rTMS uses an electromagnetic coil positioned on the side of the patient’s head. The magnetic field created stimulates the electrical impulses generated by the nerve cells (neurones).

In the case of Depression, the biological basis suggests that under-active regions of the brain responsible for regulating emotions have a significant role in the aetiology of Depression. By stimulating the prefrontal cortex with rTMS, the positive mood circuits within the limbic system, the brain’s emotional centre, are activated and this promotes recovery from depressive disorder and other psychiatric conditions. Repeatedly stimulating the nerve cells helps the frontal areas of the brain (responsible for thinking and impulse control) to regulate the deeper, emotional areas of the brain. This has an anti-depressant effect.

rTMS is suitable for patients who are adequately informed about the procedure and have consented to therapy. This is particularly relevant for individuals who have not experienced symptom improvement with previous treatment methods, such as various medications and psychiatric treatments.

Before the initial session, a psychiatrist with experience in rTMS conducts a comprehensive mental examination of each patient.

The procedure is administered by either a TMS technician or an accredited TMS psychiatrist during the therapy sessions. Since it is an outpatient procedure, it occurs in the office setting.

Before therapy can commence, your Psychiatrist must determine the optimal coil positioning on your head and the appropriate amount of magnetic energy for your treatment. Your initial mapping session typically lasts about 20-30 minutes.

A credentialed and trained technician with a mental health background performs the procedures for all follow-up treatments.

Here’s what you can expect during TMS:

1. You will sit in a comfortable chair. You won’t need general anaesthesia. You are not under sedation, and you’ll be awake throughout the treatment.
2. If it’s your first session, your technician will take many measurements of your head to determine where to place the magnetic coil. The measurements optimise the therapy sessions with personalised settings on the TMS machine.
3. Your technician will have you wear earplugs to minimise the clicking sound of magnetic impulses. 
4. Your technician will place the coil above the front area of your scalp. Next, they’ll start the treatment.
5. You’ll hear a clicking sound as the magnetic impulses are released. You’ll also feel a gentle tapping sensation beneath the magnetic coil.
6. The treatment can last from 3 minutes to 20 minutes. You can drive yourself home after the procedure and resume normal activities.

You’ll need to repeat the procedure 3 – 5 days a week for about 4 to 6 weeks. The exact length of your treatment depends on your response and specific condition.

Some patients may experience a headache following rTMS, typically relieved by taking two Panadol pills. Other common side effects include discomfort on the scalp at the location of stimulation, facial muscular tingling, and mild twitching around the eyes and/or facial muscles. However, these side effects are usually temporary and diminish throughout therapy.

Since treatment typically involves sessions five days a week for multiple weeks, you may need to miss a few hours of work each day. The duration will depend on your schedule, travel time, and appointment timing.

Each TMS session can vary in duration, up to 20 – 30 minutes.

You can request a medical certificate to attend your treatment sessions if needed.

If your treatment is covered by WorkCover or third-party insurance, your treating Psychiatrist can recommend leave for you for the duration of the treatment.