Transcranial Magnetic Stimulation

What is TMS?
Transcranial Magnetic Stimulation (TMS) is a series of repetitive, brief and highly focused magnetic pulses, used to
stimulate brain cells. TMS is an effective, non-invasive, outpatient treatment with few known adverse effects.
TMS is currently used in the treatment of Major Depressive Disorder and is usually prescribed when anti-depressants have
failed.

How does TMS work?
When a nerve cell ‘fires’, an electrical impulse travels along its length. It communicates with other nerve cells by releasing
neuro-transmitters, which create an electrical impulse in other cells. In depressed patients, the electrical activity in certain
areas of the brain have been shown to be reduced. TMS uses a focused electromagnetic coil, to rapidly pulse a magnetic
field to the targeted area of the brain.
The magnetic pulses induce an electrical current in the brain, stimulating the nerve cells, increasing the brain activity to
normal levels.

Why is TMS different to other treatments?
Medication like anti-depressants are systemic, which means that the medication is absorbed into the blood stream which
can cause numerous side effects. TMS is typically prescribed when anti-depressants have failed or the side effects are
intolerable; this may be called treatment resistant depression, or TRD.
Other treatments for TRD include Electro-Convulsive Therapy (ECT), which works by applying a brief electrical pulse to the
brain that medically induces a seizure. ECT is performed in a hospital and you will be anaesthetized and restrained during
the procedure. ECT can be associated with numerous side effects. TMS is a gentle, non-systemic, outpatient procedure
with has few known associated side effects. Patients can return to their daily activities after treatment.

Are there any side effects?
TMS is a safe and well-tolerated treatment with few known adverse effects. Clinical trials show that the most common
side effects are mild to moderate scalp discomfort and mild headaches, both of which are short-term.
Is TMS an option for me?
TMS therapy is appropriate for adults with Major Depressive Disorder (MDD), who have failed to achieve satisfactory
improvement from prior antidepressant medication in the current episode.
This means that if you have been diagnosed with MDD and medication is not working, or the side effects are intolerable,
you should ask your doctor about TMS.
Although treatment varies by individual, a typical treatment course consists of:
 Average of 30 treatment sessions
 Conducted over a 6-week period
 5 treatments per week
 Each treatment session lasts approximately 30 minutes

What to expect:
During treatment, patients relax in a treatment chair and remain awake and alert. The TMS Therapy device will deliver
magnetic pulses to specific areas of your brain known to regulate mood. These pulses will feel like tapping on the scalp.
The technician can make adjustments if the tapping is uncomfortable. Mild headache or scalp discomfort is sometimes
experienced at the site of stimulation during or after treatment. Over-the-counter analgesic may be taken to alleviate
discomfort. If discomfort persists, the strength of the magnetic field pulses can be reduced to make treatment more
comfortable.

After a treatment session, patients can immediately return to their normal routine, including driving. In clinical trials, most
patients experienced a positive response to TMS Therapy by the fourth week of treatment. Some patients may experience
results in less time, while others may take longer. It is important to continually discuss any depression symptoms with your
TMS Technician.

At your first treatment session:
Because it is important to determine how to most effectively administer your individual treatment, your first session may
last up to an hour and a half. You will be provided with earplugs to reduce the audible tapping sound that the device
emits. You can bring your own headphones (providing they are not metal) and listen to music during your treatment.
The TMS physician will first perform a test to identify your motor threshold, which is the amount of magnetic field
strength resulting in a movement of the patient’s right thumb. This test identifies the magnetic field strength that will be
used during your treatment, which is customized to deliver the correct treatment dose.
The TMS physician will then determine the location on your head where the treatment coil will be placed. In 30-second
intervals, the device will deliver rapid “pulses” of the magnetic fields. These will feel like tapping on the scalp.
The physician can make adjustments if the tapping is uncomfortable.