rTMS stands for repetitive transcranial magnetic stimulation.
rTMS was approved as a medical procedure by Health Canada in 2002 for treating major depressive disorder.
It is also used to treat several other mental and physical conditions.
rTMS is a non-medication treatment that uses a magnet applied to the scalp to stimulate specific parts of the brain implicated in these conditions. With repetitive stimulation of these areas, rTMS can alter the strength of connections between neurons in the brain, leading to changes in brain function and improving abnormal patterns that can be associated with depression.
Unlike medication, this treatment requires no special preparation. It has been shown to be effective for major depression and several other conditions.
rTMS has been shown in hundreds of studies to be beneficial in treating major depression with relatively fewer side effects than medications or electroconvulsive therapy (ECT).
Generally speaking, rTMS trials have shown that 60% of people have a significant improvement in their symptoms, and 30-40% have remission of their depression. This is not as strong a response rate as ECT. However, rTMS has relatively fewer side effects than ECT and other standard treatments.
rTMS has also been shown to be beneficial in treating other conditions. A growing body of literature has shown benefits in the treatment of pain conditions such as:
rTMS may be particularly suited for:
Like much of treatment in psychiatry, it is not known if treatment will be effective until the treatment has been tried. Overall, 60% of people with depression will see improvement.
Those with recurrent episodes of depression with improvement to a normal baseline between treatments tend to have better results from treatment. People with poor prior response to rTMS or ECT are less likely to respond to rTMS. During treatment, you will be monitored by one of the physicians in the clinic to determine whether you are getting benefits from treatment.
Most people tolerate rTMS without any significant side effects. The most common side effect is discomfort on or near the scalp. This is because the magnetic pulse that stimulates the brain will also stimulate the scalp near the magnet and can create an unpleasant feeling. This discomfort, however, typically improves over the course of treatment. A smaller proportion of people have headaches after the session itself.
A small percentage of people have feelings of being faint.
Rare side effects include the potential risk of developing hypomania (feelings of increased energy, euphoria or irritability, reduced need for sleep) or thoughts of self-harm in less than 1% of cases. There is a small risk of seizure being induced by the treatment, estimated to be about 1 in 10,000 cases. Those seizures that have occurred in treatment have not led to seizures outside of treatment sessions. In some cases, rTMS has been used as a treatment for epilepsy.
A physician involved in your care will make a referral if they believe that rTMS may be beneficial for your condition.
You will then be booked to see one of the clinic physicians to determine whether rTMS may benefit you and whether you are suitable to receive the treatment.
Conditions that may benefit from rTMS treatment include:
Pain conditions that may benefit from rTMS include:
As there is evidence for rTMS in other conditions, other indications are assessed on a case-by-case basis. In our clinic, we treat adults over the age of 18.
Individuals need to be able to sit comfortably in a chair for thirty minutes and be able to commit to the treatment (which is 5 days per week, for up to 6 weeks), and have a form of payment.
rTMS is NOT currently covered by the Nova Scotia public health plan (MSI). As a result, third-party or out-of-pocket payment is required. The clinic has financing options available. There is no charge for the initial consultation.