TMS Specialty

Depression Treatment at Hagan Health

Transcranial magnetic stimulation (TMS) is a technology that is similar to MRI scans. Simply put, electricity generates a magnetic field that passes through the skull to leave a mild electrical stimulation in the brain.  TMS works better than medication for several psychiatric disorders.  TMS has been a growing technology since its discovery 30 years ago.  It was approved for the treatment of depression in 2007, and since then it has also been approved for the treatment of anxious depression, OCD, and smoking addiction.  Other conditions such as PTSD and anxiety are being treated as well.  At Hagan Health, we have both Brainsway and Neurostar TMS technologies with which to treat psychiatric disorders. In Dr. Hagan’s first career as a neurosurgeon, some of his experience was mapping the surface of the brain to localize important areas such as speech and movement. Using “awake anesthesia” and with the brain exposed surgically, patients would be partially anesthetized but awake enough to speak and otherwise participate in the mapping of the brain. As a psychiatrist, Dr. Hagan has 20 years of experience helping with medication management and psychotherapy.  Currently, Dr. Hagan is utilizing his vast knowledge and experience to understand the brain and the mind, and to help people to be happy again with TMS treatment. Many of the patients we treat are already our own patients or new patients seeking treatment.  We welcome others to come and talk with us about TMS, and for those who are being referred by their therapist, psychiatrist, or mental health nurse practitioner, we encourage those patients to continue seeing their providers while we collaborate with them in a multi-disciplinary team approach.

Play Video

The numbers reflecting the success of TMS (transcranial magnetic stimulation) suggest that TMS is perhaps the best treatment for depression. Nationally, when patients who have not responded to medication are treated with TMS, over 80% will improve significantly, while 60% will achieve remission. That means TMS works better than medication.

Nationally, 60% will achieve remission from TMS Treatment.

Nationally, over 80% will improve significantly from TMS Treatment.

 

 

 

 

Treatment involves sitting in a comfortable chair for a 20-minute treatment, which is painless except for occasional early scalp soreness. A treater will be with you throughout every treatment..

Afterward, patients get up and leave, drive themselves and otherwise continue with their schedule for the day. There are no side effects except for rare exceptions. The usual protocol is for 30 sessions on weekdays for 6 weeks followed by a three-week taper. Insurance tends to pay for the treatment.

Is TMS an option for me?

Please take a few minutes to view the links below to see if you are a candidate for TMS. Please ask us if TMS is an option for you or for someone you care about. 

Depression

Major depression was the diagnosis first approved for treatment with TMS, and it is still the most commonly treated condition. Most patients are treated with TMS after failures of medications and psychotherapy, as insurance companies will pay for TMS treatment only after medication failures.  However, TMS treats depression much better than medication, and some would argue that TMS should be the first treatment instead of the last.  

When patients have not improved with medication, they are considered to be “treatment-resistant”. And in treatment-resistant depression, TMS treatment results in significant improvement, defined as more than a 50% reduction in symptoms, in more than 80% of patients.  And more than 60% of patients achieve remission.  That is a very high and a very impressive number of people who are happy for the first time in many years after TMS treatment.

TMS treatments for depression are done in a series of 36 treatments.  Patients have a 20-minute treatment 5 days a week for six weeks followed by 6 more treatments in a tapering schedule over three more weeks. No preparation is needed, and there is no recovery time.  After each treatment, patients are able to leave and go about their day.  Except for a rare seizure, which occurs in 1 of 1000 patients, TMS has only minor side effects of mild headache or scalp soreness in the first few days. 

It is said that after successful TMS treatment, that there is a 50% chance of relapse of depression within the first year.  However, at Hagan Health we consider that statistic to be too high, and our relapse rate is lower.  While treatments are done by certified and experienced treaters, Dr. Hagan is closely involved in determining the location and strengths of settings to provide the most accurate treatment.  In addition, Dr. Hagan meets with patients every week or two before and during treatment, and periodically after treatment, in order to insure the best possible results.  Depression varies from patient to patient, and it is important to get the know the patient and the thoughts, feelings, and circumstances that might lead to relapse.  Using cognitive therapy techniques, patients are taught to be aware of triggers and to be prepared with the cognitive tools used to reduce the chances of relapsing. 

TMS for Anxious Depression

Recently TMS has been cleared by the FDA for treatment of Anxious Depression.  This condition is one in which anxious distress is a major part of the clinical picture while depression remains the predominant diagnosis.  Anxiety which is treated along with depression is also significantly improved, while TMS is not currently considered appropriate for the treatment of anxiety without depression.

OCD

Deep TMS has recently be approved by the FDA for treatment of obsessive-compulsive disorder (OCD).  OCD traditionally has been treated primarily with exposure psychotherapy, and while it is also treated with medication such as fluvoxamine, OCD does not respond well to medication management.  Medication improves symtpoms greater than 30% in only 50% of patients, and half of OCD patients stop taking their medication due to side effects.  And while exposure therapy might improve OCD, as many as 80% of patients continue to have symptoms after psychotherapy, according to some studies.

BrainsWay Deep TMS is a noninvasive, FDA-cleared, outpatient brain stimulation procedure with proven clinical results for improving the symptoms of OCD.  The technology stimulates the brain using its patented H-coil, known as the H7 coil, resulting in a deep and broad penetration of the magnetic field into areas of the brain that are affected in OCD. Deep TMS is safe and well-tolerated, has a very low rate of side effects, and does not require anesthesia.  

Research has proven a higher level of improvement using Deep TMS.  Almost 68% of OCD patients were able to reduce symptoms by more than 30%, and 87% of those who responded saw sustained improvement for at least a year.

Smoking Addiction

BrainsWay Deep TMS is a noninvasive, FDA-cleared, outpatient brain stimulation procedure with proven clinical results to help patients to quit smoking.  Known as the addiction coil, the H4 coil was specifically designed for targeting the deep areas of the brain involved in addictions.

A large study in 14 centers examined adults who had been long-term heavy smokers, all having failed prior quit attempts using medication, therapy, or other methods. Of those that completed Deep TMS treatment, 28% achieved four consecutive weeks without smoking, most of them not smoking for at least three months after treatment.  Among all participants in the study, the average number of cigarettes smoked per week over the course of treatment was reduced by 75%.  

TMS has none of the side effects commonly found in medication to treat smoking cessation.  TMS is well-tolerated with years of safety data supporting Deep TMS.  Patients may initially experience minor headaches or pain at the site of treatment which typically subside after the first few sessions. There is no preparation, no anesthesia, and patients are able to resume daily activities immediately after each treatment session.  Treatments are done in our office.  Each treatment session lasts 25-30 minutes.  They are done daily on weekdays for 3 weeks followed by a weekly session for another 3 weeks.

BrainsWay Deep TMS offers a fresh approach that may help to quit smoking using cutting-edge neuroscience.  Clinically proven and well-tolerated, Deep TMS is the first non-invasive technology that is FDA-cleared to treat smoking addiction.