Mclean Hospital

Transcranial Magnetic Stimulation (TMS) Service

Support for Individuals With Depression

The Transcranial Magnetic Stimulation (TMS) Service is dedicated to improving the quality of life for individuals with depression, particularly treatment-resistant depression.

Our program uses TMS to treat severe depression and is particularly helpful for people with depression who have not experienced significant relief from antidepressant medications or have difficulty with side effects.

For more information or to make a referral, please call 617.855.2360.

TMS Service in the News

Read the Boston Globe article on TMS treatment for depression.

Watch this video on TMS from our friends at Brainsway.

Treatment Approach

Transcranial magnetic stimulation (TMS) uses focused magnetic impulses to non-invasively stimulate the brain in the pre-frontal cortex (the region of the brain associated with mood regulation).

TMS is non-invasive and requires no anesthesia or sedation. The procedure typically lasts less than an hour. During this time patients are awake, alert and comfortable. There are no restrictions on work or other activity before the treatment. Because no medications are administered, there are no systemic effects or cognitive after-effects (memory difficulty or ability to concentrate). Therefore, patients can return immediately to regular activity.

Patients typically receive 20 to 30 treatments over four to six weeks (five times per week). There may also be a taper phase. The course of treatment will vary according to each individual.

An initial assessment will determine the appropriate dose of the magnetic pulse and the exact area of the brain the coil should target. As the treatment progresses, the clinician will conduct periodic re-evaluations of the dose level and coil placement.

Readout screen for transcranial magnetic stimulation
TMS is a proven treatment for individuals with severe and treatment-resistant depression

During a treatment session, the patient sits in a comfortable reclining chair. A headset is applied to deliver the magnetic stimulation. Ear plugs are also provided to decrease the loud clicks associated with each magnetic pulse. Patients are given the option to watch television, listen to music, or simply relax during the treatment session. During treatment, the patient is monitored continuously to ensure correct coil positioning and comfort level.

Our collaborative team approach is aimed at maximizing the effectiveness of psychotherapy, medication management, and psychosocial treatments already offered at McLean with emerging techniques, technologies and interventions like TMS.

Admission & Cost

Admission

The Transcranial Magnetic Stimulation (TMS) Service is ideal for individuals with severe or treatment-resistant depression.

For further information about our program, please contact our admissions coordinator:

Phone: 617.855.2360

Referring clinicians should fill out the TMS Referral Form so that we may determine whether the program is good fit for the individual and gather the appropriate patient information. A completed referral form is required prior to treatment.

Cost

Coverage for TMS by public and private insurers varies greatly. While McLean Hospital accepts Medicare, Massachusetts Medicaid, and many private insurance and managed care plans, it is best to contact us or your insurance provider to determine TMS coverage. Precertification according to eligibility criteria is required.

More information on insurance providers accepted by McLean Hospital may be found on the Partners HealthCare website. You may also find it beneficial to review McLean’s patient billing and financial assistance information.

Treatment Team

Program Leadership

Oscar G. Morales, MDOscar G. Morales, MD, Medical Director

Dr. Morales is responsible for all TMS activities at McLean, including clinical, training, and current investigation of TMS in treating mental health disorders. He is on the faculty for the MGH/McLean Adult Psychiatry Residency Training Program and is involved in training of Harvard students, residents, fellows, and psychiatrists.


Paula Bolton, MS, CNP, ANP-BCPaula Bolton, MS, CNP, ANP-BC, Program Director

A nurse practitioner in the Internal Medicine Department at McLean Hospital for more than 25 years, Ms. Bolton has focused on health promotion and disease prevention for psychiatric patients. She was instrumental in both the expansion of the inpatient and outpatient Electroconvulsive Therapy (ECT) Service and the development of the Transcranial Magnetic Stimulation (TMS) and Ketamine Services.

Staff and Associates

An experienced staff of psychiatrists, registered nurses, and trained technicians work together to provide an optimal TMS experience for patients undergoing the procedure for depression which has not been adequately treated with medication and/or therapy.

FAQ

Where is Transcranial Magnetic Stimulation Service located?

The program is located on the Belmont campus, in the de Marneffe Building. For more information on directions, parking, and local accommodations, please visit our Maps & Directions page.

Who benefits most from Transcranial Magnetic Stimulation?

TMS is an outpatient service that focuses on treating those who are struggling with depression, or a depressive episode, and are not responding to medications and/or psychotherapy. TMS can also be used as an added therapy when medications and therapy alone are not enough.

Is family involved in treatment?

Family can be involved in the consultation for TMS and are welcome in the TMS suite. Family members are invited to meet with the doctor periodically to review the treatment plan. In addition, nurses are available at each appointment to talk with family members and answer questions.

Is smoking permitted?

Smoking is allowed in designated outdoor areas only. No smoking is allowed inside any of our buildings.

Are cell phones and other electronics allowed?

Cell phones are allowed in the TMS suite, but we have very poor cell signal. Staff can assist with placing a call as needed. We are just below the cafeteria—which does get better signal.

Can former patients access their medical records?

All requests for medical records should be directed to McLean’s Health Information Management Department.

Are support groups offered?

To complement our programs’ services and encourage individuals’ initiatives in their own treatment course, many self-help groups are hosted by McLean.