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Transcranial Magnetic Stimulation (TMS)

One of the Interventional Psychiatric Services (IPS) offered at Yale New Haven Psychiatric Hospital (YNHPH) is Transcranial Magnetic Stimulation or TMS.  YNHPH is the first hospital in Connecticut to offer treatment using standard TMS and Intermittent Theta Burst Stimulation (iTBS).

Conditions treated with TMS:

TMS is an FDA-cleared outpatient treatment for certain patients diagnosed with certain conditions, including:

  • Major Depressive Disorder (MDD)
  • Obsessive Compulsive Disorder (OCD)

Advantages of TMS treatment include:

  • Safe and effective response or remission of symptoms.
  • Noninvasive, outpatient procedure that does not require any anesthesia or sedation.
  • Treatment for MDD in as little as 3-minute daily sessions with iTBS.
  • Treatment for OCD in as little as 18-minute daily sessions.
  • Free from common antidepressant drug side effects such as weight gain, sedation or sexual dysfunction.
  • Has no cognitive side effects.
  • May be safely used with or without antidepressant medications.
  • Patients are able to drive themselves to and from appointments.

Frequently Asked Questions about TMS

How does TMS work?

Magnetic pulses are delivered from a coil placed on the head to stimulate nerve cells in the part of the brain thought to be dysregulated in mood disorders or OCD. Repeated stimulation of this area of the brain can have antidepressant effects or provide relief from OCD symptoms.

What is Intermittent Theta Burst Stimulation (iTBS)?

YNHPH is the first hospital in Connecticut to offer iTBS treatment with the MagVenture TMS therapy system. The Theta Burst Stimulation Protocol uses short, rapid bursts of magnetic stimulation at high frequencies on the part of a brain thought to be involved in mood disorders. Treatment using iTBS is more efficient than standard repetitive TMS protocols with equal efficacy.

What does a patient experience during TMS treatment?

TMS is a noninvasive, outpatient procedure that does not require any anesthesia or sedation. During each treatment session, patients are fully awake and alert, relaxing comfortably in a reclining chair in a private room. Patients can choose to listen to music, watch videos, or relax with earplugs. Earplugs or earbuds are required to minimize the clicking sound of the equipment and prevent hearing loss. Patients will feel a series of taps on their head under the TMS coil. If mild discomfort occurs, adjustments can be made by the treating technician.

Since there are no sedatives or anesthesia involved, patients can drive themselves to and from their appointments. Patients can also continue to take antidepressant medications while undergoing this treatment. Any changes in medications during the treatment course should be discussed with the TMS physician.

How does treatment with standard TMS device compare with the MagVenture TMS system?

Standard TMS takes approximately 39 minutes per session. Daily MagVenture TMS therapy sessions last as little as 3 minutes for MDD, and about 18 minutes for OCD. If a patient has not responded to at least one anti-depressant medication, either TMS protocol can be used.  Both therapies have demonstrated clinical safety and efficacy for patients to achieve response or remission of their symptoms.

How is TMS different from Electroconvulsive Therapy (ECT)?

ECT is a treatment for certain patients diagnosed with severe depression and certain other mental disorders, including bipolar disorder, chronic psychotic disoders or catatonia. ECT is a procedure which involves the delivery of an electrical stimulus that induces a short, controlled seizure while the patient is under general anesthesia.

TMS uses magnetic pulses, does not require anesthesia, and has no associated cognitive side effects.

Are there side effects?

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 during the procedure. 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 psychiatric medications.

Are there any contraindications?

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 may need to consult their neurologist first to understand their possible risks. If pregnant, or planning on becoming pregnant, risks and benefits will need to be reviewed with the treating OB-GYN.

How is the success of this treatment monitored?

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 and family members.

What are the benefits of TMS?

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 conditions.

How do I know TMS is safe?

TMS is not an experimental treatment. FDA cleared to treat depression in 2008, and in 2017 for OCD, thousands of people have safely undergone treatment. TMS has been recommended by the American Psychiatric Association since 2010.

How does someone get TMS at Yale New Haven Hospital?

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

Is TMS the right treatment plan for me?

To learn more about TMS treatment, please complete the Request for Information from. 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.