TMS stands for transcranial magnetic stimulation. It is used to treat depression by stimulating the brain non-invasively using electromagnetic fields, similar to those produced by an MRI machine. During TMS Therapy, a magnetic field is administered in very short pulses to the part of the brain that research has demonstrated to be associated with depression. The typical initial course of treatment is 19 minutes daily over 8 weeks for a total of 36 sessions. 

The mechanism of action of TMS is still not fully understood however the response to therapy is indisputable and has consistently demonstrated results in the majority of research being done in the field. The TMS electromagnetic pulse is generated by electrical current running through the TMS coil which by method of induction (Faraday’s law) generates a magnetic field perpendicular to the coil. This magnetic field passes through the skull unimpeded and in turn generates a corresponding electric field in the brain also by method of induction. This electric field is conducted by neural pathways under the coil in a somewhat unpredicable way as brain tissue is not uniform and anatomy varies from indivual to individual. Neurons are conductive just like the rest of the nerve fibers in your body. Depending on the protocol used and frequency of TMS pulse entire regions of neurons under the coil can either become excited or inhibited. In Depression, neurons in the left DLPFC (Dorsolateral prefrontal cortex) are targeted by the coil with an excitatory protocol (FDA cleared). Subtle changes in brain state as a result of TMS can last up to several hours and even days after a TMS session has been performed. If done repetitively over a 3-6 week period TMS induces structural changes in the brain where the coil has been placed. Increased gray matter density and blood flow to the part of the brain stimulated have all been clearly demonstrated in research using MRI brain scans.

Not everyone responds to TMS therapy for Depression but most people will. Many clinicians see a 70% – 80% response rate in their patient population. At least half of these responders will achieve full remission. In the literature TMS response rates when treating Depression have been shown to be at least as effective as medications used to treat Depression. And of course without all the side effects that medications bring.

Many patients say they can still feel benefit from TMS therapy years after their first round of TMS treatment. The effect appears to be quite durable especially in people who respond well to treatment. In some cases patients will go back for a few TMS maintenance sessions 3-6 months after their initial treatment.

Insurance coverage for Transcranial Magnetic Stimulation (TMS) treatments varies, particularly when considering different mental health conditions like depression, anxiety, and/or obsessive-compulsive disorder (OCD).

For depression, many insurance companies offer coverage for TMS therapy. This is often contingent on patients demonstrating a history of unsuccessful treatments with antidepressants. Usually, this involves trying and failing to respond adequately to at least two to four antidepressant medications from different drug classes. However, specific requirements can vary significantly between insurance providers. Therefore our team will verify with your insurance company to understand the exact coverage details for TMS therapy in the context of depression treatment.

While TMS is FDA-approved for treating OCD, coverage for TMS therapy for OCD is not as widely available as it is for depression. Some insurance companies are starting to recognize the benefits of TMS for these conditions and may provide coverage, but this is less common and often requires specific criteria to be met. These criteria can include failed medication trials. Again,our team will consult with your insurance provider for the most accurate information regarding your coverage.

Yes, however it is not covered by insurance as it is an off-label use of TMS. Click here to learn more.