Repetitive Transcranial Magnetic Stimulation

Before the treatment course begins some time will be spent stimulating the area of the brain that controls muscle movement in the hand opposite to the side of the brain on which rTMS will be given. The patient may feel small twitches in the hand during this procedure. It is not painful. This procedure is done to establish how high the machine intensity needs to be sent to affect the brain in an individual patient.

During treatment, the person sits comfortably in a chair while a magnetic coil is positioned against the scalp.

The device delivers targeted magnetic pulses that create small electrical currents. This current induces a magnetic field which can pass into the brain without resistance. If the magnetic field is of sufficient strength, it will stimulate electrical activity in the nerves below the coil, this is, in superficial regions of the brain. This stimulation may be repeated many times per second and with variation and intensity: these variations will determine the effects of the stimulation- rTMS and can be applied in different ways to either increase or decrease local brain activity.

Everyone’s experience is different, but most people describe the sensation as a tapping feeling on the scalp. It may feel unusual and, for some, mildly uncomfortable at first. Most patients adjust to the sensation quickly, and any discomfort typically occurs only during the treatment session.

Treatment sessions typically take between 20–45 minutes. A standard course of rTMS is usually delivered five days per week (Monday to Friday) over approximately four weeks.

Please inform the treating team if there are any changes to your physical health or medications during your course of rTMS treatment.

Recreational drug use and excessive alcohol consumption should be avoided, as they may increase the risk of side effects, including seizures.

The following outlines some potential side effects that might be experienced during an rTMS procedure:

A tapping sensation on the scalp during treatment,

• As the magnetic field passes into the brain, it can cause stimulation of the muscles in the scalp causing them to contract.

Mild tension or aching in the head or neck, caused by the stimulation of nerves in the scalp.

• This occurs in approximately five of every one hundred (100) participants studied and will often improve rapidly with simple pain medication (e.g. paracetamol).

Discomfort is usually temporary and may be relieved with simple pain relief (e.g. paracetamol),

Seizures are very rare.

Please discuss any side effects or concerns with the treating team at any time during your care.

While rTMS is considered a safe and well-tolerated treatment, there are some risks. All patients are carefully assessed beforehand to ensure rTMS is appropriate and safe for them. 

Seizure is the most serious potential risk, although it is very rare, occurring in approximately 1 in 30,000 treatment sessions. This risk is considered comparable to, or lower than, the risk associated with some antidepressant
medications. Individuals with a history of bipolar disorder may have an increased risk of experiencing a manic episode.

Fainting can occasionally occur and is generally not harmful, although it can sometimes be difficult to distinguish from a seizure. The TMS device produces a clicking sound during treatment, which may be loud; earplugs are provided to protect hearing and minimise discomfort. 

Metal implants or objects in or near the head may heat during treatment due to magnetic fields. For this reason, it is important to inform the treating team of any metal implants or devices prior to starting rTMS.

This treatment is available to both inpatients and outpatients receiving care under a Psychiatrist at Deakin Private Hospital. Inpatients are those currently staying at the hospital, who can receive treatment as part of their admission. Outpatients can attend the hospital for their sessions and return home the same day.

Referrals are required from a psychiatrist or GP. For referral pathways, health professionals can contact our intake team.

It is important to tell your doctor and our rTMS staff about any treatments or medication you may be taking, including non-prescription medications or herbal remedies and any changes to these during your participation with rTMS. 

We typically try and avoid significant changes to medication or starting new medications that affect the brain during a course of rTMS treatment as it is likely to confuse our understanding about what might have produced any therapeutic benefits with this treatment.