Deep Transcranial Magnetic Stimulation (TMS)

View TMS FAQs »

Deep Transcranial Magnetic Stimulation (TMS) is an FDA-approved treatment for major depressive disorder (including reduction of anxiety symptoms, commonly referred to as anxious depression) and obsessive-compulsive disorder (OCD). Smoking (nicotine) addiction is another FDA approved treatment using this device, but is not offered at this time at our facility.  As long as major depressive disorder or OCD is the primary reason for TMS treatment, other psychiatric conditions may be present and TMS may be safely administered with usual odds for a successful treatment. Studies are ongoing to investigate the use of the Brainsway and other TMS devices to treat other neuropsychiatric disorders. Most of this research for other conditions is limited, so it is difficult now to predict whether these other conditions will or will not improve, or even possibly worsen with TMS. The TMS procedure uses a specialized helmet containing a copper coil in a complex shape which targets the brain with magnetic pulses. These pulsations create weak electrical currents that stimulate parts of the brain in patients suffering from depression. The location and power (magnetic flux) of these pulses are carefully calibrated to your actual brain response, different in each person, based on matching the output of the TMS device to make your fingers or toes just barely twitch (motor threshold). See this link for an overview of the Brainsway device, from the company website:

How the Brainsway TMS device works

Here is a compendium of TMS research, with a focus on the Brainsway device:

Compendium of Research, Brainsway

If interested, see this link for a technical description of the Brainsway device, with focus on the H-7 coil: https://www.tandfonline.com/doi/pdf/10.1080/17434440.2021.2013803

The NorthShore Department of Psychiatry and Behavioral Sciences offers this service through Evanston Hospital for patients experiencing moderate to severe depression that have not experienced improvements in their condition through antidepressants or other psychotherapies.

Qualifying for TMS

TMS is only used for patients with major depressive disorder who have not seen results with previous treatments. In order to qualify for TMS, patients must:

• Be between 18-75 years old
• Have previously tried 4 antidepressants in 2 classes and have received some form of structured psychotherapy
• Currently have a psychiatrist (if you do not have a psychiatrist, our team can refer you to one)
• Provide informed consent if pregnant
• Be willing to stop alcohol consumption for the duration of the treatment
• Not have any brain tumors or other severe neurological conditions (dementia, stroke, Parkinson’s, etc…)
• Not have any metal clips, plates, screws or implanted devices in the head or neck (excluding dental work)
• Commit to a 4 or more week schedule of treatments taking place at Evanston Hospital
• Be comfortable participating in an evaluation by a NorthShore psychiatrist prior to being approved for the TMS Procedure

Brief Summary of the Experience Receiving TMS

Treatment will take place over at least 4 weeks, which requires patients to come to Evanston Hospital every weekday. The first session will take 1 hour, and further sessions will be about 45 minutes. After 4 weeks, sessions will taper off with a maximum of 36 treatments depending on each individual patient’s condition and response to TMS. Patients will schedule times for each TMS treatment in coordination with the TMS nurse.

• You will have full information about the procedure, and give informed consent for TMS
• You will have pre TMS measures of your depression and anxiety severity, using standard scales
• To begin, you will be seated in the TMS chair and the helmet will be placed onto your head.
• The TMS device will deliver short, 2 second pulses with approximately 10 to 20 second periods between them, targeting the brain with magnetic pulses.
• You will need to remain seated, but the helmet is gently secured to your head, allowing for slight repositioning without stopping treatment.  If you feel the need to reposition yourself, or take a brief break during a treatment, that is easily managed.
• If you have significant discomfort, the TMS nurse is just a few feet away in the TMS treatment room, so if you signal the need for help, the nurse will immediately interrupt your TMS session.
• After treatment is done, you may resume regular activities, including driving.
• Some patients experience mild fatigue or headaches. Pain can be managed with OTC pain reliever medication.

Post TMS

After the full course of the TMS procedure series (up to 36 treatments), your response using the same standard scales for depression and anxiety will be used to determine if you have responded (at least 50% better) or remitted (near normal). Your response to treatment will be communicated back to your referring psychiatrist. Response to TMS varies for each patient – changes are anticipated within 2-4 weeks, but not all patients will experience a change in mood. If treatment is found to be ineffective, your care team will work with you to consider next steps, in coordination with your referring psychiatrist.

Insurance Information

This procedure is covered by most, but not all insurance companies. Medicaid does not cover TMS, even when Medicaid is secondary coverage to Medicare. Please contact your insurance carrier for more information.

For More Information

TMS is currently offered at NorthShore Evanston Hospital. For more information on the procedure, to find out if you qualify or to schedule a consultation, please fill out our consultation request form. You can also view the TMS FAQs page.

*If you have additional inquiries about qualifying for TMS or the procedure, you may contact 847.570.2756 .

If you have any thoughts of harming yourself or others, please call 911 or go to the nearest emergency room.