What is TMS?

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Below is a list of examples of compulsive actions that are commonly experienced by people with OCD:

• Repetitive hand washing
• Ritualised Cleaning routine
• Positioning of objects in a very specific way
• Checking locks on doors/windows, or checking appliances are switched off over and over

So how does TMS help treat Obsessive Compulsive Disorder?

Many who suffer severe OCD and their families, understand, that despite the best medical care and psychological care, often OCD symptoms are resistant to treatment and continue to cause a huge burden and reduce functioning significantly. This is why Sydney TMS is very excited to be able to offer an rTMS treatment protocol for patients with treatment resistant OCD.

rTMS technology applied for OCD uses a slow pulsing setting applied to the front of the scalp to alleviate obsessive thinking within a matter of a few months. Treatment sessions are only 30 minutes and patient have to attend at least three sessions weekly. A full course of treatment requires 30 sessions so can be completed in 6 to 10 weeks.

Before seeking rTMS for OCD, it is recommended that patients optimise treatment with medication and cognitive behaviour therapy. rTMS can be added to existing treatments to provide added relief of symptoms.

Are you suitable to receive TMS treatment?

Research in TMS is limited to adults, so patients under the age of 18 are not recommended to have TMS at this time. Sydney TMS will continue to monitor the research in younger patients. The service will be extended when the approved research becomes available. Similarly there is limited research about the safety of TMS in pregnant women.  At this stage we do not offer TMS to those during pregnancy. To read more please refer to our those who are suitable to receive TMS on our website.

Because TMS requires the generation of electromagnetic fields it is not suitable for some patients with metal implants. This includes electronic medical devices or implants particularly near the head region. Patients with active or inactive implants (including device leads). As well as deep brain stimulators, cochlear implants, and vagus nerve stimulators. It is considered safe to offer TMS to patients with cardiac pacemakers. This is because it is sufficiently far away from the magnetic field to be effected.

For more information about TMS treatment and OCD please contact the team at Sydney TMS on 1300 177 144.

For further reading on Obsessive Compulsive Disorder please follow this link.

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Theta-burst stimulation (TBS) is a novel form of transcranial magnetic stimulation (TMS or rTMS), filling the gap and providing patients with an alternative treatment for Major Depressive Disorder.  Both theta-burst stimulation and TMS are safe, tolerable and effective in treating depression with little or no side-effects. TBS works in the same way as TMS and is administered over the prefrontal cortex. The treatment inspires activity to the region of the brain responsible for mood and emotion.

How does theta-burst stimulation differ to rTMS

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Sydney TMS is open and treating patients with depression

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The campaign to reduce the threat of COVID-19 is well underway. Visiting a Sydney TMS clinic is already considered a very low risk activity. However, we have increased measures to ensure patients and staff have minimal risk of exposure to the Coronavirus (COVID-19).

Measures to combat the spread of COVID-19

The two most important ways to combat the spread of COVID19 are social distancing and personal hygiene. Our Sydney TMS offices are stand-alone clinics and are not part of a large hospital or medical centre. Our aim has always been to provide our patients with a quiet and peaceful environment. Given the current situation, our clinics provide a very a safe space to receive treatment.

We will ensure ample time for appointments, to reduce the chance of too many patients in our clinic at any time. This allows patients to enjoy quiet, private time while waiting for their treatment session to start. This not only allows for privacy but reduces possible exposure to COVID-19 form ours.

Staff hygiene practices – going above and beyond

We have always maintained a high level of hygiene throughout our three clinics. Sydney TMS patients have always experienced the following:

• An individual TMS treatment cap,
• Neck support with disposable cover,
• Treatment chairs are disinfected and covered with new barrier,
• Offices are always maintained to a high standard with regular surface wipe downs.
• Staff have always practiced a thorough hand hygiene routine. This includes washing hands and using hand sanitiser before and after each patient. In addition, staff will now wear gloves and protective face masks during treatments.

As a new measure, we will be asking patients, to complete a brief COVID-19 questionnaire recommended by the Department of Health.

Patient Hand Hygiene

We have always provided hand sanitisers for patients to use. However, we now ask patients to make use of the hand sanitisers both on arrival and departure of our clinics.

Flu-like symptoms

If you have flu like symptoms, we ask you to call our office before your next appointment. In turn, we will notify you of any risk arising from our staff develop flu like symptoms or becoming exposed to someone with COVID-19.

Feeling anxious?

As the Corona pandemic unfolds, we are aware that uncertainty is likely to amplify anxiety. We recognise this can have a significant impact on your mental health and potential for recovery. Please feel free to talk to our staff and raise any concerns you may have. We will do our best to work with you during this challenging time. We have included some further reliable links for you should you want to know the facts about the Coronavirus (Covid-19).

The health and safety of our clients is of paramount importance to us. We will continue to maintain our strict clinical standards and hygiene protocols across all our clinic.

We will also continue to track any new advice by State and Federal Health Departments and will put in place any new guidelines recommended.

If you are an existing or new client, please call us to discuss any questions about treatment in light of COVID19 on 1300 177 144.

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Why more people are turning to Sydney TMS for depression treatment?

• Private TMS Clinics – unique stand alone clinic, away from busy hospitals and medical centres
• Specialists in TMS – 100% dedicated to TMS
• Since 2014 – we were the first of our kind and we’re experienced
• Psychiatrist assessment for every patient – we want to make sure TMS is the right treatment for you
• Dedicated and Professional Team – we care and we want you to be well

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Medicare

Funding options

TMS is playing an important role in treating depression.

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Our TMS Psychiatrist consults with every patient face to face during their treatment. At Sydney TMS, we care about your well being. It is our aim to select only those patients we think will have the best chance of responding to TMS. For many people, TMS may not be the ideal treatment. Our treating psychiatrist will provide a consultation with you before you start therapy. During this time a history of your illness journey is taken and Dr Pace will discuss the treatment with you.

You will feel supported every step of the way

If TMS is appropriate for you, Dr Pace will personally explain details of TMS therapy with you. He can take you through how TMS works and what you can expect during your treatment sessions. He will also answer any questions you may have involving the therapy. It is important to us, that every person who commences TMS treatment feels 100% confident.

Sydney TMS commitment

One of the biggest advantages of coming to Sydney TMS is consulting with Dr Pace. If there is a better treatment option available to you, he will tell you. He will also communicate this with your referring doctor.

The personal approach of Sydney TMS

We are a small organisation with less than five staff members. Dr Pace is the owner and psychiatrist of each of our clinics and as such he takes a personal approach to your care. In addition to meeting Dr Pace during the initial assessment, clients also have the opportunity of meeting Dr Pace during the course of their treatment.

All of our team members are qualified, experienced and dedicated to making your treatment journey as pleasant as possible. We pride ourselves in making your TMS treatment a positive one.

We want you to feel comfortable

Family members are an important part of your recovery. We recognise the role that family members and close friends can play in your life. We welcome you to bring along a support person to help you through your treatment. They are welcome at anytime during the therapy.

We work with your clinical team

We understand that many clinicians are still trying to understand where and when to use TMS. It is important to us to educate professionals about TMS so they can best utilise our service. Communication between our staff and your treating team is essential. We will communicate formally and informally over the course of your TMS treatment.

Making therapy easy for you

We have thought a lot about the environment we have created for our clinics. All of our locations are close to both public transport and free parking. Our clinics are stand alone offices offering a space that is welcoming, private and stress free. Sydney TMS Clinics offer our patients the latest TMS equipment. Our offices feature new modern and comfortable furniture so our patients feel at ease the moment they arrive.

Sydney TMS – always improving

It is our aim to strive to provide the best service to our patients. We build on our reputation and continually improve the experience we offer. We welcome your feedback and suggestions. Sydney TMS is also an ISO accredited business ensuring the best quality product.

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So what are the facts on Transcranial Magnetic Stimulation (TMS)?

TMS is a treatment used to relieve depression symptoms. During treatment, magnetic fields stimulate that part of the brain which regulates mood. The treatment has been available in Australia for over a decade. It has been used to treat depression around the world for over twenty years. There is a great deal of medical research supporting the treatment. It is TGA approved and endorsed by medical professionals world wide.

TMS therapy is the recommended treatment of depression when other treatments have failed. Those patients, who have not responded to antidepressant medications should consider the treatment. There are many reasons why doctors are recommending it for depression patients:

• Not everyone can tolerate antidepressant medication due to the multitude of side effects
• Some people find it difficult taking medication
• Many people are looking for an alternative to medication therapy

Get the Facts on Transcranial Magnetic Stimulation Side Effects

The side effects associated with TMS are mild in comparison with antidepressants. The most common side effects include:

• scalp irritation,
• facial muscle twitching
• mild headaches.

Many patients who experience some of the side effects find that they improve as the treatment progresses. Headaches can also be treated with paracetamol. Compare these with side effect of antidepressants:

• stomach upset
• dry mouth
• tiredness
• weight fluctuation
• sexual dysfunction

How does TMS actually work?

A magnetic pulse is generated by a coil that is positioned above the prefrontal cortex area of the brain. Magnetic pulses pass through to  the underlying brain, stimulating the neurones. The stimulation aims to improve brain activity here.

When looking at your treatment options, it is vital to consult your treating doctor. Not everyone is a suitable candidate to receive TMS treatment. If you have problems determining your own suitability, we can help you. Our in house psychiatrist will conduct a thorough individual assessment.

Can TMS be used in conjunction with other therapies?

Yes. It is possible to undergo the therapy whilst also taking medication or other psychotherapy treatments. It is important to let our psychiatrist guide you through the management of your treatment.

Please note, that TMS therapy is not recommended if you are also having ECT (electro-convulsive therapy)

How effective is TMS therapy?

There is now an extensive body of research supporting the effectiveness of the therapy in the treatment of major depressive disorder. Patients who have major depression and resistant to antidepressants should consider it. Research suggests that approximately 50% of patients will experience an improvement in depression symptoms after TMS treatment.  At Sydney TMS, we closely monitor our results and have found that we have a 60% response rate. When you compare this to 30% response rates for antidepressant medication, you can appreciate that TMS can play a very important role.

The first session is an assessment by a psychiatrist to determine suitability. Who can receive TMS treatment?

• Diagnosed with Depression by a medical doctor
• Must be over 18 years of age
• Tried two or more antidepressant medications
• Must not be pregnant
• Must not have any metal implants above the shoulder

We recommend you bring along a doctor’s referral when you come along to your assessment. Click here for a copy.

This link will take you to our referral form and provide you with an outline of everything you need. If your referring doctor would like to discuss your situation with our psychiatrist please use this link.

For more information about TMS please refer to the following:

The Royal Australian and New Zealand College of Psychiatrists

Blackdog Institute

Beyond Blue Community Forum

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The most commonly asked question we receive, is whether the cost of Transcranial Magnetic Stimulation (TMS) is covered by health care funding. To answer this, it is important to understand there are many different types of health care funding.

Medicare

Medicare funds medical treatment outside of hospital (outpatient care) such as seeing a GP or a psychiatrist. As TMS is an outpatient treatment, the obvious funder would be Medicare. The College of Psychiatrists in Australia (RANZCP) has submitted several requests to the federal government to a TMS item number to Medicare. The last such submission happened in 2018. A result to the latest submission is due in the second half of 2019. Unfortunately until this time, TMS continues to not receive Medicare funding.

Defence forces funding

Past and present defence force personnel, such as army, navy and airforce have a separate funding pool to Medicare. If someone who’s medical care is covered by this fund and has been diagnosed with Depression then TMS can be covered. Usually this requires an assessment and application form being submitted.

Workcover

People who’s medical care is covered by workers compensation or workcover, who have been diagnosed with Depression, then TMS can be paid for by their insurer after an assessment and application is submitted.

Health insurance

Health insurance such as BUPA, HCF etc usually pay for medical care delivered in a hospital setting (inpatient care). So they do not generally cover TMS treatment. There are private hospitals in Australia that do use TMS for patients admitted to hospital . So in some situations health insurers may cover TMS delivered to hospital patients.

Other insurers

Third Party that might pay for medical care in accidents or Life insurance companies may also pay for TMS treatment. This would require an assessment and application submission.

What is Transcranial Magnetic Stimulation?

As the name implies, TMS uses magnetic therapy to target that part of the brain that controls mood. The magnetic pulses reignite neurones that may have become inactive over time. In Australia, TMS helps patients with depression or Obsessive-Compulsive Disorder. TMS is an approved treatment when depression symptoms are resistant to medication therapy. It is also a treatment used for patients with OCD (obsessive compulsive disorder)

Is TMS effective in the treatment of depression?

TMS has the support of hundreds of research studies showing its effectiveness in treating depression. For patients where previous treatments have not worked many people do not have a lot of choice. Electroconvulsive (ECT) therapy is often the next option provided when everything else has failed. TMS plays a vital role for clinicians and patients with depression, as it fills the gap between antidepressants and ECT.

How can patients receive funding for TMS therapy?

As discussed above, several groups who’s medical care is payed by government bodies should contact their case workers. Organisations like veterans affairs or workcover would be able to advise if funding is available for TMS treatment. Unusually the case manager will contact Sydney TMS and book an assessment to see if TMS is a suitable. After the assessment, our psychiatrist will provide the case manager with a report as to the suitability of TMS. Associated costs for the treatment are also provided. If the case manager approves TMS funding, then treatment can commence within a week or two after the assessment.

Why choose Sydney TMS for your treatment?

At Sydney TMS we believe that there are significant advantages for the patients receiving TMS in an outpatient clinic. The main one being that the patient can go on with their own routine whilst undergoing treatment. There is no need to be hospitalised to receive TMS as no sedation or anaesthetic is required. The patient can travel to and from treatment sessions and going about their day to day business. They can also bring along a family member or friend for each session. At the end of the day, the patient can return to enjoy the comforts of their own home. At Sydney TMS we have developed several treatment programs and payment plans to make TMS as accessible as possible. So we recommend making an obligation free appointment to assess if TMS is suitable for you. During this assessment, we can also discuss in length with you the fees, costs and payment plans available to you. We believe we are the most competitive TMS service in NSW, so make sure you come in to see us for an assessment and quote.

Please visit our website or follow us on Facebook as we will publish updates as they occur.

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