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Repetitive transcranial magnetic stimulation

Dr Daya Howpage introducing rTMS neuromodulation
Dr Daya Howpage introducing rTMS neuromodulation

Dr. Daya Howpage holds a Ph.D. and MBA, showcasing a unique blend of scientific expertise and business acumen. With a solid educational background, Daya is a highly qualified scientist recognised for his exceptional contributions to science and mental health.

Daya is an accredited TMS (Transcranial Magnetic Stimulation) therapy provider and trainer. His commitment to advancing modern treatment for deserving mental health patients is evident through his role in training and facilitating TMS therapy. Daya actively participates in research initiatives, collaborating with undergraduate medical students at the Faculty of Medicine, University of Western Sydney (UWS).

Our rTMS services

MRI-guided TMS represents a revolutionary approach to brain health, offering precision, personalisation, and enhanced diagnostic capabilities in treating depression and PTSD.

With its potential to improve patient outcomes and advance neuroscience research, it stands at the forefront of modern medicine’s quest to unlock the mysteries of the human brain.

MRI-guided precision-focused treatment is now available at Carlingford Practice.

Advanced intermittent theta-burst stimulation (iTBS) is used for rTMS therapy at Mind Connections Specialist Health Services. Compared to traditional rTMS devices, therapeutic effectiveness is increased through iTBS by optimised intensities and shorter intervals.

rTMS is a non-invasive therapy for treatment-resistant depression. Criteria are
a) patients who have not responded to therapeutic doses of two or more antidepressant Medications.
b) Patients do not want medications because of the proven side effects.

What happens during sessions?

A treatment coil is placed on the scalp near your brow and programmed to create a magnetic field, which activates neurons in your brain. It generates electrical impulses and activates brain cells, which release neurochemicals involved in healing. The course comprised x 35 sessions, minimum x 3 sessions/week. The duration of the effects of rTMS treatment might differ. Some may progress to maintenance treatment for relapse prevention.

rTMS therapy is non-invasive and does not need anaesthesia, seizure induction, or loss of consciousness. You walk in, have the therapy session fully awake, leave the clinic and go about your day afterwards. The side effects are usually mild, transient, and can be easily managed.

What is rTMS?

Repetitive Transcranial Magnetic Stimulation (rTMS) is a non-invasive treatment that uses magnetic fields to target and activate nerve cells in the brain (neurones).

During sessions, a treatment coil is put on your scalp, near to your brow. Neurones are activated as a result of extremely tiny electrical currents created by magnetic fields. These electrical currents activate brain cells, which are proven to create neurochemicals that are involved in healing.

rTMS therapy is non-invasive and does not need anaesthesia, seizure induction, or loss of consciousness. You are fully awake during the treatment and are free to leave the clinic and go about your day afterwards. There are minimal risks with rTMS, and any side effects are usually mild, transient, and/or can be easily managed.

The duration of the effects of rTMS treatment might differ from one patient to the next. Some patients may have long-term clinical improvement, while others may only see short-term clinical improvement. Patients who show signs of improvement in the short term may benefit from recurrent therapy and/or maintenance care sessions.

Once started, therapy sessions usually last between 19-25 minutes (depending on the protocol used). rTMS therapy is typically administered five days per week (weekdays) for four to six weeks.


FAQ answers for rTMS

Patients who are adequately educated about the procedure and make an informed decision to consent to therapy, especially if earlier treatment methods (such as various medicines and psychiatric treatments) have failed to give symptom improvement.

When other types of therapy have failed to show treatment resistance, rTMS is used to treat mental health issues, such as anxiety. Although rTMS doesn’t always cause remission, it can reduce the severity of your symptoms. That means you’ll enjoy a better quality of life.

  • The FDA approved rTMS for OCD.
  • The FDA approved rTMS for treatment-resistant depression.
  • Research suggests that rTMS could trigger slow sleep waves. As a result, patients may experience a better night’s rest.
  • Specialists have started using rTMS treatment for addiction disorders, mainly when people develop depressed moods with withdrawal symptoms.
  • According to research, rTMS can effectively improve the cognitive abilities of patients with early to moderate stages of Alzheimer’s Dementia. However, the positive effects of rTMS may persist for only up to few weeks.

According to available data, the risks associated with rTMS therapy for children are minimal and typically comparable to adults.

On the day of your treatment, feel free to bring headphones and your favourite music to listen to throughout the session, as well as a bottle of water. Also, you can watch your favourite TV program during the treatment.

Since rTMS does not need sedation or anaesthetic, there is no need to fast. Remove any accessories that are magnetic or respond to magnetism.

The staff can provide you with earplugs to use throughout the treatment.

A psychiatrist with experience in rTMS conducts a complete and thorough mental examination of each patient before the initial session.

Before therapy can begin, your psychiatrist must establish the best position for the magnets on your head and the right amount of magnetic energy for you. Your initial mapping session generally last about 20-30 minutes. A credentialled and trained technician who has a mental health background  usually perform all follow up treatments

Treatment sessions range in length from 19 minutes for most cases. Patients are given rTMS 3–5 days per week for 4–6 weeks. The number of sessions may vary based on an individual’s reaction to therapy.


The TMS coil slightly touches the patient’s scalp. As a result, patients report a tapping feeling on the scalp. In addition, during therapy, some patients experience mild twitching around the eyes and/or facial muscles. However, these side effects are only present for the length of the therapy.

Compared to conventional antidepressants, which typically take six weeks to show effects, most patients report positive mood changes with rTMS as early as the first week of treatment.

The results vary from patient to patient. Some patients’ remission may last a year or longer, and some may receive four to six weekly maintenance treatments.

When you experience positive emotions, you will return to your normal personality. Generally, when patients are happy with their emotions, they function better.

Memory impairment is not caused by rTMS. In general, patients’ ability to think improves simultaneously with improved role functioning.

Some patients experience a headache following rTMS, which is usually relieved by two Panadol pills. Other common side effects include discomfort on the scalp at the location of stimulation, facial muscular tingling, spasms or twitching and light-headedness.

You are free to leave after the rTMS session. You can drive and return to work following the treatment. If you are prone to headaches, you may want to arrange for someone to drive you.

Ask for a consultation