Frequently Asked Questions about TMS

1. Why choose Brighter Day TMS clinic?
• We have been serving patients in Fort Collins for over four years and
performed over 4000 treatments.
• Dr. George is dedicated to the clinic and provides personal attention to
each patient.
• Our TMS technician works one on one giving TMS treatments and Dr
George monitors daily progress.
• Our results exceed those published in TMS studies with over 60% achieving
remission of their depression and over 90% seeing significant improvement.
• Brainsway Deep TMS was selected by Dr. George because it provides the
deepest and broadest stimulation of the brain area with depressed function.
• Brainsway has a unique patented coil unlike any other TMS device on the
market giving deeper stimulation over a broader area.
• Our clinic is the only local clinic providing Brainsway Deep TMS.

2. Is TMS covered by insurance?
TMS is covered by most major insurance companies for patients who meet
insurance requirements for treatment resistant depression (have
already tried medications). Our in-network insurances include Blue Cross Blue
Shield, United, Aetna, Cigna, TriCare, and Medicare.

3. Does TMS actually work?
In the studies leading to FDA approval 3 out of 4 patients improved. 51% of
individuals treated with deepTMS achieved remission and 75% of individuals
treated improve (improvement means at least a 50% reduction in symptoms).
This is remarkable considering these individuals have already tried 2 to 4

4. How does Brainsway deepTMS work?
Brainsway deep TMS is a non-invasive procedure involving stimulation of a part
of the brain called the Left Dorsolateral Prefrontal Cortex. The stimulation
activates the nerve cells in this region of the brain improving depressive
symptoms. The stimulation is produced by a treatment “coil” contained in a
helmet. During the treatment, the helmet is gently positioned on the left front side
of your head, over this region of the brain. Short pulses of electricity sent through
the treatment coil generate magnetic fields that turn on and off very rapidly.
These magnetic fields are similar to those used in magnetic resonance imaging
(MRI) systems. The magnetic field penetrates the skull and induces a weak
electric current that briefly activates the nerve cells in this region of the brain and
improves depressive symptoms. Read More

5. When Should Brainsway deep TMS be used?
Brainsway deep TMS is indicated for the treatment of depressive episodes in
adult patients suffering from Major Depressive Disorder who failed to achieve
satisfactory improvement from previous antidepressants medication treatment in
the current episode. It simultaneously treats both the left and right sides.
Frequently patients have significant anxiety with their depression and this too is
improved with TMS treatments.

6. Who is not a candidate for TMS therapy?
Brainsway deep TMS delivers a magnetic field that could cause any metal
objects that are near the device to move or to get hot. The treatment should not
be used if you have metal implants in or around your head (except for standard
amalgam dental fillings or dental implants). Brainsway deep TMS should not be
used if you have implanted electronic devices in your body chest height or
higher. These implants could cause serious injury if TMS is used. You should tell
your doctor if you have any metal devices or objects in your head or body in
order to determine if those devices could be affected by the treatment.

7. Does TMS treat OCD?
Brainsway TMS was approved for the treatment of obsessive-compulsive
disorder (OCD) by the FDA in 2018. TMS is done along with OCD exposure
response prevention therapy to provide successful reduction in OCD and
improve a patient’s quality of life. Insurance coverage for TMS treatment for OCD
is becoming more common. Read more.

8. Does TMS improve anxiety and other mental illnesses?
TMS has been successful for treating bipolar depression, anxiety, addiction, and
other mental illnesses. The treatment involves magnetic stimulation of brain
structures and networks to the appropriate areas of the brain and can bring
significant improvement to patients. However, these applications are not yet FDA
approved and thus are considered an off-label use.

9. Does TMS have side effects?
The safety of Brainsway deep TMS was demonstrated in a clinical study
involving 233 patients with moderate to severe Major Depressive Disorder. The
patients ranged in age from 22 to 68 years old. Long term safety has been
demonstrated in a clinical study. During a course of 16 weeks of ongoing
treatment, the therapy was safely tolerated. Furthermore, no negative effects of
treatment were seen during a 3-month follow-up period. Longer term effects of
the exposure to the treatment are not known. However, exposure to other
devices (such as MRI scanners) with the same type and strength of magnetic
fields produced by Brainsway deep TMS coil are not associated with significant
short-term or long-term safety concerns.

10.Can TMS therapy go wrong?
There was one case of a seizure reported in the above mentioned safety study.
This seizure was due to high alcohol consumption during the night before the
treatment. 3 more seizures out of 50,000 treatment sessions were reported in
other studies using Brainsway deep TMS in subjects on high doses of
antidepressants which are known to increase the risk of a seizure. A seizure
triggered by TMS is generally brief lasting only while the stimulation is being
applied. None of the people who have experienced Brainsway deep TMS
induced seizure during the studies have suffered lasting physical effects.
Generally it is recommended to forgo treatment if you have had less than 4 hours
sleep the night before and also to avoid use of alcohol during your TMS
treatment course. Both of these (inadequate sleep, alcohol use) increase the risk
of a seizure in someone, regardless of seizure history, during a TMS treatment.
You should discuss with your doctor if you have had a seizure, or if you have a
medical condition or change in a medical condition which may put you at
increased risk of having a seizure, i.e. brain injury, change in medications,
change in electrolyte balance, ect. Your doctor will decide if it is appropriate for
you to receive Brainsway deep TMS treatment.

11.Is there any discomfort from the TMS treatments?
There are reports of headaches, discomfort from a tapping sensation, and jaw
discomfort in some patients. During TMS a clicking sound is emitted. Patients
must use earplugs. There have been no reports of hearing loss after the
treatment during the clinical study when earplugs were used. Usually, these
issues decrease or go away altogether with successive treatments. Let the
technician know as adjustments can be made in the helmet position.

12.What side effects from other depression treatments (ie. Medications or ECT)
were not seen in TMS clinical trials?
There were no deaths, no systemic side effects such as weight gain, dry mouth,
and sexual problems and no decline of memory function during treatment and
many people report improved clarity of thinking.

13.Is TMS worth the cost?
If you have suffered with depression and tried many medications, the cost of
TMS is worth the potential life changing improvement. In most cases, insurance
will cover a major portion of the cost.

14.What is the age cut off for TMS?
Insurance will generally cover adult patients ages 18 and up.

15.Will Medicare pay for TMS?
Medicare covers TMS for treatment resistant depression if their criteria are met.