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Repetitive Transcranial Magnetic Stimulation (rTMS)

TMS for Depression

A significant number (30%) of patients fail to respond to antidepressants for depression. Some patients who have been treated with multiple antidepressants are still severely depressed. In such cases, "treatment-resistant" patients often receive Electroconvulsive Therapy, or ECT. While ECT can be highly effective, some patients suffer unwanted side effects, including memory loss or headaches.

Image of a Doctor and a Patient

After 10 years of testing, the FDA approved a novel technique for treating treatment-resistant patients in October 2008. Repetitive Transcranial Magnetic Stimulation, or rTMS, is a non-invasive procedure done in a doctor's office. The results are similar to those of ECT, but rTMS has several advantages. First, the patient is not under anesthesia and can actually relax, read, or listen to music during the 20-minute procedure. A small curved device, about the size of a cupped hand, rests lightly on the patient's head, delivering focused magnetic stimulation directly to the area of the brain thought to be involved with regulating mood. The magnetic field pulses are the same strength as those used in magnetic resonance imaging (MRI) machines. Patients treated with rTMS have fewer side effects than those treated with ECT. The most common is scalp irritation from the pulses, which are similar to being tapped repeatedly.

Typically patients receive six weeks of daily treatment, and some patients receive regular intermittent treatments thereafter to alleviate low mood.

In open-label clinical trials, one in two patients suffering with treatment-resistant depression improved significantly, and one in three patients were completely free of depression symptoms after six weeks of treatment. rTMS therapy is proven safe and effective for the treatment of major depressive disorder in adult patients who have failed to achieve satisfactory improvement from one prior antidepressant medication at or above the minimal dose and duration in the current episode.

TMS for OCD

Obsessive-compulsive disorder (OCD) is a chronic, often disabling disorder defined by unwanted and distressing thoughts and repetitive behaviors that the person feels driven to do. About 40% of people with OCD do not respond to medications or OCD therapy and few people find their symptoms resolve. TMS was FDA approved in 2018 for the treatment of obsessive compulsive disorder (OCD) and it is thought TMS modifies the brain networks involving OCD. TMS for OCD involves 29 treatments done once daily for 5 days a week. Each session involves the patient be provoked by the things they have obsessions or compulsions for about 5 minutes before the TMS starts. By activating the neurocircuitry of OCD and then stimulating those regions with TMS can reduce OCD symptoms in people with treatment resistance to medications and OCD therapy. The FDA noted 38% of patients receiving dTMS had at least a 30% reduction in OCD symptoms, compared with 11% of patients who received sham TMS. Post marketing analysis of 219 patients from 22 community sites demonstrated a response rate of 57.9% after 29 sessions, with improving response rates and response magnitudes with longer treatment durations, 50% at 31 days and 78% after 60 days. Studies suggest that the mechanism of action of TMS for OCD is different from medications and OCD therapy, and non-response to either is not a predictor of response to TMS. We are the first service in South Carolina to have TMS treatment for OCD.

TMS for Smoking

Smoking is one of the leading causes of death in developed countries. The addiction to nicotine, similar to the addiction to drugs and alcohol, involves modulation of the brain reward system and causes uncontrollable desire to smoke. Approximately 38 million U.S. adults smoke cigarettes, and 480,000 die from smoking each year. Cigarette smoking has been found to harm nearly every organ system in the body and is the leading cause of preventable death in the U.S. and of disease burden worldwide (Brian L et al., JAMA Intern Med 2014). Many people can't quit alone and fail to respond to nicotine replacement therapies.

TMS was FDA approved for smoking cessation in 2020. The TMS reduces craving by stimulation brain regions associated with craving. In a prospective, double blind, randomized, sham controlled, multi-center trial which enrolled 262 people randomized into two groups: an active treatment group treated with Brainsway's H4 Deep TMS coil, and a sham (placebo) control group. The treatments were performed daily, five days a week for 3 weeks, followed by an additional 3 sessions once a week for 3 weeks (for a total of 18 sessions over the course of 6 weeks). Of people completing the treatment, 28% quit smoking for greater than 4 weeks compared to 11% of people that received placebo. Of people that didn't quit, those that received TMS smoked less per day than those who received placebo.

We are the first service in South to have TMS treatment for smoking cessation.

Our Locations

  • Brain Stimulation IOP

    Institute of Psychiatry
    67 President Street
    Charleston, SC 29425
    miles
    Categories: Brain Stimulation Treatments
    Institute of Psychiatry
    67 President Street
    Charleston, SC 29425
    miles
    Categories: Brain Stimulation Treatments
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  • Psychiatry East Cooper

    East Cooper Medical Arts Center
    1280 Hospital Drive
    Mount Pleasant, SC 29464
    miles
    Categories: Brain Stimulation Treatments
    East Cooper Medical Arts Center
    1280 Hospital Drive
    Mount Pleasant, SC 29464
    miles
    Categories: Brain Stimulation Treatments
    View Details
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