How to Prepare for Your First TMS Session

Understanding Transcranial Magnetic Stimulation (TMS) Therapy

By Charles Miller, CRNA, CMO, Founder of Scenic City Neurotherapy

 

Transcranial Magnetic Stimulation (TMS) is a cutting-edge, non-invasive treatment designed to help individuals struggling with treatment-resistant depression, anxiety, and OCD. Unlike traditional treatments such as medication or therapy alone, TMS stimulates specific brain areas responsible for mood regulation using targeted magnetic pulses. At Scenic City Neurotherapy (SCN), we use advanced neuronavigation technology and the SNT Protocol to provide an exact and practical TMS experience.

If you are considering TMS therapy for yourself or a loved one, you may have questions about the process, its effectiveness, and what to expect before treatment begins. This guide will walk you through everything you need to know about pre-TMS treatment, preparing you for a successful therapy journey. Prefer a video format? Watch here: Key Steps for Navigating Transcranial Magnetic Stimulation.

 

How Does TMS Work?

TMS therapy involves sending painless magnetic pulses into targeted areas of the brain, specifically the dorsolateral prefrontal cortex. This part of the brain plays a key role in mood regulation, and in individuals with depression, it often shows reduced activity. TMS works by stimulating neurons in this area, effectively rewiring neural pathways to restore balance and resolve symptoms.

At Scenic City Neurotherapy, we use advanced neuronavigation technology to ensure precision in targeting these key areas in the brain. This technology allows us to map each patient’s brain for an optimized treatment plan, setting us apart from other clinics.

 

Who Is a Candidate for TMS Therapy?

TMS is an FDA-approved treatment for major depressive disorder (MDD), anxiety, and OCD. It is particularly beneficial for individuals who have not responded well to medications or traditional therapy. You might be a good candidate for TMS if you:

• Have tried multiple medications with little to no improvement
• Experience unwanted side effects from medications
• Struggle with persistent depression or anxiety
• Want a non-invasive, drug-free treatment option
• Are not pregnant or do not have metal implants in the head (other than dental work)

A consultation with our SCN Care Team will help determine whether TMS is the right option for you. If needed, we can also discuss other potential options, like Minimally Stimulated Ketamine Infusion Therapy ((MSKIT®).

 

What to Expect Before Your First TMS Session

If you and the SCN Care Team decide to proceed with TMS registration, here’s what to expect.

1. Comprehensive Initial Evaluation 

Before treatment begins, you will undergo a detailed evaluation with our TMS Care Team. During this session, we will:

• Review your medical history and previous treatments
• Discuss your current symptoms and goals
• Explain the treatment process and expectations

If you’re approved for TMS therapy after your evaluation, here’s what to expect before your first session.

 

2. Brain Mapping

Your first session is called the ‘mapping’. Mapping is a fancy term for ‘locating’ the area of the brain to be treated. For the treatment of depression, this area is called the left dorsolateral prefrontal cortex, which is just above the left eyebrow. 

At SCN, we use advanced neuronavigation technology to ensure that the TMS pulses are precisely targeted. This personalized mapping process improves the effectiveness of treatment by ensuring that the magnetic stimulation reaches the correct areas of the brain.

During the mapping visit, we will determine your ‘motor threshold’ (the amount of energy required to invoke a stimulus). Once complete, you will receive your first treatment. Your treatments will be administered by a rTMS Therapy Certified Technician.

 

3. Preparing for the First Session

The day-of your first TMS session it’s best to:

• Continue any prescribed medications unless advised otherwise
• Dress comfortably.
• The room can be cool. We provide blankets, or you can bring your own.
• You can eat and drink before and after the session, but not during.
• Use the bathroom before your treatment.
• Music and phones aren’t allowed due to metal restrictions, but our friendly staff will be there to keep you entertained and supported.
• You can drive yourself home after each session.

Your first session will last around 60 minutes, as we take time to ensure optimal placement and comfort. 

For classic TMS (rTMS), future sessions typically last approximately 20 minutes and are scheduled one treatment per day, Monday-Friday, for 6 weeks with a 3-week wean, totaling 36 sessions.

If you choose to undergo the SNT protocol, the iTBS or theta burst treatments, will last approximately 3-minutes each, 10 sessions per day for five consecutive days, totaling 50 iTBS sessions.

 

Common Questions About TMS Therapy

1. Do I Have to Wear a Cap?

Our TMS protocols do not require anesthesia or a head cap, and they do not interfere with your medications. 

2. How Soon Will I See the Results?

Every individual responds differently to TMS therapy. Some patients experience noticeable improvements in mood within 2-3 weeks, while others may take the full treatment cycle to experience significant relief.

3. Are There Any Side Effects?

TMS has minimal side effects compared to medications. The most common ones include mild headaches or scalp discomfort, which usually subside within a few sessions. There is a very small risk of seizure, but this is extremely rare, especially with our advanced targeting methods.

SCN also offers ketamine-assisted TMS for patients who may benefit from an additional boost in brain plasticity.

4. Can I Resume Normal Activities After TMS?

Yes! Since classic TMS does not require sedation or downtime, you can immediately return to your daily routine, work, and driving after each session.

While the SNT protocol does not require sedation, you will need to plan for a more intensive week with the following considerations:

• Treatment Schedule: You’ll have a 50-minute gap between treatments each day.
• Local Amenities: Feel free to visit nearby parks, restaurants, and stores within a ten-minute drive from our clinic. Our large parking lot is also ideal for walking.
• Private Room: Each patient is provided with a private room equipped with two chairs. You’re welcome to bring a supportive friend or family member. The room is plain, so getting outside is recommended.
• Food and Refreshments: You’ll have access to our kitchen, or you can have food delivered.
• Work and Side Effects: It’s advisable not to work during this week as the treatment can be mentally taxing. Side effects may include fatigue and drowsiness by the end of the day.

For both protocols, if you choose to incorporate ketamine into your treatment plan, please arrange for a driver, as you won’t be able to drive yourself. For detailed guidance on this, be sure to watch our Key Steps for Navigating Minimally Stimulated Ketamine Infusion Therapy (MSKIT®) video.

 

Why Choose Scenic City Neurotherapy for TMS?

At SCN, we take a personalized and science-driven approach to TMS therapy. Our clinic stands out due to:

• The SNT Protocol: A unique method that enhances TMS outcomes, with patients reporting over 90% remission from depressive symptoms.
• Neuronavigation: Advanced Magstim technology ensuring accurate and effective treatment every time.
• Ketamine-Assisted TMS: A revolutionary combination proven to enhance brain healing.

We are committed to providing evidence-based, compassionate care that helps our patients regain control of their mental health.

 

Ready to Begin Your TMS Journey?

If you are ready to explore TMS as a treatment option, we invite you to schedule a no-cost consultation at Scenic City Neurotherapy. Our team will guide you through the process and help you determine if TMS is right for you.

 

Learn More About TMS:

• Visit our TMS Therapy webpage for more details.
• Watch real patient testimonials to hear how TMS changed their lives.
• Read our Post-TMS blog to learn about what happens after treatment.

Contact us today and take the first step toward lasting relief.

 

About Scenic City Neurotherapy

Founded in 2019, Scenic City Neurotherapy is at the forefront of advanced and comprehensive treatments for those facing treatment-resistant conditions. Our mission is to optimize brain function and elevate well-being through cutting-edge therapies. We specialize in two pioneering approaches: Minimally Stimulated Ketamine Infusion Therapy (MSKIT®) and Transcranial Magnetic Stimulation (TMS).

If you are exploring innovative solutions for mental health, chronic pain, and other neuro-degenerative conditions, Scenic City Neurotherapy offers transformative treatment options. Join us in leading the charge towards groundbreaking brain optimization treatments and empowering individuals to reclaim their lives.

Contact Founder and Chief Medical Officer, Charles Miller today to learn more about our proven protocols for Minimally Stimulated Ketamine Infusion Therapy (MSKIT®). Call 423-228-0579 or visit www.ScenicCityNeuro.com.