rTMS FAQs

How is rTMS different from ECT (Electro Convulsive Therapy)?

The two treatments are very different:

• rTMS treatment does not require anaesthesia
• rTMS treatment does not require sedation
• rTMS treatment does not produce a medically induced seize
• rTMS therapy has a milder side effect profile
• rTMS sessions are longer in duration and require more sessions in a treatment course

How will rTMS help me?

The potential benefit of rTMS for you is that it may lead to an improvement in your mental health condition. rTMS has been shown to be a highly effective treatment for a number of conditions however, not all patients respond equally well. As with all forms of medical treatment, some patients recover quickly, others recover only to relapse again and require further treatment, while others may not respond at all. It may take up to two weeks after the TMS treatment is completed before symptom improvement occurs although most patients report an improvement within the course of the treatments. Some patients may also require further follow up treatments.

What will actually happen to me when I have rTMS?

Before treatment begins, the psychiatrist who is prescribing your rTMS will need to identify the correct placement of the magnets on your head and the prescribed dose of magnetic energy for you. Your first appointment typically lasts about 60 minutes. During this appointment:

• You will be taken to a treatment room, asked to sit in a reclining chair and given earplugs to wear during the procedure.
• An electromagnetic coil will be placed against your head and switched off and on repeatedly to produce stimulating pulses. This results in a tapping or clicking sound that usually lasts for a few seconds, followed by a pause. You will also feel a tapping sensation on your forehead. This part of the process is called mapping.
• The psychiatrist who is prescribing your rTMS will determine the amount of magnetic energy needed by increasing the magnetic dose until your fingers or hands twitch. Known as your motor threshold, this is used as a reference point in determining the right dose for you. During the course of treatment, the amount of stimulation can be changed, depending on your symptoms and side effects.

The rTMS psychiatrist will then issue a prescription for future treatment sessions, which will be adhered to by the rTMS treatment Credentialed Clinician.

During each subsequent treatment you are seated in a comfortable chair. You are fully conscious and responsive. There are no medications involved in the treatment. The rTMS clinician positions the magnet over the appropriate area of the scalp as prescribed by the psychiatrist and activates the magnet.

You will need to remove any metal hair clips, earrings and studs, glasses and hearing aids during your treatment. For ease of treatment it is preferable that you do not have gel, mousse or other products in your hair.

During treatment, you hear a clicking sound and feel a tapping sensation on your head. Many patients will be able to listen to music, watch television, read a magazine or talk to the credentialed mental health clinician who stays with you during the treatment. The procedure will take between 20 – 40 minutes, depending on your specific prescription.

At the end of the treatment you can return to your usual routine activities, including driving your car.

How many treatments will I need?

The number of treatments that you will have depends on your mental health condition, how quickly you respond to the treatment and the clinical judgement of your psychiatrist. rTMS is typically given 5-6 times a week for 20 treatments. Treatment needs vary from individual to individual but typically your psychiatrist will prescribe maintenance treatment if your depression symptoms are returning.