TMS FREQUENTLY ASKED QUESTIONS
1What is TMS?
TMS is a non-invasive treatment where magnetic pulses are delivered to stimulate nerve cells in the part of the brain controlling the mood, which is often underactive in patients with depression. Repeated stimulation of this part of the brain has proven to produce an antidepressant effect on people suffering from depression. TMS is also known as rTMS (repetitive transcranial magnetic stimulation) because more than one magnetic pulse is delivered to the brain during a treatment session.
2Am I a candidate for TMS?
TMS is indicated for the treatment of major depressive disorder in adult patients who have failed to receive satisfactory improvement from prior antidepressant medication in the current episode. MagVenture TMS Therapy is available by prescription only. Your doctor will use medication dosing records and depression scores among other measures to determine whether or not you are a candidate for MagVenture TMS Therapy.
3How long does treatment take?
TMS Therapy is offered as Express TMS® which lasts 3 minutes or as standard TMS, lasting 19-37 minutes. One treatment is given per day, 5 times per week, over a period of 4-6 weeks.
4What does TMS feel like?
You sit in a chair in a relaxed position. When the magnetic pulses are delivered you hear a clicking sound and feel a tapping sensation on your head. Many patients are able to watch television or read during treatment.
5Are there any side effects associated with TMS therapy?
TMS treatment is without the side effects typically experienced with antidepressants, such as weight gain and sexual dysfunction. TMS may, for some, cause headache or nausea, but you should be able to resume your daily activities right after treatment. However, please note that TMS Therapy is a medical procedure and any side effects experienced during or after receiving the therapy should be reported to your doctor.
6Is TMS covered by my insurance?
TMS is reimbursed by most insurance providers. Their policies may, however, vary. Pre-authorization, treater requirements (MD, CMA, RNP, RN etc.), number of drug failures, to name a few, can impact claim approvals. Always refer to your insurer’s policy guides. For more information see our costs and coverage page for a list of insurance providers and more details on their policies.
SPRAVATO™ FREQUENTLY ASKED QUESTIONS
1What is SPRAVATO™?
SPRAVATO™ (esketamine) CIII nasal spray is a prescription medicine, used along with an antidepressant taken by mouth, for treatment-resistant depression (TRD) in adults. Click here to learn more about SPRAVATO™
2Are there any restrictions on eating or drinking on my SPRAVATO™ treatment days?
Some patients taking SPRAVATO™ may experience nausea or vomiting. Because of this, you should avoid eating two hours before, and drinking liquids 30 minutes before, treatment.
3What should I tell my doctor before starting SPRAVATO™
Before you take SPRAVATO™, talk to your doctor about your full medical and depression treatment history, including if you have a history of abusing prescription or street drugs or a problem with alcohol. Do not take SPRAVATO™ if you have a blood vessel disease (aneurysm), an abnormal connection between your blood vessels (arteriovenous malformation), a history of bleeding in the brain or are allergic to esketamine, ketamine or any of the ingredients in SPRAVATO™. Be sure to tell your doctor if you have any heart (e.g., high blood pressure) or brain problems (e.g., stroke or history of brain injury), liver problems, psychosis, are pregnant or plan to become pregnant or are breastfeeding or planning to breastfeed. You should not take SPRAVATO™ if you are pregnant. You should not breastfeed if you are taking SPRAVATO™. Tell your healthcare provider about all the medicines that you take, including prescription and over-the-counter medicines, vitamins and herbal supplements.
4What side effects could I experience on SPRAVATO™
Serious side effects reported with SPRAVATO™ include sedation and dissociation, and there is a risk of abuse and misuse with SPRAVATO™. There’s an increased risk of suicidal thoughts and behavior with SPRAVATO™. Call your doctor right away if you have new or sudden changes in mood, behavior, thoughts or feelings. Other possible serious side effects include increased blood pressure, problems with thinking clearly or bladder problems. The most common side effects include: Dissociation, dizziness, nausea, sedation, spinning sensation, reduced sense of touch and sensation, anxiety, lack of energy, increased blood pressure, vomiting and feeling drunk Because of the possibility of nausea and vomiting, you should avoid eating two hours before, and drinking liquids 30 minutes before, taking SPRAVATO™.
5What should I do if I miss a treatment session?
It is very important to make every effort to stay on the treatment plan that you and your doctor have made. However, if you do miss a treatment, contact your doctor as soon as possible to discuss how they would like to address this situation. It is possible that your dose or dosing frequency may be changed if you’ve missed more than one or two treatments.
6How long will I stay on SPRAVATO™?
You and your doctor will decide how long you stay on SPRAVATO™, based on how you respond to it and how stable that response is. Your doctor will determine the dosing frequency based on how you feel.
7How often will I take SPRAVATO™
You’ll take SPRAVATO™ twice a week for the first month. During the second month, you’ll take it once a week. After that, you’ll take it once a week or once every two weeks. You’ll continue to take your oral antidepressant as prescribed.
8How quickly will I see improvement of my depression symptoms with SPRAVATO™?
In clinical studies, improvement of depression symptoms was demonstrated at four weeks by SPRAVATO™ plus an oral antidepressant, compared with placebo nasal spray plus an oral antidepressant.
9What happens during the observation period after taking SPRAVATO™?
The observation period is a time right after you administered SPRAVATO™, when you will be allowed to comfortably rest, and during which a healthcare professional will check for any treatment side effects that you might experience. The observation period will last for at least two hours. Sedation and dissociation (feeling disconnected from yourself, your thoughts, feelings, space and time) are among the possible serious side effects during and after taking SPRAVATO™, and you should expect your healthcare professional to ask you about these possible side effects during this period. You should expect to have your blood pressure checked before starting treatment and periodically during the observation period, as some people treated with SPRAVATO™ have a temporary increase in blood pressure after treatment. Once your healthcare professional gives you the okay to leave, you should discuss your plans for the remainder of that day, and which activities are or are not appropriate. You should not drive or operate machinery until the day after a treatment session, following a restful sleep, even if you think you feel well enough to do so. Because of this driving restriction, you will need to plan for your rides on treatment days.
10What should I do if I don't respond to SPRAVATO™?
Not all patients will respond to SPRAVATO™. Your doctor may decide that you complete the first four weeks of SPRAVATO™ treatment to see whether or not you have had satisfactory depression-symptom improvement. If you’ve done this, talk to all of the healthcare professionals involved in the management of your treatment-resistant depression about appropriate next steps. Do not stop your SPRAVATO™ treatments without first discussing your reasons and concerns with your doctor and formulating a treatment plan with them.