Pioneer Health TMS

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FAQ

FAQ

Frequently Asked Questions

We understand that you may have some questions about TMS, from its efficacy and safety to its application in various psychiatric disorders and beyond. We address the most common questions and concerns about TMS, but please contact us if your question is not here, or if you’d like more details.
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What is TMS?
Transcranial magnetic stimulation (TMS) is a non-invasive treatment for depression and several other conditions.

It is drug-free, safe, usually long lasting and now we are having no out of pocket costs if treating depression. Its been around for 40 years and has been heavily researched but it has taken time coming to Australia. TMS involves using magnetic fields to stimulate different parts of the brain. When this is done repeatedly it can lead to to growth and strengthening of neural connections (this is also known as neuroplasticity). TMS also increases the natural release of brain hormones responsible for depression such as seritonin.

TMS doesn’t involve any drugs or sedation. Nothing is placed inside the body. TMS avoids the side-effects associated with antidepressants.
Will TMS work for my depression?
TMS has been extensively studied and we have high quality evidence for its efficacy in depression. TMS has approximately 60% efficacy in patients who have failed multiple antidepressants. Of these patients, 71% remain in remission after one year. In patients who are not treatment-resistant but are highly sensitive to medication, the efficacy is approximately 80%.

Reference: Camila Cosmo, Amin Zandvakili, Nicholas J Petrosino, Yosef A Berlow, Noah S Philip. Repetitive Transcranial Magnetic Stimulation: Recent Critical Advances in Patient Care. Current Treatment Options in Psychiatry. 2021 Mar; 8:47-63.
What does TMS cost?
TMS for Depression:
TMS is covered under Medicare for treatment-resistant depression only. That means that patients who have tried at least two types of antidepressants (each from a separate class) will receive their TMS treatment sessions with no out-of-pocket cost. Consultations with Dr David Tadj (TMS lead GP) and Dr Shanek Wick (Psychiatrist) are bulk billed.
PLEASE NOTE: You must have a current Medicare card.
TMS for other conditions:
TMS for conditions other than treatment-resistant depression is not covered under medicare and will incur a private fee. Costs vary from patient to patient and condition to condition. You will be provided with a quote at your initial consultation.
Will TMS work for other conditions?

There is increasing evidence that TMS is effective for a number of other conditions, including: 

•    Obsessive Compulsive Disorder (OCD)
•    Post Traumatic Stress Disorder (PTSD)
•    Bipolar Affective Disorder (depressive phase)
•    Tinnitus
•    Addiction (such as alcohol)
•    Chronic Pain

There is currently research underway into TMS for dementia, stroke, Parkinson’s disease, eating disorders, chronic fatigue syndrome, autism and attention deficit disorder.

How does TMS work?
TMS involves stimulation of nerve cells by using focal magnetic impulses. During a single session, a patient receives thousands of stimulations directed at specific targets in the brain depending on which condition is being treated. When this occurs, brain cells change their activity. This results in safe, non-invasive, long-lasting change.
What are the benefits of TMS?
The main benefits include the following:

  • A course of TMS often results in long-lasting change.
  • TMS is drug free. Patients do not have to deal with medication related side effects.
  • Research suggests TMS has a higher effectiveness than antidepressants in patients with mild-moderate depression who have not responded to 2 or more antidepressants.
    • What are the risks of TMS?

    TMS has few side effects and is often long lasting. Some patients may occasionally experience temporary light headedness or mild scalp tenderness after treatment. These side effects can be usually fixed quite easily with some modifications. Risk of seizure is very low if you have no risk factors (1 seizure in 50,000 treatment sessions if you have no risk factors). This risk of seizure with TMS is lower than almost every single antidepressant.

    Is TMS new?
    TMS was actually invented in the 1985 by Dr Anthony Barker in Sheffield. It was FDA approved in 2007 for Depression. In subsequent years it was used to treat anxiety disorders (PTSD, OCD) and chronic pain.

    TMS has been present in Australia for around 15 years. However, the big change in recent times is that Medicare began to subsidise TMS for the first time in November 2021.
    Is TMS the same as ECT?

    No, it’s not. ECT (Electroconvulsive therapy) and TMS (Transcranial Magnetic Stimulation) are not the same. While both come under the overall category of “Neurostimulation,” they are actually quite different.

    ECT uses an electric current to specifically cause a seizure. When a person experiences a seizure it is thought that there is a large dump of neurotransmitters (seritonin, noradrenhaline and dopamine) resulting in the “hitting of a reset button.”

    TMS on the otherhand uses a focal magnetic field to penetrate the skull and stimulate the nerves of the brain. This stimulates both growth and healing. Unlike ECT, we do NOT want to cause a seizure.

    ECT is usually done as an inpatient in hospital. It requires sedation that this overseen by an anaesthetist. ECT if often saved by patient with severe catatonic depression or psychosis. TMS, unlike ECT is not associated with cognitive side effects such as memory loss.

    Can I drive after TMS?
    Yes, you can drive, work, study or do anything that you would do normally. There are no limitations or restrictions on what you can do. There is also no need for any fasting before treatment.
    Should I come off my medication prior to TMS?

     No. Rather, we recommend not making any changes to your mediction prior to commencing TMS. This allows us to more clearly ascertain the cause of any of your improvements. Often patients who respond well to TMS do end up coming off their medication.

    Please note: this is general advice and your TMS psychiatrist may provide different advice depending on your personal circumstances.

    TMS has worked for me, should I stop my antidepressants?

    Not just yet. Your TMS psychiatrist will discuss this issue during your final TMS session. If you have had notable clinical improvement, your TMS psychiatrist will provide your GP a plan for how you can start weaning yourself off the antidepressant. This process should be done cautiously, conservatively an in consultation with your GP.