Navigating Your TMS Experience at CSIP: Step-by-Step

Transcranial Magnetic Stimulation (TMS) therapy is an FDA-cleared, non-invasive treatment used to address depression, depression-related anxiety, and obsessive-compulsive disorder (OCD) when other treatments have been ineffective. At Collaborative Solutions in Psychiatry, we understand that many patients want a clear understanding of how the NeuroStar TMS procedure works before pursuing treatment.

NeuroStar TMS therapy is typically administered five times per week over the course of seven to eight weeks. Each appointment lasts around 30 minutes. There are 36 total treatments in a course when treating depression or anxious depression symptoms, and 29 total treatments in a course to treat OCD.

When you choose NeuroStar TMS therapy at Collaborative Solutions in Psychiatry (CSIP), your treatment will go through three important phases: Intake, Active Treatment, and Post-Treatment. Below is a step-by-step explanation of each phase, including what to expect as you move through your TMS journey.

Intake Phase

The Intake Phase ensures that TMS therapy is safe and appropriate for your needs. During this phase, several important steps will take place:

  • Screening by TMS Staff: Our trained TMS team will assess your medical history to review that TMS therapy could be safe for you and rule out any major red flags that might make TMS unsuitable.
  • Free Consultation: You’ll have the opportunity to meet with our TMS staff, learn more about TMS therapy at CSIP, and take a tour of our facility. This is a great time to ask questions and understand what treatment entails.
  • Confirm Patient Information & Financial Plan: During this step, we’ll gather and confirm any additional patient information needed. We’ll also discuss arrangements for your financial plan—whether through insurance coverage (if criteria are met) or using private pay options. Please note, even if your insurance is in network with our clinic, some insurance plans will still require a prior authorization to be approved before you begin treatment. Our team will assist in this process and work with your insurance company on your behalf during this process. Some insurance plans may require 15 days or more to approve or deny this request.
  • Pre-Procedure Evaluation with a Medical Provider: Before beginning treatment, you will meet with a medical provider to review your medical and mental health history. During this visit, the provider will determine if there are any treatment considerations needed to ensure the best possible outcomes.

Once one of our medical provider confirms that TMS is a suitable option for you and your insurance coverage or financial plan is arranged, you’ll move on to the next step.

  • Scheduling Your Mapping Procedure & First Treatment: After approval, you’ll schedule your mapping procedure, and set a daily treatment time for your series of TMS sessions.

Active Treatment Phase

The Active Treatment Phase begins at your mapping procedure, and continues through your subsequent, daily TMS treatments. *Please note that all TMS treatments take place in our office, as the procedure requires in-person care. We’ll work with you to find appointment times that fit your schedule and make the experience as convenient as possible.

  • Mapping Procedure & First Treatment: On the day of mapping, one of our physicians will determine the correct location for treatment based on your individual brain structure. This ensures the magnetic pulses are targeted exactly where they’re needed. Based on your pre-procedure evaluation and clinical assessment during the mapping session, your physician will collaborate with their care team to develop a personalized TMS prescription and treatment plan tailored to your specific needs and goals. In addition to TMS, they may suggest supportive strategies such as regular exercise, healthy sleep routines, balanced nutrition, and mindfulness practices. This holistic approach is designed to enhance your overall well-being and help you achieve the best possible outcome from your treatment. After the mapping procedure, during the same appointment, you’ll receive your first TMS treatment.
  • Daily Treatment: The next weekday following your first treatment, you’ll return to begin the series of subsequent daily sessions over several weeks (typically five days a week for about seven weeks). Each session is scheduled in a 30 minute appointment, and the treatment will last around 20 minutes. You’ll remain fully awake and alert during the treatment.
  • Your sessions will be administered by one of our trained TMS Technicians under the direction of our physicians. You’ll remain fully awake and alert throughout the process, and your technician will be with you the entire time to ensure you’re comfortable and that the treatment is well-tolerated.We understand that everyone experiences treatment differently, and we want you to feel at ease in our space. During your session, you’re welcome to watch TV, listen to music, read, or enjoy an audiobook or podcast. You’re also welcome to chat with your technician—or, if you’d prefer a quiet experience, you can let us know, and your technician will respectfully limit conversation.

    To help you feel as relaxed as possible, we offer comforts like blankets, fans, and even fidget toys for those who may feel anxious. Our goal is to make each visit as supportive and calming as possible while helping you stay on track with your care.

  • Check-Ins with Medical Providers: During the Active Treatment Phase, you will have regular office visits with our providers to monitor your progress. These check-ins are essential to assess how well the treatment is working, address any concerns, and make any necessary adjustments to your treatment plan.
  • Weekly Rating Scales: Throughout the Active Treatment Phase, you will be required to complete weekly rating scales to help track your progress. These assessments can be sent to you by email or completed in person during your office visits. Regular completion of these scales is crucial for evaluating the effectiveness of your treatment and is required by insurance.

Post-Treatment Phase

Once your treatment course of TMS is complete, you will enter the Post-Treatment Phase, where the focus shifts to evaluating the results and planning your next steps in your mental health journey.

  • Follow-Up with Physician: After completing your TMS course, you will meet with your physician to review the outcomes of the treatment. During this visit, you’ll discuss next steps and receive recommendations for ongoing mental health care.
  • Future TMS Courses: While TMS therapy can provide significant relief, it is not a cure. In some cases, our physician may discuss whether additional TMS courses are needed in the future and when they should be considered, based on your progress and ongoing mental health needs.

What Happens During a NeuroStar TMS Treatment Session?

NeuroStar TMS therapy is typically administered five times per week over the course of seven to eight weeks. Each appointment lasts around 30 minutes. Here’s what to expect during a typical treatment session:

  1. Preparation: You’ll sit in a reclined, comfortable chair, much like one you’d find at a dentist’s Before starting, you will be asked to remove any magnetic-sensitive items like jewelry or electronic devices.
  2. Positioning: A padded magnetic coil is positioned against your head, focusing on the areas of the brain responsible for mood regulation. Once the coil is in place, the treatment session will begin.
  3. During the Session: As the magnetic pulses are delivered, you might hear a clicking sound or feel a light tapping sensation on your scalp. Many patients describe this as mildly uncomfortable but not painful. You will be encouraged to use earplugs that are offered each appointment to reduce the noise and protect your hearing. Throughout the session, your TMS technician will ensure you’re comfortable and monitor the process to ensure everything is functioning as it should.
  4. After the Session: Once the treatment is completed, the coil is removed, and you can immediately resume your regular daily activities, including driving or working. No anesthesia or sedation is required during the treatment, so there is no downtime or recovery period.

Recovery After NeuroStar TMS Therapy

The beauty of NeuroStar TMS therapy is that it is a non-invasive procedure, meaning there is no extended recovery time. After each session, you can immediately go back to your usual activities without any interruption. Unlike medications that may cause systemic side effects, TMS treatment only targets specific areas of the brain and avoids common medication-related complications.

Most patients begin to notice symptom improvement after one to three weeks of treatment, but the response varies. Some experience rapid improvements, while others may notice gradual changes. Based on your progress, additional sessions may be recommended to maximize the treatment’s long-term effectiveness.

Schedule a Consultation to Understand What is Involved in the TMS Procedure

At Collaborative Solutions in Psychiatry, we believe it’s crucial for patients to fully understand the TMS procedure before beginning treatment. If medication hasn’t provided the relief you’re seeking, NeuroStar TMS therapy may be a highly effective alternative with minimal side effects.

Call us today to schedule your consultation and take the first step toward better mental health. Our team will be happy to answer any questions and help you determine if TMS therapy is the right option for you.

References

  1. George MS, et al. Mechanisms and efficacy of TMS in treating depression: A comprehensive review. Am J Psychiatry. 2022;179(5):423-431.
  2. Fitzgerald PB, et al. Clinical outcomes of transcranial magnetic stimulation in depression. J Clin Psychopharmacol. 2023;43(3):217-225.
  3. O’Reardon JP, et al. Safety and tolerability of TMS therapy in treatment-resistant depression: A meta-analysis. Biol Psychiatry. 2021;89(10):950-960.