TMS Therapy

• • TMS Treatment • •

TMS Therapy in Southern California

Neuro Wellness Spa is a leading provider of transcranial magnetic stimulation (TMS). Our Medical Director and Founder, Dr. Martha Koo, M.D., is a pioneer in the development and application of TMS therapy. After completing her undergraduate studies at Princeton University and receiving her medical degree from the David Geffen School of Medicine at UCLA, Dr. Koo has maintained a private practice for over 20 years and is passionate about using TMS and other therapies to improve access and quality of mental health care for her patients.

What is transcranial magnetic stimulation (TMS) therapy?

TMS safely treats symptoms of anxiety and depression. It relies on the use of magnetic energy. This stimulates parts of the brain affected by mental health disorders.

It began as a treatment option for non-responsive depression. Since, it has grown to include other disorders as well. However, it remains a depression alternative treatment option for many people. The Neuro Wellness Spa is one of the top providers of TMS therapy.

TMS is both non-invasive and non-systemic. It has fewer side effects than other treatments. In some cases, no side effects at all. Other treatments rely on deep brain stimulation or vagus nerve stimulation. Unlike those treatments, TMS does not require electrode implantation or surgery. It will not cause seizures or require the use of anesthesia sedation. In fact, TMS will not affect cognitive function. Patients can go about daily activities following treatment.

At our office, we show you exactly how the process works before your first session. When you make an appointment, you’ll see in person how TMS looks, and feels.

How Does TMS Therapy Work?

Transcranial magnetic stimulation (TMS) is a safe and effective treatment that uses magnetic pulses to stimulate different areas of the brain. TMS is non-invasive (does not require surgery), non-systemic (does not affect the entire body) and well-tolerated. TMS therapy can be used alone, or in conjunction with other treatment modalities including behavioral therapies and medication.

During TMS treatment, patients recline in a treatment chair and remain awake and alert. A TMS magnet is positioned over the patient’s head to deliver pulses to specific areas of the brain. Patients report that the pulses feel like taps on the scalp. Each treatment session lasts about 30 minutes, after which patients can immediately return back to their daily routines.

TMS is well tolerated. Sometimes patients experience mild scalp discomfort or mild headache during treatment. Most patients notice symptom improvement with TMS after 2 weeks of treatment (8-10 sessions).

History of TMS Therapy

TMS was first FDA indicated in 2008 for the treatment of depression. A year later, it joined the list of therapy options offered by Neuro Wellness Spa. From then until now, TMS has been the focus of numerous studies and the number of TMS providers has increased dramatically across the United States, and even around the world.

Although TMS was invented in 1985, the principles behind TMS date back to 1881, when an English physicist, Michael Faraday, observed an electric current passed through a wire coil created a magnetic field. He learned that by controlling the rate of change in that magnetic field, he could induce a secondary current in another conductor. These observations would shape the advancement of TMS treatment in the decades that followed.

Over a century later, scientist Anthony Barker and collaborators constructed the first transcranial magnetic brain stimulator. Because magnetic fields can pass through the skull with little resistance, today’s scientists can induce currents in specific cortical areas using TMS. Since its FDA clearance in 2008 for depression and 2018 for OCD, numerous studies have suggested TMS may also be a promising treatment for a broad range of other psychiatric conditions.

Neuro Wellness Spa recognizes the benefits that TMS offers. We are here to help.

TMS Services

Standard TMS

36 treatment sessions of TMS, typically conducted over 9 weeks

Express TMS

3-minute TMS using theta-burst technology

Six Day Accelerated TMS

36 treatment sessions of TMS conducted in six days

TMS plus Photobiomodulation

Combines TMS and low-level light therapy also known as photobiomudulation (PBM) therapy

TMS plus IV Ketamine

Combines TMS and IV ketamine

TMS plus IV Nutrition

Combines TMS and IV nutrition

We accept insurance from the following providers

• • Frequently Asked Questions • •

Additional Information on TMS Therapy

  • Why Choose TMS Therapy?

    The initial response for mental health treatment is with psychiatric medications and therapy. In many cases, psychiatric medication does not prove to be effective. The severity of side effects from medication can drive people away from medication.

    Because TMS is FDA-approved, it has been proven as an alternative to medication. Medication has proven to not be right for everyone. TMS might be a better option.

    Neuro Wellness Spa is able to discuss treatment options with you. We can discuss if you’re a suitable candidate for TMS in depth – contact us today to get started on your treatment plan.

  • Effectiveness of TMS Therapy

    Since 2009, Neuro Wellness Spa has found a remission rate of 82% in treating patients through TMS for depression. The numbers are great. But the positive effect of this treatment on a patient’s life cannot be captured in numbers.

    Depression is a chronic illness. There is no cure. That means remission is not for life. Data shows about 15% of patients see a relapse into depression in the first year after treatment. TMS is a sustainable treatment option to combat this relapse. Remission periods will depend on certain factors.

    Remission factors include:

    • Diet
    • Exercise
    • Continued therapy
    • Severity of illness
    • Lifestyle
    • Continued use of medication if needed

    At Neuro Wellness Spa, we strive towards 100% satisfaction after sessions. We welcome clients who are experiencing a relapse after treatment to make another appointment and begin again. If you’re currently in a depression relapse, we’re ready to treat you. Call to make an appointment today.

  • Side Effects of TMS Therapy

    TMS does not have the same side effects as a systemic treatment. The brain is treated directly. Unlike medication, it does not enter the bloodstream. Without an invasive procedure or use of anesthesia, there are no effects on cognitive function.

    Overall, patients tolerate TMS treatment very well. A common side effect might be a headache following the first few sessions. This is the result of neuron stimulations. This can occur if the neurons have not been utilized during the depressive phase. There could also be slight discomfort at the site of stimulation, lightheadedness, or even spasms and twitching of facial muscles. With every session, these symptoms lessen and eventually disappear.

    Serious side effects are rare. They depend on other factors, such as certain mental health issues not treated through TMS. Possible serious side effects include mania, hearing loss, or seizures. The mania tends to be triggered in people with bipolar disorder who undergo TMS therapy.

    At Neuro Wellness Spa, we take care of all of our clients during each session. We monitor how their body is responding to treatment. If the treatment is not working, we stop sessions and find an alternative that’s suited for our client. Contact us today to learn more about the TMS process and how it might feel for your body.

  • Does TMS Only Work With Depression?

    As mentioned before, TMS therapy has been proven to help treat anxiety as well. Currently TMS is also used to combat cognitive decline, alleviate chronic pain, and treat autism.

    TMS is still in an extensive research phase. It can be used to diagnostically test connections between the skeletal muscle and neurological system. This determines the progression of different diseases and potential damage. It is particularly useful for movement disorders, stroke, multiple sclerosis, and motor neuron diseases. Over time, more research discoveries will lead to the expansion of TMS therapy treatment options.

    You might have a condition that can be treated with TMS. To find out if Neuro Wellness Spa can help with your symptoms or disorder, contact us.

  • Preparing for TMS Therapy

    Prior to TMS therapy, a patient would take part in a psychiatric and physical exam. Since this is an alternative treatment option, a patient should be able to show proof of attempts at treatment through depressive medication or counseling.

    With the use of magnets in this therapy, it is important to disclose implanted or metal medical devices. The magnets may interfere with the function of devices like:

    • Pacemakers
    • Stents
    • Cochlear implants
    • Electrodes monitoring brain activity
    • Aneurysm clip/coil
    • Bullet fragments

    You’ll have an appointment to discuss physical and mental history with your provider. This is the opportune time to disclose important medical history. In addition to interference from the above listed devices, there are other elements to report. These include a family or personal history of seizures, other medications, frequency of headaches, and any other severe medical issue.

    Have a question about your medical history? Get in touch with us.

  • What to Expect During TMS Treatment

    This outpatient procedure takes place in a doctor’s office. FDA has certain requirements around the number of sessions a person should have if using TMS to combat depression. This normally involves 36 daily appointments, 5 days a week over a period of 4 to 6 weeks. After the initial period, there will be 6 taper sessions. All of these sessions last somewhere between 18 to 24 minutes.

    During the session, an electromagnetic coil is placed on the skin on the scalp. You will feel this close to the forehead. That coil discharges magnetic pulses to stimulate nerve cells in the prefrontal cortex. This is done continuously throughout the session with intermittent pulses.

    In the first appointment, you can expect to be taken to a treatment room. From there, the process begins. The administrator conducts mapping to determine the level of magnetic energy that will be necessary. You determine the threshold – so pay attention to when you reach the threshold by noting if your hands or fingers begin to twitch. This serves as an indicator that you have found the right level of magnetic energy for treatment.

    At Neuro Wellness Spa, we understand you might be nervous about experiencing TMS for the first time. We can make you feel more comfortable by answering any lingering questions you may have – make an appointment with our office.

TMS Therapy Treatment Process

When you arrive for your first TMS session, you will initially be greeted by a trained TMS technician.

They will then lead you to your treatment room, where you will rest on a comfortable chair that has the ability to both recline and elevate your legs. You will be fitted for a cap that the treating psychiatrist will use to mark your TMS treatment areas. You will wear this cap for every TMS treatment.

The treating psychiatrist will then come in and use the TMS machine to locate your proper treatment area, in addition to finding your motor threshold.

Based on your psychiatric history, the treating psychiatrist will also decide the type of TMS treatment and which side the coil attached to the TMS machine should be placed in order to provide the most effective treatment for your needs.

After, the treating psychiatrist finds the proper placement and answers any additional questions you may have.

Your TMS technician will then prepare you for your first full treatment. Generally, we allow between 18 and 30 minutes for each session, depending on the type of TMS treatment the psychiatrist prescribes. The technician will then make sure you feel as comfortable as possible, situating the chair to your liking and offering blankets and water.

Each treatment room is equipped with a flat screen TV connected to our Neuro Wellness Spa Netflix account.

Where you can choose from a variety of TV shows, movies, or meditative scenery to watch during your treatment. You may also choose to use your phone or iPad, or you may use the time to meditate; however, it is important that you do not sleep during the treatment as it may decrease the efficacy. If you prefer, the technician will offer you earplugs, but they are not required. In order to ensure that your head doesn’t move during treatment, a pillow behind you will then be wrapped around the sides of your head.

Once you are comfortable, the TMS technician will place the TMS coil on your head in the space that the psychiatrist has marked and will start your treatment.

If at any time you require a break, feel pain, or believe the coil may have accidentally moved, your TMS technician can pause your treatment to make sure you are comfortable.


Alternative to Antidepressant Drugs – Try TMS

Some people who suffer from depression are able to achieve symptom remission with medication. However, it may take up to 10 weeks after starting an antidepressant to notice improvement, and even then, symptom improvement only occurs in about one third of patients.

Many people experience symptom relief with medicants, but others may find that their conditions are resistant to medication. For those with treatment resistant mental health disorders, there is a need for alternative treatment options – like TMS. With durable, long-lasting treatment efficacy, TMS is a safe and effective treatment option for those who have not experience satisfactory relief from traditional treatments.

Research shows 1 in 10 Americans utilize some form of antidepressant medication. However, antidepressant medications are not effective and tolerable for everyone. Side effects of antidepressants may include:

  • Nausea
  • Weight gain
  • Constipation
  • Sexual dysfunction
  • Insomnia
  • Fatigue

At Neuro Wellness Spa, over 93% of patients have experienced noticeable improvement with TMS treatment. Typically, TMS has no side effects. However, some patients report mild scalp discomfort and mild headache during active treatment. During TMS treatment, patients remain awake and alert and are able to return to their daily activities immediately following a treatment session.

Since TMS received FDA indication for depression in 2008 and OCD in 2018, many health insurance providers have opted to provide coverage for TMS therapy. At Neuro Wellness Spa, we work with insurance companies to get our clients covered for their TMS recovery therapy. Contact us today to find out if your insurance will cover TMS.

Future of Transcranial Magnetic Stimulation Therapy: Advances Since 2009

From 1881 until now technological advancements and extensive research has greatly contributed to several notable developments in the application of TMS:

  • Efficiency & Speed. As TMS device technology has improved, TMS treatment sessions have become shorter. Theta burst stimulation (TBS), or express TMS, was FDA cleared in 2018. Express TMS uses a 3-minute treatment protocol, whereas standard TMS uses a 20-30-minute protocol. Shorter treatment times have made TMS more accessible and convenient for patients.
  • Expanded Research. Since 2008, TMS has been the focus of numerous studies for various mental health disorders. As a result of its efficacy, TMS was indicated and FDA cleared for the treatment of OCD in 2018.

Since its FDA clearance in 2008 for depression and 2018 for OCD, emerging research has suggested TMS may also be a promising treatment for a broad range of psychiatric conditions.

Neuro Wellness Spa recognizes the benefits that TMS offers. Contact us today to learn more about TMS or to schedule a consultation.

For more information about the services we offer or whether TMS treatment is covered by your insurance provider, contact us today.

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