Frequently Asked Questions
What is Transcranial Magnetic Stimulation (TMS)?
Transcranial Magnetic Stimulation is a non-invasive (does not involve surgery), non-medication treatment that stimulates areas of the brain.
How does TMS Therapy work?
During TMS therapy, a magnetic coil is placed over the scalp, which when turned on generates electromagnetic stimulation; much like those generated by MRI machines. The magnetic coil delivers a series of magnetic pulses to the head, causing stimulation in a specific area of the brain.
What is the typical course of TMS Therapy?
TMS therapy requires a course of treatment sessions. The initial course of treatment typically consists of 5 treatments per week over a four to six week period.
How long does an appointment take?
Appointments are scheduled for a half hour. During treatment, you will be awake in a comfortable chair.
How long do I have to rest after a TMS treatment?
TMS is a very simple treatment and doesn’t require any special attention after a session. You can drive home or even return to work right after a session.
Do I need a doctor to refer me to Optimind?
No, a referral is not required as our clinic physicians are fully qualified to evaluate the safety and appropriateness of TMS, and to prescribe a course of treatment.
That said, wherever possible, we will collaborate with your GP and/or specialist and are happy to do so to support the very best care for you. The clinic physicians have specific training and certification to ensure safety and appropriateness of treatment at Optimind, however it is important to note that your own general physician and psychiatrist will continue to oversee your physical and mental health during the course of rTMS treatment and on its completion.
Is TMS Therapy safe?
Transcranial Magnetic Stimulation has been studied by researchers for 20 plus years. TMS Therapy is well tolerated and has been shown to be safe in clinical trials. The most common adverse event associated with TMS therapy is scalp pain and discomfort, generally mild to moderate.
Occasional muscle twitches (during treatment) or headache may occur. Should headache occur it can be treated with over-the-counter ibuprofen.
Some clients experience mild fatigue post-treatment.
The incidence of any of these adverse events declines markedly after the first week of treatment.
The only serious side effect or risk associated with TMS treatment is seizure, which is rare at less than 1%.
Does TMS cure Alzheimer disease?
Alzheimer disease is a complex, progressive disease. While there is ongoing interest and research into the use of TMS related to Alzheimer disease to alleviate symptoms and/or slow the progression, at Optimind we do not offer or suggest TMS as a treatment or cure for this complex disease.
What is the cost of TMS treatment?
The cost of treatment depends on the course of treatment pursued. For details, see our Fee Schedule.
Is TMS covered by provincial health insurance (MSP) in British Columbia?
TMS was approved by Health Canada originally for the treatment of depression in 2002, however cost is a barrier and most provincial and territorial health-care systems do not cover the cost of the therapy. The exceptions are Quebec, Saskatchewan, and Yukon, and the more recent addition of Alberta and Nova Scotia. This is in contrast to the United States, where there are more than 1,300 clinics and TMS is covered by most major insurance plans including every state’s Medicare and Medicaid programs.
In BC, the Ministry of Health Technology Assessment Committee recently (February 2022) made a recommendation for provincial funding of TMS treatment for depression which is very good news, however at this time it remains only a recommendation. (n.b. the same recommendation was made in Ontario in 2016 and it is not yet a funded treatment in that province).
Is TMS covered by extended medical insurance?
It would be necessary to consult with your individual provider.
As a physician-prescribed treatment, this would be eligible under Health Spending Account and/or an eligible medical expense according to CRA for income tax purposes.
Who cannot have TMS Therapy?
Persons with a history of seizures would not be indicated for TMS Therapy.
TMS Therapy is contraindicated in persons who have conductive, ferromagnetic or other magnetic sensitive metals implanted in their head or above the shoulders with the exception of the jaw.
Since TMS therapy utilizes a strong magnet, the most notable risk is to those who have any form of metal implanted in or near their head or neck, whether by accident or by design.
Here are some examples of metal in or around your head that might exclude you from TMS treatments:
- Aneurysm clips
- Any medical implant containing metal
- Cochlear implants
- Metal stents
- Shrapnel or bullet fragments
- Tattoos containing magnetic or magnet-sensitive ink
Patient care dictates that no one fitting these criteria is a good candidate for TMS.
Persons with braces and/or metal fillings or dental implants as well as pacemakers are acceptable for treatment.
The clinic physician at Optimind will review and screen for contraindications that could make the administration of TMS Therapy clinically unsafe prior to prescribing treatment.
I’ve heard of the SAINT Protocol, does Optimind offer accelerated TMS?
We do offer an accelerated treatment option where deemed appropriate and desirable by our medical staff and client.
Medication doesn’t work for me, am I a candidate for TMS?
TMS is a safe, effective, and strongly-recommended treatment for Major Depression according to the highly respected Canadian Network for Mood and Anxiety guidelines (2016) which state:
More than 30 systematic reviews and meta-analyses have been conducted on rTMS in depression, with most studies involving patients with some degree of treatment resistance (i.e., having failed at least 1 or 2 antidepressant trials). Overall, rTMS is considered a first-line treatment for MDD for patients who have failed at least 1 antidepressant treatment.
Importantly, TMS is also an excellent choice if you prefer to try a non-medication treatment first.