PsyQ: Who might be a good candidate for transcranial magnetic stimulation (TMS)?

Eric Patterson, LPC

Eric Patterson, LPC

Answer: Transcranial Magnetic Stimulation (TMS) can be a good choice of treatment for people with depression, obsessive-compulsive disorder (OCD), or a smoking addiction who have not otherwise responded to conventional medications, according to Eric Patterson, LPC, a counselor who practices in Pennsylvania. It can also be helpful for those who experience severe side effects from medications used to treat these conditions.

However, Patterson cautions that there are also some patients for whom TMS might not be a good fit. This includes pregnant women, individuals recovering from a brain injury or TBI, people with a history of severe headaches or seizure disorder, as well as those with braces, stents, dental fillings, implants, and any other types of metal in their neck or head. Facial tattoos made of a magnetic-sensitive type of ink can also pose a problem.

“Before performing TMS on any patient, providers should perform a full evaluation of their health and mental health state to determine whether they are a good candidate,” Patterson explains. He adds that clinicians who recommend TMS to patients with psychiatric disorders may want to explore deep TMS, which uses wider (H-shaped) coil that covers a larger portion of the head than traditional TMS, and which also penetrates more deeply, thus magnifying the results.

Since TMS can be expensive, he stresses that it’s also important for patients to find out if the procedure will be covered by their insurance. Most insurance companies will cover TMS (both traditional and deep TMS) for those with a diagnosis of major depressive disorder (MDD) who have tried medications and counseling without their symptoms resolving. However, it is often not yet covered for other conditions.

Patterson further notes that people with depression who undergo TMS can typically continue taking medication as well. Some studies have found that the combination can bring about the most favorable outcomes. 

More on TMS for OCD.

 

Last Updated: Sep 9, 2021