FAQ

Scroll down to view the answers to the most Frequently Asked Questions:
  • What is the history of TMS Therapy?
  • What is TMS Therapy?
  • What is involved in a TMS treatment?
  • How does a TMS treatment feel?
  • How does a patient determine if TMS is right for them?
  • Can a patient miss a treatment during the week?
  • What should a patient expect when receiving TMS?
  • How soon would benefits of TMS treatments be seen?
  • Who should not have TMS treatments?
  • Does TMS hurt?
  • Will treatment be covered by insurance?
  • Is TMS Therapy a possible treatment for other conditions?
  • How do I get started?

What is the history of TMS Therapy?
  • First used in 1985, TMS has been used by researchers around the world to help understand the function of different parts of the brain. As of 2018, over 17,000 papers have been published regarding the use of TMS in stimulating select regions of the brain.
  • Since the mid-1990s, TMS has been studied as antidepressant therapy.
  • In 2006, the largest randomized, placebo-controlled study ever conducted with TMS Therapy was completed. This study was sponsored by Neuronetics/NeuroStar.
  • In 2008, the NeuroStar TMS Therapy system was cleared for use by the FDA for the treatment of adult patients with major depressive disorder who have failed to receive satisfactory improvement from at least one prior medication antidepressant treatment.
  • Brainsway Deep TMS received FDA clearance to treat major depression for those who have not improved from prior antidepressant medication treatment in 2013. 
  • In March 2014, the FDA gave clearance for the NeuroStar TMS Therapy System to broaden its indication to the treatment of Major Depressive Disorder in adult patients who have failed to receive satisfactory improvement from prior antidepressant medication in the current episode.  
  • Since this time, now five other devices have been FDA cleared for use in the US:  MagStim, MagVenture, CloudTMS, NextStim, and Mag and More.  
  • In the fall of 2018, Brainsway received FDA clearance to treat OCD with TMS and MagVenture received Theta Burst protocol approval.  Multiple other devices now feature this same protocol.  

What is TMS Therapy?
  • TMS Therapy is a non-systemic and non-invasive form of neuromodulation, which stimulates nerve cells in an area of the brain that is linked to depression, by delivering highly focused MRI-strength magnetic pulses.  Non-systemic means that the treatment does not circulate in the bloodstream of the body like medication therapy.  Non-invasive means that the treatment does not involve surgery; nothing is put in the body.  
  • Patients being treated by TMS Therapy do not require anesthesia or sedation and remain awake and alert throughout the treatment.
  • TMS treatment for depression is an outpatient procedure that is prescribed by a psychiatrist and performed in a psychiatrist’s office. Generally, the treatment lasts less than one hour.
  • The treatment is typically administered Monday through Friday, over a period of 4-6 weeks; some patients may need additional treatments beyond the typical protocol to reach remission.  In our office, patients average a total of 36 TMS treatments.  

What is involved in a TMS treatment?
  • A TMS treatment session is conducted using a device which generates pulsating magnetic fields.  This magnetic field is the same type and strength as those produced by some MRI machines.
  • The pulsed magnetic field is delivered to the head of the patient.  Specifically, a region of the brain is targeted that is believed to be responsible for depression and its symptoms.  This region is called the dorsolateral prefrontal cortex.  

What does a TMS treatment feel like?
  • During a TMS treatment, the patient will feel a sensation on the scalp.  Nothing is truly touching the patient's head, but the magnetic pulses make the scalp muscles contract which gives the sensation. Some patients describe the sensation as a "tapping" or "knocking" sensation.  

How does a patient determine if TMS is right for them?
  • A consultation appointment with a psychiatrist is required prior to being scheduled for TMS treatments in our office.
  • Interested patients should schedule a consultation by calling 615-348-8200.  You may schedule a tour in our office prior to the consultation if you would like to meet the staff and see the device.  
  • Once approved by a psychiatrist for TMS treatment, the patient will be scheduled.  

Can a patient miss a treatment during the week?
  • While it is very important to maintain a consistent pattern of receiving treatments Monday thru Friday, exceptions can be made, if needed. Discussions of specifics can be addressed during or following a consultation.  
  • If a patient has to miss more than a day or two during the entire course, the Doctor may recommend makeup sessions on the weekend if/as needed.
  • If travel is a necessary part of the patient's job, then we will make it work by maximizing the schedule in our office and partnering with TMS facilities across the country. 

What should a patient expect when receiving TMS?
  • Treatment does not involve any anesthesia or sedation and patients remain awake and alert during the treatment. Patients are able to drive and/or return to work and complete other daily activities immediately after treatment.
  • Patients typically engage with the technician, particularly in our office we utilize the workbook, TRAIN YOUR BRAIN:  Your record of Care with TMS,www.TMSworkbook.com.  This is based upon a workbook that Dr.Cochran and our TMS Coordinator, Lauren Valencia, LCSW wrote together.   

How soon would benefits of TMS treatments be seen?
  • Most patients have experienced results by the third or fourth week of treatment, however, everyone is different and some patients may notice benefits more quickly.  Unfortunately, other patients may take longer.  During the consultation, the doctor will review our office results and what most of our patient's experiences have been.  

Who should not have TMS treatments?
  • TMS therapy should not be used by anyone who has ferromagnetic metal in their head.  In the consultation, the doctor will review this contraindication with you.

Does TMS hurt?
  • The most common side effect related to TMS treatment is scalp discomfort in the treatment area.  Some patients report little or no discomfort, others report discomfort which generally dissipates after the first few treatments.

Is TMS covered by insurance?
  • Yes!  Many insurance companies cover TMS, including many branches of Blue Cross Blue Shield, Anthem, Cigna, United Behavioral Health and others.  Dr. Cochran and many clinicians who are part of the Clinical TMS Society have spent years working with insurance companies to improve their policies. After your full evaluation with the Doctor (which is covered by insurance), we will do a full benefits investigation for you to tell you if your insurance covers the treatment.  We then get a prior authorization and develop a proposal so you know what you are going to pay.  
  • In the instances when TMS was not covered by insurance, we have been very successful in helping our patients get reimbursed after the treatments on appeal. We also have patient assistance programs that can make the treatments very affordable if that is desired.

Is TMS Therapy a possible treatment for other conditions?

  • TMS therapy is cleared by the FDA for the treatment of depression and as of fall 2018, Obsessive Compulsive Disorder (OCD).  As OCD is a newer indication, insurance is not yet covering this indication.  
  • Any FDA cleared treatment available to a physician may be used OFF-label with careful consideration and written patient consent on a case-by-case basis. During the consultation, the doctor will determine if you are a good candidate for TMS and review all options for your specific treatment. 

How do I get started?
  • Contact us for a Free Initial Consultation or Free Call with our TMS Administrator at 615-348-8200. You may also email tms@healnashville.com if you prefer.