs to be paid for by the patient.
Yes, a referral from a psychiatrist or GP is required including completion of a TMS Referral Form, which can be obtained via the contact details below.