FREQUENTLY ASKED QUESTIONS
HOW WELL DOES RTMS WORK?
rTMS doesn't help everyone. Research and clinical experience suggest that, for depression, about a third of those receiving the treatment do not experience any improvement. Another third show a substantial response, but still have some symptoms, and the final third experience a complete remission (disappearance) of their depression. Ongoing research is focused on enhancing response rates and predicting who is most likely to respond.
HOW LONG DO RTMS EFFECTS LAST?
Some patients require no further treatments after receiving a course of rTMS. In other cases, though, symptoms start to return after about six to nine months and additional sessions are required to maintain treatment benefits over the long term. Research suggests that some 30 to 40 percent of those who have had a course of rTMS have symptoms reemerge within a year.
WHAT ARE THE SIDE EFFECTS OF RTMS?
The most common side effects of rTMS are local headache or muscle pain in the scalp or forehead for a few hours after a session. During the treatment there can be some discomfort due to stimulation of scalp and jaw muscles by the magnetic field. In some cases people experience mild fatigue after treatment. In very rare instances the treatment can induce a seizure. rTMS does not have any known lasting negative effects, and does not impact cognitive functions such as memory or concentration.
WHO CAN RECEIVE RTMS?
Anyone with symptoms of depression, anxiety, OCD, or PTSD symptoms that have not resolved with conventional treatments is in principle a candidate for rTMS. There are a few rule-outs, including having metal embedded in or near the head or having an implanted stimulator, pacemaker, or similar device. We currently do not accept patients with a history of seizure. Our psychiatrist will evaluate you and come to a determination about whether rTMS is an appropriate treatment for you.
CAN I RECEIVE TMS TREATMENT WHILE ON MEDICATIONS?
In most cases, you will continue taking your medications as prescribed by your doctor. A few medications are not compatible with rTMS treatment because they interfere with its effects or increase the likelihood of an adverse event. These medications would need to be reduced or discontinued for the duration of the treatment.
WHAT DOES A COURSE OF RTMS TREATMENT LOOK LIKE?
Once we have received a referral, our psychiatrist will assess you to determine whether rTMS is a suitable treatment. If we accept you for treatment, we do some preliminary data collecting, including measuring your brain's excitability, recording a sample of your EEG, and having you complete some online symptom questionnaires and cognitive tests. Treatment is done every weekday for 15 to 30 sessions, usually one session a day. Around the 15- to 20-session mark our psychiatrist will assess your progress, and if there has been a partial response we will provide more sessions aimed at reducing your symptoms further.
WHAT DOES A TMS TREATMENT SESSION LOOK LIKE?
A typical session involves the patient filling out a few symptom questionnaires, then sitting comfortably in a chair while a technician positions the electromagnetic coil in a chosen spot over his or her scalp. A series of rapid magnetic pulses is then delivered for between 3 and 30 minutes while the patient is awake and alert.
HOW DO I GO ABOUT GETTING A REFERRAL?
Our rTMS services require a referral from a primary care provider. If you would like a referral, contact us and we will send a referral form to your family doctor or nurse practitioner.
HOW MUCH DOES RTMS TREATMENT COST?
rTMS is not currently covered by OHIP. Some private insurers will cover the treatment on a case-by-case basis. Otherwise, you will need to cover the cost of your own treatment. Depending on the number of sessions required to get a good clinical result, the cost is between $2,250 and $4,500.