FAQ

Have some questions? We’re here to help. Below are common questions about TMS.
Please call (480) 565-6440 for a CONSULTATION and to discuss how our customized TMS treatment program may help you improve your life.

Why choose Lighthouse Psychiatry ?

What is TMS?


Lighthouse Psychiatry is not your typical psychiatry clinic. We pride ourselves on a “patient’s first” mentality. We deliver a customized approach and solution to help individuals we care for. Our strong belief in a team approach enables to engage with the individual during the whole time the person is with us. We believe each individual is important. They need to feel they are important. Our approach to TMS therapy is also a defining distinction of our clinic. We strongly believe in maximizing the benefits of TMS treatment with the incorporation of talk therapy during the TMS treatment time. As TMS is actively stimulating the brain and improving the biological processes, we incorporate psychological tools to help improve the mental component of the brain. By combining biological effects and psychological effects, we strive to achieve the best possible outcome for the individual. This approach has enabled us to achieve amazing results. Our ultimate goal is to help individuals have a decrease reliance on medications.​​
Transcranial Magnetic Stimulation (TMS) is a noninvasive and innovative approach used to treat depression and other mental illnesses. TMS works by stimulating the brain by using electromagnetic fields, similar to those produced by an MRI machine, to improve overall brain function. During TMS Therapy, a magnetic field is administered in very short pulses to a targeted region of your brain that research has demonstrated to be associated with depression and other mental illnesses. The typical appointment time per day of treatment is 60 minutes over 6 weeks. The daily schedule of TMS allows for a gentle and gradual process to establish lasting effects to brain function.

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Is TMS Therapy a good alternative for patients who cannot tolerate the side effects associated with antidepressant medications?

How does TMS Therapy work? 

TMS directly stimulates the brain without involving the rest of your body, which is drastically different from strictly medication-based treatment that have side effects such as weight gain, sexual dysfunction, nausea, dry mouth, sedation, and many other symptoms. Contrary to medication-based side effects, the most common side effects related to TMS includes headache and mild scalp discomfort which are only temporary and occur during mainly at the begin of the program. TMS Therapy is cleared by the U.S. Food and Drug Administration (FDA) for the treatment. Like any treatment option, you and our clinical team will work together to find the most appropriate treatment option for you.

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The TMS Therapy system uses short pulses of magnetic fields to stimulate the area of the brain that is thought to function abnormally in patients with depression. The magnetic field produces an electrochemical effect in the brain that leads to overall brain function improvement. These neuroplastic effects result in changes that are beneficial in the treatment of depression and other mental illnesses. Such of the benefits may include improvements in memory, concentration, mood, energy, and overall cognitive function.


Is TMS Therapy like other alternative therapies which use magnets to treat some illnesses? 

Is TMS Therapy like electroconvulsive therapy (ECT)? 

No. TMS Therapy involves a unique method of using very powerful pulsed magnetic fields for potential therapeutic benefit. The intensity of the magnetic field is similar to that of the magnetic fields used in MRI. These techniques differ radically from the popular use of low intensity, static magnetic fields. These products deliver weak and undirected static fields that are not capable of activating brain cells. Feel free to contact us you have more questions about the difference of TMS technology versus other low intensity magnetic devices.

No, TMS and ECT procedures are very different. While both are effective in the treatment of depression and other mental illnesses, there are significant differences in safety and tolerability. During the TMS Therapy procedure, patients sit in a chair and are awake and alert throughout the entire procedure – no sedation is used with TMS Therapy. Patients can transport themselves to and from treatment at our outpatient clinic. TMS Therapy was also shown to have no negative effects on memory function in clinical trials.  In contrast, “shock therapy,” or ECT, intentionally causes a transient seizure using electrical stimulation, not magnetic stimulation. Patients receiving ECT must be sedated with general anesthesia and paralyzed with muscle relaxants during the treatment in a hospital setting for safety purposes. Recovery from an ECT treatment session occurs slowly, and patients are usually closely monitored for minutes or a few hours after a treatment. Short-term confusion and memory loss are common, and long-term disruptions in memory have been shown to occur and may persist indefinitely in some people. Because of the side effects associated with ECT, a significant amount of caregiver support is required.

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What is a typical course of treatment with TMS Therapy? 

In clinical trials, patients received TMS Therapy 5 times per week for approximately 30-40 minute sessions over 6 weeks. Based on clinical judgment, some patients may achieve sustaining benefit with a routine maintenance schedule.

What are the potential risks of TMS Therapy? 

Does TMS Therapy cause brain tumors? 

No, TMS Therapy uses the same type and strength of magnetic fields as MRIs (magnetic resonance imaging), which have been used in tens of millions of patients around the world and have not been shown to cause tumors. The magnetic energy used in a full course of TMS Therapy is a small fraction of just one brain scan with an MRI.

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TMS Therapy is well tolerated and has been proven to be safe in clinical trials. The most commonly reported side effect related to treatment was scalp discomfort during treatment sessions. This side effect is generally mild to moderate, and occurs less frequently after the first week of treatment. Less than 5% of patients treated with TMS Therapy discontinued treatment due to side effects. In clinical trials, over 10,000 TMS treatments demonstrated its safety, with no occurrence of seizures. However, there is a small risk of a seizure occurring during treatment. This risk is no greater than what has been observed with oral antidepressant medications. While TMS Therapy has been proven effective, not all patients will benefit from it. As in any treatments for depression, patients should be carefully monitored for worsening symptoms, signs or symptoms of suicidal behavior, and/or unusual behavior. Families and caregivers should also be aware of the need to observe patients and notify their treatment provider if symptoms worsen.

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Does TMS cause memory loss? 

No, TMS Therapy was systematically evaluated for its effects on memory. Clinical trials demonstrated that TMS Therapy does not result in any negative effects on memory or concentration.

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Is TMS Therapy uncomfortable? 

How long does the TMS effect last? Will I need any therapy beyond the first induction course? 

The most common side effect related to treatment was scalp discomfort during treatment sessions. This side effect was generally mild to moderate, and occurred less frequently after the first week of treatment. If necessary, you can treat this discomfort with rest and/or an over-the- counter analgesic. Less than 5% of patients treated with TMS Therapy discontinued treatment due to side effects.

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In most patients, the clinical benefit of TMS Therapy was maintained through 6 months of follow-up study. Our goal is that the individual does well after the induction course and begin to live a more proactive life. Talk to your doctor about your long-term treatment plan which may or may not include various approaches to lifestyle modifications.

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Can I also take antidepressant(s) if I am receiving TMS Therapy? 

Will TMS Therapy be covered by my insurance? 

Yes. TMS Therapy can be initiated with or without medications onboard. But we recommend no changes to your medication prescription during treatment. Any changes to medication prescription can begin to take place during the taper phase of the treatment program.

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TMS Therapy is now covered by many insurance companies around the country. Companies that are currently covering TMS Therapy include BCBS, MHN (HealthNet), Cigna, Aetna, Magellan, Compsych, United (UHC), (Optum), UMR, TriCare (military), TriWest/Veterans Choice Program (military), and others. Our team will work closely with you to make the insurance process as easy as possible.

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Will TMS Therapy be covered by MEDICARE? 

If my insurance does not cover TMS therapy, how much does it cost?

TMS Therapy is already covered by many private health insurance companies. Medicare coverage is region-based. Medicare covers TMS is various regions throughout the country. Currently, Lighthouse Psychiatry is working with the local Arizona Medicare agency to potentially offer TMS therapy to local Medicare recipients. Please contact us at (480) 565-6440 to find out the progress. This is a constantly changing status. Our goal is to ultimately offer TMS to Medicare recipients.

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Although most major insurance companies and Medicare have policies to cover TMS, the criteria for coverage is typically very specific and strict. Our team works extremely hard to help the individual receive coverage. But there are occasions were the insurance companies and Medicare just will not cover the treatment. Thus, we are excited to offer various opportunities for the individual to self-finance for our TMS treatment program. We work closely with Advance Care, National Bank of Arizona, MidFirst Bank, and Wells Fargo Bank.

Also, the actual cost of treatment depends on the specific condition being treated, because some treatment programs are longer and some are shorter and some may require maintenance.

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​How long does it take to get enrolled and begin the TMS treatment program?

There are several steps to get enrolled into treatment. 1) In general, we require an initial psychiatric consult/intake appointment to speak with one of our psychiatrist and clinical team member. We need to assess whether the individual is a good candidate to receive TMS treatment. We try really hard to schedule intake appointments within a reasonable time frame of 1-2 weeks. But this can vary depending on availability. We try to be accommodating to the patient’s schedule. 2) Financing is the next step. If insurance is providing coverage, we will need to submit to the insurance a preauthorization/predetermination form for approval. This can take on average 5-15 days depending on the responsive of insurance company. If the person is looking to self-finance the treatment, then we can quickly move onto the next step. 3) Scheduling for the initial step of TMS treatment. The 2-hour appointment includes both cortical mapping of the brain and the first TMS treatment. 4) Scheduling of the remaining treatment appointments. One of the key to success from our program is our emphasis on commitment by the patient. We are proactive about scheduling out the remaining appointments so the patient knows how to coordinate their other activities. 5) Some patients may require taper or maintenance treatments and thus we schedule those appointments out. 6) Graduation. Once the individual completes the program, they graduate from the program. Most of our graduates have done extremely well.

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I have already tried different types of medications, will TMS be any better?

Many clinical studies have shown TMS treatment to be effective for patients with depression, regardless of how many medications the individual has tried. That said, some insurance companies do require the individual to have several medication trials in the current episode before offering coverage.

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How long does it take for TMS to work?

Each individual responds to TMS differently. We have seen as early as 7 days to as long as by the end of the program. Many times, patients do not recognize improvements taking place, but their family members or close friends are usually the first to notice a change.

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How effective is TMS therapy?

Is TMS Safe? 

The national average of patients responding to TMS is approximately 65% and remission occurs in about 33%. At Lighthouse Psychiatry, the average is much higher because we adopt our unique integrative TMS approach of combining a modified talk therapy into the TMS program.

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Clinical trials have proven the safety of TMS Therapy in treating patients who’ve had an inadequate response
to prior antidepressant medications. Treatment with TMS Therapy caused very few side effects and was generally well tolerated by patients. The most common side effect reported during clinical trials was scalp discomfort—generally mild to moderate and occurring less frequently after the first week of treatment. Fewer than 5% of patients discontinued treatment with TMS Therapy due to adverse events. Over 10,000 active treatments were performed across all clinical trials demonstrating its safety:
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 No seizures
No systemic side effects
No weight gain
No sexual dysfunction
No sedation
No nausea
No dry mouth
No adverse effects on concentration or memory
No device-drug interactions

TMS Therapy should not be used (is contraindicated) in patients with some implanted metallic devices or some non-removable metallic objects in or around the head. Make sure to inform us of any implanted metals in your initial consultation.

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Is brain imaging necessary for TMS Therapy for depression? 

Brain imaging (MRI, fMRI, CT, PET scan, etc) is not necessary to determine the appropriate brain region of TMS treatment. The area of treatment known as the Dorsal Lateral Prefrontal Cortex (DLPFC) can be properly located and confirmed without the use of brain imaging scans. We use a standardized methodology to determine the location of targeted region.

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What condition is TMS therapy used to treat? 

TMS is used to treat many different mental illnesses. Beyond depression, TMS can be used to treat anxiety, bipolar, PTSD, OCD, ADHD, chronic pain, and autism. TMS is an FDA-cleared treatment neuromodulation treatment modality primary for depression. That said, the scientific community has been actively investigating the application of TMS for use with other mental illnesses beyond depression. Based on our understanding of neuroscience and how TMS can impact neuroplasticity, there is growing scientific evidence for use of TMS for treating anxiety, bipolar, PTSD, and other illnesses. A large explanation for this effect is because of similar regions of the brain that are involved amongst all of these mental conditions. Beyond depression, treatments
of these other conditions are considered “off-label” but are clinically applicable as an alternative treatment modality to  medications.  Off-label treatments are covered by private insurance companies and medicare.

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