Transcranial Magnetic Stimulation - TMS Service - Lakeside Clinic
TMS can now be offered at Lakeside Clinic for suitable patients, as defined by our psychiatrists.
What is Transcranial Magnetic Stimulation?
Transcranial Magnetic Stimulation (TMS) is a therapeutic, medical procedure for the treatment of psychiatric disorders, such as major depression.
TMS involves stimulation of an area of the brain using a pulsing magnet placed on the scalp. The magnet is designed to give a focused beam of magnetic energy inducing small electrical currents with the aim of altering brain function for therapeutic purposes.
TMS works by changing brain electrical activity and the brain chemicals that are involved in controlling mood.
Why is TMS used?
TMS may be an appropriate treatment option for adult patients with Major Depression, who have failed to achieve a satisfactory response from prior antidepressant medications and focused psychological therapy sessions (defined as treatment resistant depression).
The aim of TMS treatment is to lift a patient’s mood. With an improvement in mood there is often an associated improvement in sleep, appetite, energy and concentration and a decrease in negative thoughts. TMS is an acute treatment for depression and a patient will require ongoing treatment from a Psychiatrist to maintain remission.
Who can have TMS?
Like with any other treatment for Depression, not all patients benefit from TMS treatment.
As TMS involves magnetic energy, there are some people who are unable to have TMS. Exclusions to TMS include:
- Cardiac Pacemakers / Defibrillators
- Previous head / brain surgery
- Cochlear Implants
- Brain Aneurysm Clips
- Previous seizures / fits / epilepsy
- Neurostimulator / Biostimulator
- Significant neurological disorder (MS, Cerebral lupus, Brain Tumour, etc)
- Facial tattoos which have metallic or magnetic-sensitive ink, any other metal devices or object implanted in or near the head
NB. Standard dental fillings and braces are not affected by the magnetic field and are acceptable for treatment with TMS.
TMS is a treatment for serious psychiatric conditions. It is important to understand that there may be alternative treatments for a patient’s condition, which may include medications and psychotherapy. Although there is a range of treatments, individuals will recover and respond in different ways and at different rates. Some people do not recover completely and others may take a long time to respond and recover.
Whether TMS or an alternative treatment is most appropriate is based upon a thorough physical and psychiatric evaluation and depends on the patient’s prior experience with these treatments, the nature of their psychiatric condition, their response to medication and other considerations.
How is TMS different to ECT?
TMS is not as effective as electroconvulsive therapy (ECT), and is not a replacement for ECT.
Currently there is no evidence to support the use of TMS and ECT concurrently.
The treatments should be seen as complementary with some patients whose depression does not warrant treatment with ECT being appropriate for TMS treatment.
The two treatments are really very different:
- TMS treatment does not require anaesthesia
- TMS treatment does not require sedation
- TMS therapy does not have a risk of memory or concentration disturbances
- TMS treatment sessions are longer in duration and require more sessions
- ECT intentionally causes a seizure
What about pregnancy?
In view of the paucity of evidence on the safety of TMS in pregnancy, pregnant women should not have TMS outside of a properly conducted and ethically approved clinical trial.
The research to date indicates that TMS is relatively safe when patients are carefully screened for relevant exclusions and treatment is given within recommended safety parameters and evidence based guidelines. With appropriate screening, the overall risks are low. Patients may experience localised pain, neck pain and/or possible headaches, which can be relieved with analgesics. TMS does not lead to any memory difficulties or loss in concentration.
Making a referral
Patients can be referred to Lakeside Clinic for admission via 1300 656 604.
Referrals can also be faxed to 02 4941 3476.