What should I expect when having TMS?
The patient may feel a tapping sensation under the coil (this occurs due to a twitch produced in the scalp muscles as the magnetic field crosses into the brain). The magnetic field can also stimulate small nerves around the head and face producing a muscle twitch in the forehead, face or eye region. The stimulation can be applied in a variety of ways: the most common two ways are either as a long train of pulses administered approximately one per second or as short bursts of a large number of pulses administered over a few seconds at a time.
If the rTMS is effective in treating depression, this usually takes at least several weeks to start working. Sometimes symptoms will not improve substantially until after a course of treatment is completed: this seems strange but we do see some patients who do not notice much until they have finished treatment: in the weeks afterwards they then notice a gradual improvement in depression. Research has shown that longer courses of TMS produce better responses than shorter ones. Some patients will be well after 4 weeks but some require up to 6 weeks to get a good outcome. Treatment is usually 5 days per week but if this is too hard to manage, doing treatment 4 days, and perhaps 3, per week, is still likely to be helpful.
How Do You Get Access to TMS Treatment?
In Australia, ~ 90% of TMS is currently provided to inpatients in private psychiatric hospitals although it can be safely provided as an outpatient treatment in almost all patients.
Professor Fitzgerald is involved in the provision of inpatient and outpatient TMS at the Epworth Hospital in Camberwell, Victoria. He also determines the TMS treatment protocols for TMS Australia. TMS Australia currently has clinics providing TMS in Melbourne CBD, Sydney CBD, Brisbane (Toowong, Booval), Geelong, Narre Warren, Mornington, Sydenham, Keilor East, The Gold Coast, Wagga Wagga and Murrumbateman.