Who Qualifies For TMS Therapy?

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By Dr. David Woo - December 12, 2022

Transcranial magnetic stimulation (TMS) therapy is gaining popularity as a treatment for a variety of medical and mental health conditions.

During this non-invasive outpatient procedure, patients wear a helmet containing an electromagnetic coil. This coil sends magnetic pulses gently through the scalp to the part of the brain that regulates mood, stimulating neurons that are thought to be underactive in someone with depression. The activated neurons release chemicals called neurotransmitters, improving communication between different regions of the brain. By targeting specific brain regions and structures known to cause mood disorders, TMS can correct imbalances and reduce symptoms.

TMS is currently approved by the U.S. Federal Drug Administration for treatment of major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and anxious depression. However, studies have found it successful in treating numerous other conditions, including:

Anxiety
Post-traumatic stress disorder (PTSD)
Parkinson’s disease
Attention-deficit hyperactivity disorder (ADHD)
Substance abuse disorders
Alcohol addiction
Tobacco/nicotine addiction

Studies show TMS to be safe, well-tolerated, and highly effective, even for patients considered to be treatment-resistant; that is, not seeing positive results from prescription medication. In studies on TMS and depression, 58% of treatment-resistant patients saw improvement in their symptoms and 37% no longer met the diagnostic criteria for MDD.(2,3) Follow-ups revealed that 60% of TMS-responsive patients experienced long-term positive changes lasting a year or more.(4)

TMS also has a very short list of possible risks, especially compared to prescription drugs. SSRIs for depression are numerous, long-term and often severe. 38% of patients using SSRIs report side effects including sexual dysfunction, changes in appetite and weight, and sleep disturbances.(5)

Headaches are the most commonly reported of TMS side effects, most of which are mild, short-lived and easily treatable with over-the-counter painkillers.(6)

More and more patients around the world are seeking the benefits of TMS therapy as an alternative to, or in combination with, traditional therapies and medications.

What is the Criteria for TMS Therapy?

To qualify for coverage, patients must have been diagnosed with MDD and already tried psychotherapy and at least four antidepressants from two different drug classes (SSRIs, SNRIs, MAOIs, or atypical agents) without seeing results.

The presence of any of the following may disqualify you from TMS coverage.

Implanted medical devices such as heart stents, pacemakers, or aneurysm clips
Cochlear hearing implants
Bullet fragments or other non-removable metals inside the body near the head
History of seizure or epilepsy
Brain illness, traumatic brain injury, brain tumor, or stroke(7)

Insurance

We accept all major insurance plans that cover TMS therapy. Read here to learn more about insurance coverage for TMS and for instructions on how to find out if your plan covers TMS therapy.

Contact Us Today

To learn more about TMS, schedule an appointment with us today. Contact us online or call us at 212.731.2033.

Resources:

1. Anagha K, Shihabudheen P, Uvais NA. Side Effect Profiles of Selective Serotonin Reuptake Inhibitors: A Cross-Sectional Study in a Naturalistic Setting. Prim Care Companion CNS Disord. 2021;23(4):20m02747. Link. Accessed November 4, 2022.

2. O’Reardon JP, Solvason HB, Janicak PG, et al. Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial. Biol Psychiatry. 2007;62(11):1208-1216. Link. Accessed November 4, 2022.

3. Locher C, Koechlin H, Zion SR, et al. Efficacy and Safety of Selective Serotonin Reuptake Inhibitors, Serotonin-Norepinephrine Reuptake Inhibitors, and Placebo for Common Psychiatric Disorders Among Children and Adolescents: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2017;74(10):1011-1020. Link. Accessed November 4, 2022.

4. Dunner DL, Aaronson ST, Sackeim HA, et al. A multisite, naturalistic, observational study of transcranial magnetic stimulation for patients with pharmacoresistant major depressive disorder: durability of benefit over a 1-year follow-up period. J Clin Psychiatry. 2014;75(12):1394-1401. Link. Accessed October 5, 2022. Accessed November 4, 2022.

5. Cascade E, Kalali AH, Kennedy SH. Real-World Data on SSRI Antidepressant Side Effects. Psychiatry (Edgmont). 2009;6(2):16-18. Link. Accessed November 4, 2022.

6. Transcranial Magnetic Stimulation. The Mayo Clinic. Published November 27, 2018. Link. Accessed November 4, 2022.

7. What is TMS Treatment for Depression? U.S. News and World Report. Published February 7, 2022. Link. Accessed November 16, 2022.

Dr. David Woo

Dr. David Woo is the owner and head clinical psychiatrist at Madison Avenue TMS and Therapy in New York City. Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.

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