Repetitive trans-cranial magnetic stimulation (rTMS) works by applying magnetic pulses to specific areas of the brain. The timing and duration of the pulses are adjusted to either stimulate or lower the activity level of the nerve cells in those areas, depending on what is being treated. rTMS is most often used to treat depression or anxiety, in people who have not been helped by medication.
If someone has tried two different antidepressant medications without results, a third medication has only a 20% chance or less of working. For these same people, rTMS works about 50% of the time.
Did you know? rTMS can treat:
- Anxiety
- Bipolar Disorder
- Depression
- PTSD
- Mild Cognitive Impairment and Early Alzheimer’s
- OCD
- Chronic Pain
- Tinnitus
To learn more about rTMS at MDABC, please visit our rTMS FAQ and Policies page or read our rTMS brochure.
rTMS is currently not covered by BC’s Medical Services Plan. In some situations, however, Worksafe BC or an extended health care plan may pay for the treatments.
- If your doctor has recommended rTMS as a potential treatment, please have them submit a referral (using the form at the link below) to:
- Adult Psychiatric Clinic at MDABC
- Attn: Dr. Sheehan Chowdhury
- You do not need to be a patient of MDABC to be referred for this treatment.
- If you are a General Physician and would like to make a referral
rTMS can treat:
- Anxiety
- Life can be stressful, so it’s normal to feel anxious from time to time. However, anxiety can also be excessive and persistent. If you find that your anxiety or constant worrying prevents you from completing your daily activities, this could be a sign of Generalized Anxiety Disorder (GAD). Struggling with GAD is common. Unfortunately, common treatments do not work for everyone; half of patients with GAD may not respond to first-line medications.
- Bipolar Disorder
- Bipolar Disorder (BD) is a mood disorder that affects about 2% of the population. People with bipolar disorder experience intense emotional states known as manic, hypomanic, and depressive episodes. Most patients with bipolar disorder will spend most of their time being ill in a depressive episode. Bipolar depression can be challenging to treat, and treatment resistance is common.rTMS can be an effective treatment for bipolar depression. rTMS helps modulate abnormal brain activity in circuits responsible for mood, allowing the brain to shift to a more healthy state.
- Depression
- Depression is a common but serious disorder that can affect your behavior, thoughts, and feelings. Depression is characterized by persistent feelings of sadness with a loss of interest in activities you once enjoyed. Unfortunately, many patients are treatment-resistant, meaning they have not improved even after trying two antidepressants. At this point, the likelihood of responding to another antidepressant is as low as 15% (1). Fortunately, rTMS is a highly effective option for treatment-resistant depression.
- PTSD
- PTSD occurs in people who have experienced or witnessed an extremely traumatic experience. After experiencing significant trauma, you may be left repeatedly re-living or re-experiencing that traumatic event. With rTMS, we can strengthen the brain’s ability to process traumatic memories and prevent traumatic memories from intruding into your life.
- Mild Cognitive Impairment and Early Alzheimer’s
- Dementias or Major Neurocognitive Disorders can impair one’s ability to live independently and meaningfully interact with their loved ones. Generally, people who have these diseases will progress from having mild cognitive impairment (MCI) to progressively worsening stages of dementia. Mild cognitive impairment (MCI) is not normal ageing. It occurs when there is an objective decline in cognitive abilities, but the person is still relatively independent. 10-15% of people diagnosed with MCI will convert to having a Major Neurocognitive Disorder (dementia) every year. Alzheimer’s disease is one of the most common Major Neurocognitive Disorders (dementia). Alzheimer’s is a degenerative disease in which people’s cognition will progressively decline over an average of 10 years until their death.
- OCD
- Obsessive-compulsive disorder (OCD) involves experiencing repetitive, intrusive thoughts, urges, or images that cause anxiety. These obsessions can be unwanted or even be recognized as irrational but are uncontrollable. In response to these obsessions, people may engage in compulsions which are repetitive behaviours or mental acts that the person feels compelled to engage in. For example, you may have obsessive thoughts about potential contamination, and in response, you feel compelled to repeatedly and excessively clean. Patients with OCD often experience significant problems in their daily lives as a result of these obsessions and compulsions.
- Chronic Pain
- Chronic pain causes significant disability and loss of quality of life. Up to 27% of people struggle with chronic pain. Unfortunately, medications may not always be effective, and sometimes the side effects are unbearable. A trial of rTMS for chronic pain can involve short daily appointments for 2-3 weeks. If the treatment is effective, your doctor may recommend less frequent maintenance treatments.
- Tinnitus
- Tinnitus is often experienced as a ringing, roaring, clicking, hissing, or buzzing in one’s ears. It affects up to 19% of the population and can cause significant psychological distress.(1) TMS for tinnitus involves short daily appointments for two weeks followed by less frequent maintenance treatments. The initial course may be longer if co-morbid depression is also treated.
- 1) Liang, Z., Yang, H., Cheng, G., Huang, L., Zhang, T., & Jia, H. (2020). Repetitive transcranial magnetic stimulation on chronic tinnitus: a systematic review and meta-analysis. BMC psychiatry, 20(1), 1-13.