TMS
Behavioral Health & Psychotherapy Services Located in Fairfax, Vienna and Sterling, VA, and North Bethesda, MD
Our Mission and philosophy
Our mission is to do our best to safely reduce suffering in the world and find better ways to strengthen mental health wellbeing and share our knowledge with others so they can do it over again. We believe that practicing medicine is about providing outstanding service. This is about keeping things simple, pleasant, predictable, and going the extra mile to assist a patient. It often was taking more time to talk about the concerns so that the patient is feeling comfortable with the treatment they are undergoing.
Our passion is to educate our clients, keep them well informed about each step of care, and empower them to invest in their mental health and physical wellbeing.
In medicine, not all questions, unfortunately, could be answered, but what we should be able to always provide is great service, clear communication, and compassionate care. Innovation in medicine, as in many other fields, necessitates aways asking if there is a more sophisticated way of doing things. While we respect the knowledge we possess, we must also continue asking about how we can achieve better results or outcomes.
At Inspire TMS, we are at the forefront of innovation in Mental Health. By utilizing state-of-the-art technology, we make every effort to reduce the symptoms of depression, anxiety, and other mental ailments. We respect all cultures, ethnicities, and backgrounds and are enthusiastic to hear our patients’ stories to better guide care. During TMS, we support positive wellness practices, help enhance lifestyle modifications, and incorporate TMS therapy into a patient’s treatment program.
What is tms AND HOW DOES IT WORK?
Transcranial Magnetic Stimulation (TMS) is an FDA approved, safe, non-invasive, outpatient magnetic therapy used to treat Major Depressive Disorder and other mental health conditions.
TMS uses MRI-strength magnetic waves to stimulate the brain in areas responsible for emotion and mod regulation, which is often under-active in patients with depression and other mood disorders. For depression this area is the dorso-lateral prefrontal cortex (DLPFC). The DLPFC connects all the different brain areas that are involved with depression.
IS TMS RIGHT FOR YOU?
TMS is a safe neuromodulatory therapy that has been cleared by the FDA since 2008 for patients with depression who have failed to achieve satisfactory improvement from tow prior antidepressant medications at or above the minimal effective dose and duration in the current episode.
- Who have tried > 2 anti-depressant medications and still depressed.
- Have intolerable side effects to the medications.
- Have psychiatric comorbidities such as ptsd, anxiety, ocd.
- Have medical comorbidities such as chronic pain and fibromyalgia.
tms contraindications
The only firm contraindication to TMS is the presence of a magnetic-sensitive device in the head or neck area such as:
- Cochlear implants
- Brain aneurysm clips or coils
- Implanted electrodes
- Stimulators
- Implanted cardiac defibrillators.
tms insurance coverage
TMS was first approved by the FDA in 2008; however, insurance plans did not provide coverage for TMS for many years. As of now, all major insurance companies have a positive TMS coverage policy. Below are the insurances we currently accept.
Learn More about TMS
TMS faq
Why TMS?
Depression is a treatable condition, but for some people, standard treatments such as antidepressants and behavioral therapy aren’t effective. Also, the high prevalence of medication resistance (about 33%) has been a driving force in the development and application of TMS in many psychiatric clinics today.
Who is TMS for?
In order to qualify for TMS, you need to be at least 18 years and older, have inadequate response, reduction of response over time, or no longer tolerate an effective dose of medications. If that is the case, talk to your provider to add TMS into your customized treatment plan.
How does TMS work?
TMS uses magnetic currents to gently stimulate areas of the brain involved in control of mood regulation. The most common stimulus target for treating depression is left DLPFC (dorso-lateral prefrontal cortex). By stimulating this area of the brain, depressive symptoms improve.
What happens in the initial appointment?
You will be seated in a comfortable recliner next to the machine. No anaesthesia or medication required for this procedure. Each patient gets their own personal white cap allowing consistent coil placement. optional earplugs are provided, if the noise generated by machine is bothersome. to personalize the TMS settings, Mapping will be performed to establish your unique treatment intensity and location. You will then proceed to TMS treatment, which varies from 3 min to 20 min, dependent on your individual treatment protocol. During the treatment you will relax and remain awake. You can watch TV, listen music, read or talk. At the end of your sessions, you can drive and return to your day as normal.
How long does the full TMS course last?
TMS treatment requires 5 treatment sessions per week. The whole course of treatment can take from 4 to 6 weeks, dependent on your individual treatment plan. It is important to understand that there is a high inter-individual variability in baseline neurophysiology hence some TMS plans may require a different protocol or timing (either shorter or longer), in order to be effective.
Are there any contraindications to TMS?
The only absolute contraindication to TMS is the presence of an implanted (non-removable) magnetic-sensitive device within head or neck area, such as cochlear implant, brain aneurysm stent, deep brain stimulator, cardiac pacemakers, etc. The magnetic coils could cause sensitive metals to heat or shift, putting you at risk for injury. Having a current medical condition that can increase your probability of seizures is a relative contraindication that needs to be discussed with your neurologist before you could start TMS.
Does TMS have any side effects?
The most common side effect to TMS include application site discomfort which is mostly tolerable and subside in intensity during the treatment course. Treatment parameters and the position of coil can always be adjusted to enhance patient comfort. The seizure risk, according to the most recent data, is less than 0.1% over an entire treatment course. Each patient is carefully assessed prior TMS, eliminating the risk factors that can increase seizure potential.
| TMS | Antidepressants |
| No | Dry Mouth, Indigestion, Upset Stomach |
| No | Long-term Weight Gain, Changes in Appetite |
| No | Lower Sex Drive |
| No | Increased Suicidal Ideation |
| No | Insomnia |
Is TMS the same as shock therapy?
TMS is absolutely different from shock or ECT therapy. ECT is more invasive procedure, administered in a hospital under anesthesia. While ECT may have a significant recovery time and affects cognition and memory, TMS is an office based procedure that requires no hospital stay or recovery time, and patients report few to no side effects.
Will my insurance cover TMS?
TMS therapy is covered by all major insurances besides Medicaid (if primary/sole coverage). Prior starting the treatment, we determine any remaining deductible, copays, or coinsurance that you may owe. If you are pursuing off-label treatments (TMS for anxiety, PTSD, etc. ) that are not covered by insurance, we offer a sliding scale based upon your household income. PTSD, anxiety, and other psychiatric conditions often co-exist with Depression. When using insurance for depression treatment, we waive any fees associated with an off-label treatment targeting other symptoms.
Is TMS used to treat anything other than depression?
Anxiety, PTSD, and OCD are often treated with TMS. There is evidence that TMS may be helpful to treat schizophrenia, fibromyalgia, along with Migraine Headaches, Bipolar Disorder, Parkinson disease, Multiple Sclerosis etc.
Will TMS affect my current medications?
While TMS is highly effective as monotherapy for depression, in clinical practice, some patients will continue taking their antidepressant medications while receiving TMS. Medications are also utilised as a maintenance strategy after completion of TMS course. According to the consensus of Clinical TMS Society, “TMS can be administered with or without the concomitant medications” and “there is no evidence of an increased risk of adverse events by combining medications with TMS” (Perera et al. 2016, p. 344).
How Successful is TMS therapy?
Success rates and individual results will vary, as might be expected based on the unique neuronal properties and inter-individual variability in baseline neurophysiology. Yet TMS is successful in more than 70% of people, meaning that most patients who undergo TMS treatment experience relief in their symptoms. About 50 to 60% of patients go into full remission, meaning they become asymptomatic after one full course of TMS. Maintenance TMS therapy sessions may be performed in the future, if necessary.