Transcranial Magnetic Stimulation (TMS)

TMS uses pulsatile magnetic fields to stimulate parts of the brain thought to be underactive in people with certain forms of depression. During treatment, an electromagnetic coil is placed against the side of the patient’s head to target certain portions of the brain.

TMS is a daily treatment that takes approximately 35 minutes per session for about six weeks. Patients receive their treatment in a private room at Yale New Haven Psychiatric Hospital.

During the treatment, patients wear earplugs to protect their hearing. Many patients choose to listen to music during their treatment.

One of the benefits of TMS is there are no medications or anesthesia required and patients can drive themselves to and from their appointments. Patients who currently take antidepressants can also continue to take their medications while undergoing this treatment.

Patients experience a range of sensations but most experience a clicking sensation over the site of stimulation. Over time, tolerability for the treatment improves. This is not a “one size fits all” treatment and there are ways to adjust treatment parameters for each patient’s needs and comfort level.

TMS is a very well tolerated and safe treatment with few side effects. There are no known cognitive side effects. Some patients may experience minor sensitivity at the stimulation site, mild headache or light-headedness. Very rarely, some people will have vasovagal or fainting episodes. There is also a very small risk of seizure, lower than the risk associated with many commonly used medications.

Patients with metallic objects in the head or neck will not be able to undergo treatment because of the magnetic fields used. Patients with a history of seizure or traumatic brain injury will also need to consult their neurologist first to understand their possible risks.

There are several ways to monitor the reduction of depressive symptoms in patients, including regular evaluation with the treating psychiatrist, the use of validated psychometric scales, and collaboration with the patient’s primary psychiatric provider.

TMS can offer relief for patients who have not responded to or who have been unable to tolerate antidepressants. It is also safe in patients who may not be able to take certain medications due to comorbid medical problems.

One important study to note is the STAR*D trial. It looked at the chances of achieving response and remission in depressive symptoms after successive trials of medications. For patients that meet the criteria of treatment resistant depression (TRD), or have failed to respond to at least two antidepressant trials, the likelihood of achieving response or remission with additional medications drops to about 13%.

However, naturalistic studies have shown that similar patients who undergo TMS can achieve response up to 50% of the time.

TMS is not an experimental treatment. FDA cleared in 2008, thousands of people have safely undergone treatment.

“It’s well established in terms of safety and how well it will work,” said Dr. Proops.

Interested in TMS? Talk to your doctor to get a referral.

Patients must currently be under the care of a psychiatrist or psychiatric APRN to receive treatment. However, we welcome all inquiries. Please complete the Request for Information form. Our patient navigator will contact you to explain our referral and intake process.

To learn more about TMS treatment, please complete the Request for information form. Our IPS staff will contact you to explain our TMS referral and intake process. You must currently be under the care of a psychiatrist or psychiatric APRN to receive treatment.