Labyrinth Psychiatry Group and TMS Center · Cranford, NJ
TMS Therapy in Cranford, NJ
Transcranial magnetic stimulation (TMS) is an in-office treatment for depression that has not improved enough with medication, and for obsessive-compulsive disorder (OCD). There is no anesthesia, and you can drive yourself to and from each visit.
Who TMS is for
Depression that medication has not relieved, and OCD.
During TMS, a magnetic coil placed against the head sends repeated low-intensity pulses to the part of the brain involved in mood. You stay awake in a comfortable chair, and nothing is implanted.
- Depression. The FDA cleared the first TMS device in 2008 for people whose depression did not respond to at least one antidepressant in the current episode. Many people who come to TMS have tried several.
- Obsessive-compulsive disorder. In 2018 the FDA permitted a deep TMS system for OCD, after a trial in which 38 percent of patients responded to active treatment compared with 11 percent on a sham device.
- People who could not tolerate medication. TMS may also be considered when side effects made antidepressants hard to continue.
A website cannot decide whether TMS fits you. The evaluation does, based on your diagnosis, what you have tried, your safety history, and your goals.
How a course works
From the first evaluation to the last session.
- 01
Evaluation
A psychiatric evaluation reviews your diagnosis, the medications and therapy you have tried, your medical history, and safety questions. TMS is one option the team may discuss; it is not decided in advance.
- 02
Insurance review
Plans usually ask for proof of the diagnosis and of earlier treatment before they approve a TMS course. Bring your insurance card and a list of past medications, including ones you stopped because of side effects.
- 03
First session
Your technician takes measurements to set the machine and position the coil on the front of your head. You get earplugs to soften the noise the coil makes.
- 04
Daily sessions
A standard course is 36 sessions for depression and 30 for OCD, five days a week, which takes about six to eight weeks. Each session lasts 19 to 45 minutes, depending on the diagnosis. The pulses feel like a light tapping; tell the technician if it is uncomfortable so the coil can be adjusted.
- 05
Progress checks
The care team tracks your symptoms, side effects, and daily functioning through the course and explains how you will decide together whether to continue. A response cannot be guaranteed.
- 06
After the course
Follow-up care continues after the last session. In a one-year study, about a third of patients came back for more TMS sessions after their first course, so plan that conversation with your psychiatrist.
What the research shows
Results from real practices, and their limits.
Depression in everyday practice
Across 42 US practices, 307 patients who had not improved with an average of 2.5 antidepressants had TMS. Clinicians rated 58 percent as responding and 37 percent as in remission at the end of treatment. Carpenter et al., 2012
One year later
Of 120 patients who responded to TMS, 62.5 percent still met response criteria through a year of follow-up. About 36 percent received more TMS sessions during that year. Dunner et al., 2014
OCD
After six weeks of daily deep TMS, 38.1 percent of patients responded, compared with 11.1 percent on sham treatment. One month later the figures were 45.2 and 17.8 percent. Carmi et al., 2019
Side effects
According to NIMH, the most common are discomfort where the coil sits, tingling of the scalp or face, mild headaches, and brief lightheadedness. Seizures are possible, but the risk is low. Dr. Savatta notes that there are no known long-term side effects, and that TMS is not associated with problems with memory or thinking.
Insurance and approval
What plans usually ask for before TMS.
Plans set their own rules, and most require approval before the first session. A published Medicare coverage policy, for example, looks for:
- A diagnosis of major depressive disorder
- No clinically meaningful improvement from antidepressant trials in at least two different drug classes, or side effects that stopped those trials
- A trial of evidence-based psychotherapy without enough improvement
- Adult age, and none of the safety exclusions listed below
Your plan’s criteria may differ. For a longer explanation, read Is TMS covered by health insurance?
Listed insurance plans
Plans the practice lists.
- Aetna
- Blue Cross Blue Shield
- Cigna
- Medicare
- TRICARE
- UnitedHealthcare / Oxford
This list is not a guarantee of coverage. Confirm participation and TMS benefits with the practice and your plan. Insurance and access
Safety screening
When TMS is not an option.
Tell the care team about your full medical history, your medications, and anything metal or electronic in your body. TMS is generally not used for people with:
- A seizure disorder or a history of seizures
- Metal or electronic devices in or near the head, such as deep brain stimulators, electrodes, cochlear implants, aneurysm clips, or stents
- Implanted heart devices close to the coil, such as a pacemaker or defibrillator
- Head tattoos made with metallic ink
- Certain neurological conditions, such as epilepsy, a brain tumor, or a history of severe head injury
Remove earrings and other magnet-sensitive items before each session.
Other options for hard-to-treat depression
TMS, SPRAVATO, or ECT?
ECT is done under general anesthesia. SPRAVATO is a nasal spray taken in the office, followed by at least two hours of observation, and you cannot drive until the next day. TMS needs neither anesthesia nor an observation period. None of them is right for everyone, and the evaluation looks at which options fit your history.
Common questions
TMS questions patients ask first.
Does TMS hurt?
Most people describe the pulses as a tapping on the scalp. Scalp discomfort, tingling of the face or jaw muscles, and mild headaches are the common side effects, and the technician can adjust the coil if a session is uncomfortable.
Can I drive myself to and from TMS?
Yes. TMS does not use anesthesia or sedation, so you can drive yourself and return to your usual activities after each session.
Is TMS covered by insurance?
Medicare and many commercial plans cover TMS for depression when their criteria are met, and most require approval before the course starts. The practice lists Aetna, Blue Cross Blue Shield, Cigna, Medicare, TRICARE, and UnitedHealthcare / Oxford; confirm your own benefits with the office and your plan.
How much does TMS cost?
The cost depends on whether your plan approves the course and on your deductible and copays. Ask the office what your plan requires and what you would pay before the course begins.
Can I keep taking my antidepressant during TMS?
Many people do. In the long-term study cited on this page, patients stayed on antidepressant medication after TMS. Your psychiatrist decides what to continue or change.
Is TMS the same as ECT?
No. ECT is done under general anesthesia with a muscle relaxant. TMS uses magnetic pulses while you are awake and does not need anesthesia. The two are considered for different situations, and the evaluation covers which options fit you.
Where can I get TMS therapy in New Jersey?
Labyrinth Psychiatry Group and TMS Center offers TMS at two offices: 11 Commerce Drive in Cranford, Union County, and 1 Ethel Road, Suite 103B, in Edison. Call 908-336-1187 or send a request to start with an evaluation, and say which office is closer.
Service details
What to know about this care.
TMS Therapy Q & A
What is transcranial magnetic stimulation (TMS) therapy?
Transcranial Magnetic Stimulation or TMS therapy is a non-invasive treatment where magnetic pulses are delivered to stimulate nerve cells in a part of the brain that is important for controlling mood. This region of the brain is often underactive in patients with depression. Repeated stimulation of this part of the brain has proven to produce an antidepressant effect on people suffering from depression.
TMS therapy is often recommended in cases where psychotherapy and medications have not delivered great results. It may also be used for patients who experience side effects from psychiatric medications.
What does TMS therapy treat?
TMS therapy can treat both OCD and Depression, which both affect mental functioning and emotions. After an extensive and advanced psychological evaluation, it will be determined if TMS is an appropriate fit for you.
TMS might be a part of your comprehensive treatment plan for:
Treatment-Resistant Depression (those who do not respond adequately to multiple antidepressant medication trials within in a window of time)
Obsessive-Compulsive Disorder (OCD)
TMS therapy will not be an option for you if: you get seizures, you have any devices in your head such as deep brain stimulators, electrodes, cochlear implants, or you have head tattoos with metallic ink. Be sure to let your provider know if this is the case for you.
What should I expect during TMS therapy?
TMS therapy might sound intimidating to those who are unfamiliar with the process. Our team here at Labyrinth Psychiatry Group can answer any questions you might have, so you are more comfortable throughout the process. After removing any earrings or other magnet-sensitive items, the procedure can begin being set up.
Before we begin the treatment, a pair of ear plugs will be given to you to reduce some of the noise produced by the coil. You will then get set up in a comfortable chair as your technician takes some measurements to adjust the machine’s settings and coil.
The TMS coil goes on the front of your head, so the pulses can reach the frontal lobe of your brain. The machine releases electromagnetic pulses every few seconds which feel like a slight tapping sensation. This tapping is not painful, but if you are having slight discomfort, the technician will adjust the coil for you.
To get ideal results from TMS, patients should come in for five sessions per week for about 6-8 weeks. Patients will have a more specific idea of the number of treatments needed after an initial evaluation. Treatments are between 19-45 minutes in length, depending on the diagnosis.
You may experience mild side effects, such as headaches, but overall TMS is extremely well tolerated. You can expect to drive yourself to and from your TMS treatment as it will not cause sedation. This treatment does not require any anesthesia and there are no activity limitations after the treatment session. To learn more about TMS therapy and how it might be a great fit for you, call to request an appointment today!