Home / Deep TMS
Deep TMS for depression and OCD
Deep transcranial magnetic stimulation (Deep TMS) is an FDA-cleared treatment for adults with depression that has not improved enough with antidepressant medication, and for adults with obsessive-compulsive disorder (OCD). You stay awake throughout, and you can drive yourself home afterward.
Scheduling your TMS evaluation: what to expect
You can request your first visit online. Booking holds a time for you; it does not start treatment. Our team will verify your insurance benefits, and you will complete your paperwork online in our secure patient portal (Osmind).
Insurance
- Buckingham Advanced Psychiatry is in-network with select commercial plans. Coverage varies by plan, and we do not accept every plan.
- The online form does not ask for insurance. After you book, our team will contact you to collect your insurance information and verify your benefits.
- TMS may require prior authorization from your plan. Coverage for depression and OCD can differ, so we cannot promise coverage until your plan confirms it.
- We verify your benefits and will share what your plan indicates before treatment starts, so you can make an informed decision. Final costs depend on your plan's determination.
Costs and cancellations
- If your plan does not cover part or all of a service, you are responsible for that portion. We will go over this with you before you agree to proceed.
- Financial responsibility and cancellation information is included in the paperwork you will review before your first visit. Please ask us if anything is unclear.
Privacy
- The online scheduler asks only for your name and the type of visit. Please do not enter medical details, symptoms, or insurance IDs in scheduling or by regular email.
- Your health information is protected under HIPAA. Our Notice of Privacy Practices and communication consent are part of your paperwork.
- We share information with other providers or your insurer only as needed for your care and payment, or when you give written permission.
Paperwork, completed online in Osmind
- Patient intake and health history
- Consent to evaluate and treat, and consent for communication (phone, text, email)
- Notice of Privacy Practices acknowledgment
- Financial responsibility and cancellation information
- A photo ID and your insurance card (front and back)
Your evaluation is a medical visit with a physician, who will decide whether Deep TMS is appropriate for you. Booking does not guarantee you will be a candidate.
For non-urgent scheduling only. If you are in crisis or having thoughts of harming yourself, call or text 988 or go to the nearest emergency room. Individual results vary.
What Deep TMS is
TMS uses magnetic pulses to stimulate specific areas of the brain involved in mood and in the repetitive thoughts and behaviors of OCD. Over a course of treatment, repeated stimulation is thought to change how these circuits work.
BrainsWay's Deep TMS uses a helmet with a specially designed "H-coil." It is designed to reach a broader and deeper area of the brain than the figure-8 coils used in conventional TMS. Different H-coils are used to target the areas involved in depression and in OCD.
Deep TMS is not electroconvulsive therapy (ECT). It does not cause a seizure, does not require anesthesia, and it has not been shown to affect memory.
Is Deep TMS right for you?
BrainsWay Deep TMS is FDA cleared for adults with major depressive disorder whose current episode has not improved enough with antidepressant medication. For depression, it is also cleared to reduce anxiety symptoms in people with depression and anxiety, and for adults up to age 86.
It is also FDA cleared as an add-on treatment for adults with OCD, alongside the medication or therapy you already receive.
It may be a fit if you
- Are an adult with major depression or OCD
- Have tried medication, and for OCD often therapy too, without enough benefit, or couldn't tolerate the side effects
- Can come in five days a week during the main part of treatment
Deep TMS is not safe if you have
Metal implants in or around the head (standard dental fillings are fine), or implanted electronic devices anywhere in the body, such as a pacemaker, cochlear implant or neurostimulator. We also review your seizure history, medications and alcohol use during your evaluation.
A typical course for depression
- Each session
- About 20 minutes of stimulation, and shorter with some protocols. Plan on a short visit.
- How often
- Five days a week for about four to six weeks, often followed by a period of less frequent sessions
- During treatment
- You sit in a chair, awake, wearing earplugs. You'll hear clicking and feel tapping on your scalp.
- Afterward
- You can drive and go back to work or your usual activities right away
- Medication
- Most people stay on their current medications. We review them with you before starting.
- First session
- Includes mapping, which finds the right position and strength for your treatment. It takes longer than later visits.
Your psychiatrist will set your exact schedule and protocol. Improvement is usually gradual, and many people don't notice a change until several weeks in. Not everyone responds to TMS, and we'll be honest with you about how likely it is to help in your situation.
Deep TMS for OCD
BrainsWay's OCD treatment uses a different coil (the H7) than depression treatment, aimed at brain circuits involved in obsessions and compulsions. It is FDA cleared as an add-on treatment for adults with OCD.
How OCD treatment differs
- Sessions are daily, five days a week, for about six weeks.
- Each session takes about 20 to 30 minutes.
- Right before each session, a staff member briefly guides you to bring up your OCD thoughts. This is part of the treatment protocol and is kept short and supported.
- You keep up your current therapy and medications unless we agree on a change.
Insurance coverage for TMS for OCD varies more than coverage for depression. We check your plan before you start.
Side effects
The most common side effects are headache and discomfort or pain at the treatment site. These are usually mild and tend to lessen after the first week or so.
Seizures are rare. They have mostly occurred in people with other risk factors, such as heavy drinking before a session or high doses of certain medications. We screen for these before you start and ask about them during your course.
For full safety information, see BrainsWay's safety information.
Coverage for TMS
Coverage for TMS depends on your plan. Call us at (484) 212-6067 and we'll check your benefits, explain your costs and handle any prior authorization before you start. More about insurance
Off-label TMS
Doctors sometimes use an FDA-cleared treatment for a condition that isn't on its label, based on research and clinical judgment. This is called off-label use. It is legal and common in psychiatry, but the evidence is usually more limited than for the cleared uses.
We may consider Deep TMS off-label for the conditions listed here, after a detailed evaluation.
Bipolar depression
Studies of TMS for the depressed phase of bipolar disorder, including randomized trials, have had mixed results. TMS can occasionally trigger hypomania or mania, so we review your mood-stabilizing treatment first and watch closely for mood changes during the course.
Post-traumatic stress disorder (PTSD)
Evidence for TMS in PTSD comes mainly from smaller clinical trials. It is best considered alongside trauma-focused therapy, not in place of it.
Cost
Insurance rarely covers off-label TMS, so these treatments are usually self-pay. We'll go over the expected cost and the likely benefit with you before you decide.
Frequently asked questions
Does TMS hurt?
Will I need someone to drive me?
What if I miss a session?
Do you treat adolescents with TMS?
Can I keep seeing my therapist during TMS for OCD?
Ask whether Deep TMS is right for you
Monday–Friday, 9:00 a.m.–5:00 p.m.