rTMS Frequently Asked Questions

Does rTMS work?

Our scientific results show that after an average of 21 sessions recovery can be achieved in 78% of clients.   These results are based on a combined treatment of rTMS and psychotherapy.

Is it really that effective?

rTMS is effective in combination with psychotherapy. Furthermore, rTMS is most effectively applied when the correct assessment of biomarkers (from a QEEG assessment) is made (as shown in this study).

Can I just get rTMS without cognitive therapy?

Studies show that rTMS without counseling has a significantly lower efficacy, so we do not recommend this.

How many sessions do I need?

On average our clients need about 20 rTMS treatment sessions. For the best results treatment sessions should be held 2 or 3 times a week. Usually the client notices an effect within 8 to 12 sessions. .

Are there any side-effects in rTMS treatment?

There are some side-effects in rTMS treatment. Some patients experience a transient mild headache which is often easily remedied with a light painkiller. During discharge of the coil you will hear a 'click' sound and the volume depends on the strength of the stimulation. This may have a temporary effect on hearing so patients can choose to wear earplugs.

Extensive trials in rTMS have ensured its safety as a treatment method. During the research phase in rTMS there was one instance of a patient having a seizure. The risk of a seizure is dependent on many individual characteristics.  People with a history of epilepsy have an increased risk of experiencing a seizure during TMS.  A QEEG test is a means to assess this risk. 

We comply with the internationally established safety guidelines and the risk of a seizure for people with no medical history of epilepsy or other condition is very limited.

Is rTMS painful?

People undergoing rTMS describe the 'magnetic taps' as irritating, but not painful. After a few sessions clients often get use to this feeling.

Does rTMS really have a long term effect?

We tentatively conclude that the effects of rTMS in combination with psychotherapy lasts at least six months for the majority of clients. However, a number of clients opt to return for follow-up treatment once a month or once every 2 to 3 months to maintain the effects or to prevent relapse. 

Research shows that after six months depressive symptoms are significantly lower than at intake.

How is rTMS different from Electroconvulsive Therapy (ECT)?

Research has shown that in the treatment of unipolar depression, rTMS is as effective as Electroshock therapy or Electroconvulsive therapy (ECT). However, unlike Electroshock therapy or ECT clients do not require hospitalization and the side-effects are not as severe.

In ECT electric currents are distributed across the brain and there is a heightened risk of memory loss, rTMS on the other hand targets a specific area of the brain.

What is the difference between rTMS and Neurofeedback?

Neurofeedback is a method that has been extensively studied in the treatment of ADHD, sleep and epilepsy. However, there is very little controlled research done on the effects of neurofeedback on depression. For this reason Neurofeedback cannot be seen as an evidence-based approach to treat depression. rTMS is extensively studied in the treatment of depression and therefore has a greater chance of treatment success.

Can anxiety also be treated with rTMS?

Anxiety is an illness which is common in people with depression and is often treated with psychotherapy. rTMS in combination with psychotherapy may be a recommended treatment to help patients with anxiety disorders.

Can I drive myself home after treatment?

Unlike some medications, rTMS does not affect your ability to drive. The experience of intensive treatment, however, can be tiring. If you would not feel comfortable driving after this experience you would be advised to ask a friend to drive you home after a treatment session.

Should I stop taking antidepressants?

If you are considering phasing out your intake of antidepressant medication rTMS is a recommended treatment for this period in order to avoid relapse. It is not necessary to entirely eliminate medication before the treatment starts and antidepressant medication can still be taken throughout the treatment period. Any changes to your medication should be made in consultation with your prescribing doctor or psychiatrist.

Why is a QEEG assessment required?

This is for two reasons. The first is safety. We review the QEEG to decide whether you are eligible for treatment. Certain brain activity is found in about 5% of the population which does not make treatment with rTMS possible. This activity increases the possibility of seizure and in such cases we would first seek the approval of a neurologist if treatment were to start.

The second reason we conduct a QEEG assessment is so we are better able to personalize the treatment in order to improve the efficacy of rTMS for the individual client.

Who qualifies for rTMS?

A diagnosis of depression may qualify an individual to undergo rTMS.

rTMS is not recommended for people who:

• have epilepsy
• are pregnant / planning to get pregnant

Furthermore, we first contact your prescriber if you have used the unregistered drug Parnate.

Would I be eligible for reimbursement via a private or public insurance provider?

Eligibility for reimbursement changes in each country and also depends on your health care provider. You will need to contact your clinic to find out more.

Do I need a referral from my GP?

A referral is not necessary but in some cases it may be necessary for reimbursement from a health care provider.