The TMS treatment process
A psychiatrist typically performs TMS therapy while the patient remains seated in a chair. Patients are awake throughout their treatments, and they do not feel pain as magnetic coils are placed on their heads. All patients feel are light tapping sensations on their heads caused by the magnetic pulses entering their brains.
During a patient's first appointment, the psychiatrist places an electromagnetic coil on their head and establishes what is known as their motor threshold. This is done by increasing the intensity of the magnetic pulses until it makes the patient's fingers twitch. The magnetic coil used is typically as powerful as those used for magnetic resonance imaging (MRI). Patients are instructed to remove any magnet-sensitive devices on them, like jewelry or credit cards.
The first appointment takes longer than follow-up treatments since the psychiatrist needs to determine the patient's motor threshold. Once a patient's motor threshold has been determined, magnetic pulses of the same intensity are sent into the patient's prefrontal cortex. Targeting the area with these pulses stimulates the production of serotonin – a neurotransmitter linked to mood regulation. The psychiatrist might check for the patient's motor threshold after the first session if there are signs it has changed over the duration of their treatments.
Patients are often given earplugs during their treatment since the magnetic coil used to send pulses into the patient's brain makes a loud, clicking sound like an MRI machine does.
The TMS treatment process does not cause any pain, so there is no need for general anesthetics or sedatives during treatment. A typical session takes about 20 to 50 minutes. There is no recovery period after getting this treatment, so patients can often drive themselves back home and resume their normal activities immediately. Patients can ask the psychiatrist to stop a treatment session at any time if they feel uncomfortable.
A new form of TMS therapy called deep transcranial stimulation has also emerged. It involves stimulating a larger area of the patient's brain using magnetic pulses that penetrate deeper using specialized H coils that create magnetic waves that penetrate up to two inches below the skull.
The deep TMD treatment process opts for cushioned helmets that generate magnetic waves. It is an outpatient procedure, as is the case with conventional transcranial magnetic stimulation.
Psychiatrists typically perform a physical and psychiatric evaluation before starting TMS treatments to determine if patients have pre-existing conditions or other health problems that could inhibit their treatments. For example, TMS treatments are typically not recommended for women who are pregnant or plan to be. Some medications can also inhibit the effectiveness of the TMS treatment process.