Transcranial Magnetic Stimulation FAQs

What is TMS Therapy?
TMS stands for transcranial magnetic stimulation. It is used to treat depression by stimulating the brain.  It uses an electromagnetic field similar to those produced by an MRI. During Cascade TMS Therapy a magnetic field is administered in very short pulses.  These pulses are directed to the part of the brain that research has demonstrated to be associated with depression. The typical course of TMS therapy treatment is around 19-37 minutes daily over 4 – 6 weeks.
Is Cascade TMS therapy uncomfortable?
No. The most common side effect of TMS therapy was scalp discomfort during treatment sessions. This side effect was generally mild to moderate. Typically it occurred less frequently after the first week of treatment. You can treat this discomfort with an over-the-counter analgesic. If these side effects from the TMS therapy persist, your doctor at Cascade TMS in Portland, OR can temporarily reduce the strength of the magnetic field pulses being administered. This should make treatment more comfortable. As a note, less than 5% of patients treated with TMS Therapy at Cascade TMS in Portland, OR discontinued treatment due to side effects.
How does TMS therapy work?
The Cascade TMS therapy system uses short pulses of magnetic fields to stimulate the area of the brain that is thought to function abnormally in patients with depression. The magnetic field produces an electric current in the brain that stimulates the brain cells called neurons. This results in changes that are thought to be beneficial in the treatment of depression. Read more about how Cascade TMS therapy in Portland, OR works.
Is TMS therapy from Cascade TMS a good alternative for patients who cannot tolerate the side effects associated with antidepressant medications?
TMS therapy is non-systemic. This means it does not circulate in the blood through the body. It does not have side effects such as weight gain, sexual dysfunction, nausea, dry mouth, sedation, etc. that are common with medications. The most common side effects reported are headache and scalp discomfort – generally mild to moderate – occurring less frequently after the first week of treatment.
Can I also take antidepressant(s) if I am receiving TMS therapy from Cascade TMS in Portland, OR?
Yes. In clinical trials, TMS therapy was safely administered with and without other antidepressant medications.
Is TMS therapy from Cascade TMS similar to electroconvulsive therapy (ECT)?
The two procedures are very different. While both methods of therapy are effective in the treatment of depression, there are many differences in safety and tolerability.

During TMS Therapy, patients sit in a chair and are awake and alert throughout the entire 19-37 minute procedure. No sedation is used with Cascade TMS Therapy. Patients can transport themselves to and from treatment as well.

In over 10,000 active treatments with TMS Therapy systems in clinical trials, no seizures were observed. TMS Therapy was also shown to have no negative effects on memory function.

“Shock therapy,” or electroconvulsive therapy (ECT), intentionally causes a seizure. Patients receiving ECT must be sedated with general anesthesia and paralyzed with muscle relaxants. Recovery from an ECT treatment session occurs slowly. Patients are closely monitored for minutes or even a few hours after a ECT treatment.

Short-term confusion and memory loss are common with ECT but not with TMS. Long-term disruptions in memory have been shown to occur with ECT therapy. These may persist indefinitely in some people. Because of the side effects with ECT, a significant amount of caregiver support can be required.

What is a typical course of treatment with Cascade TMS therapy?
A typical course of TMS Therapy at Cascade TMS in Portland, OR is 5 times per week for 19-37 minutes sessions, depending on what the doctor determines is the correct protocol, over 4-6 weeks.

Any additional treatments are based on clinical judgment.

Can Cascade TMS therapy cause brain tumors?
No. TMS Therapy uses the same type and strength of magnetic fields as MRIs (magnetic resonance imaging). These types of magnetic fields have been used in tens of millions of patients around the world and have not been shown to cause tumors. The magnetic energy used in a full course of TMS Therapy is a small fraction of just one brain scan with an MRI.
Is Cascade TMS therapy like other alternative therapies which use magnets to treat some illnesses?
No. Cascade TMS Therapy involves a unique method of using pulsed magnetic fields. The intensity of the magnetic field used in TMS is similar to that of the magnetic fields used in magnetic resonance imaging, or an MRI. These techniques differ vastly from the popular use of low intensity, static magnetic fields. Low intensity, static magnetic fields deliver weak and undirected fields that are not capable of activating brain cells.
Does TMS therapy cause memory loss?
No. The TMS therapy system was systematically evaluated for its effects on memory. Clinical trials demonstrated that TMS therapy does not result in any negative effects on memory or concentration.
What are the potential risks of Cascade TMS therapy in Portland, OR?
TMS Therapy has been shown to be well tolerated. The TMS therapy system has been demonstrated to be safe in clinical trials with many patients. Over 10,000+ active treatments have been performed in clinical trials. The most commonly reported side effect related to TMS therapy treatment was scalp discomfort during treatment sessions. This side effect was generally mild to moderate, and occurred less frequently after the first week of treatment. Less than 5% of patients treated with TMS therapy at Cascade TMS in Portland, OR discontinued treatment due to side effects.

In clinical trials, over 10,000 TMS treatments demonstrated no occurrence of seizures. However, there is a small risk of a seizure occurring during treatment. This risk is no similar and no greater than what has been observed with oral antidepressant medications.

TMS therapy has been demonstrated to be effective but not all patients will benefit from TMS therapy. TMS patients should be carefully monitored for worsening symptoms, signs or symptoms of suicidal behavior, and/or unusual behavior. Families and caregivers should also be aware of the need to observe patients and notify their treatment provider.

How long does the antidepressant effect last? Will I need any therapy beyond the first treatment regimen?
TMS therapy from Cascade TMS in Portland, OR is the only TMS system with the durability of its effects established over 12 months. In a clinical trial of TMS therapy, 2 out of 3 patients who had either responded to treatment or completely remitted their depression symptoms reported 12 months later that they remained at the level they were at the end of the trial. After the trial, only 1 in 3 patients needed to return for additional ‘maintenance’ sessions.
Is Cascade TMS therapy covered by my insurance?
It usually takes time for healthcare insurers to establish coverage policies for newly approved treatments such as TMS therapy. Many commercial and Medicare plans have recognized the effectiveness of treating depression with TMS Therapy and now cover TMS as part of their plans. Please contact us at Cascade TMS at (503) 433-3200 for more information about insurance coverage.
Does FDA-clearance of the TMS therapy system mean that all TMS devices are cleared for use in major depression within the United States?
No, the TMS Therapy system that Cascade TMS uses, called Neurostar, is the first TMS device to be cleared by the U.S. Food and Drug Administration (FDA) for the treatment of major depression.

This TMS Therapy system in use by Cascade TMS in Portland, OR is also the first TMS device to have been evaluated in a large, multicenter, controlled clinical trial, as well as the only TMS system with the durability of its effects over 12 months established.