What is Repetitive Transcranial Magnetic Stimulation (rTMS)

Repetitive transcranial magnetic stimulation is a type of brain stimulation therapy that is used to treat major depression. You may have this procedure if your depression has not responded to medicine and other treatments.

In rTMS, an insulated magnetic coil is held directly against your forehead. It delivers short electromagnetic pulses to specific areas of the brain responsible for mood regulation.

These electric currents stimulate nerve cells in the targeted area. You may have multiple treatments of rTMS.

Discuss with your Doctor:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.
• Any metal you may have in your body, such as a cochlear implant, spinal cord stimulator, pacemaker, stents, plates or screws.

What are the risks?

Common side effects of treatment include:

• A headache.
• A feeling of lightheadedness.
• Discomfort, twitching, or tingling in your scalp.
• Discomfort in your jaw or cheek on the side of your face where you had the procedure.

Rare side effects include:

• Seizures. These are more common in people who have epilepsy, a history of seizures, or are already taking certain medicines that can trigger seizures.
• Experiencing periods of elation or irritability and high energy (mania). This is more common in people who have bipolar disorder.
• Hearing loss. This can happen if you do not have good ear protection during treatment.

What happens before the procedure?

• Ask your health care provider about changing or stopping your normal medicines.

What happens during the procedure?

• You will be seated in a reclining chair.
• You will be given earplugs to wear.
• Your health care provider will use a machine to place an electromagnetic coil against your forehead.
• Your health care provider will use a computer program to send electromagnetic pulses through the coil to specific areas of your brain.
• You may hear clicking sounds and feel tapping on your forehead.
• Your health care provider may adjust or move the coil during your treatment session.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Keep all follow-up visits as told by your health care provider. This is important.

Care After Repetitive Transcranial Magnetic Stimulation

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• A headache.
• Lightheadedness.
• Mild discomfort, twitching, or tingling in your scalp.
• Discomfort in your jaw or cheek on the side of your face where you had the procedure.

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider. This may include pain medicines.
• Keep all follow-up visits as told by your health care provider. This is important.
• Watch for any symptoms of depression.

Contact a health care provider if:

• Your headache and scalp discomfort continue after your treatment series is done.
• You have hearing loss or difficulty hearing.
• Your depression continues or gets worse.

Get help right away if:

• You experience a period of elation or irritability and high energy (mania).
• You have serious thoughts about hurting yourself or others.