Your questions, answered

TMS, or transcranial magnetic stimulation, is a non-invasive treatment that uses precisely targeted magnetic pulses to influence activity in specific brain networks. An electromagnetic coil placed against the scalp generates brief magnetic fields, which pass through the skull and induce small electrical currents in the underlying brain tissue.

Typically TMS is used when medications are not enough, or when a patient cannot tolerate their side effects. The evidence is robust for the treatment of depression, anxiety, OCD, PTSD and functional pain disorders.

The brain is an electrochemical organ. Medication works on its chemistry,
while neuromodulation works on its
electrical activity. TMS is one such
neuromodulation method.

There are different protocols for different conditions. A treatment may be anywhere from 3 to 40 minutes long.

Unlike many medications, the side
effects are minimal.
Patients typically
report a transient headache, scalp tenderness
or fatigue.

A psychiatrist determines the TMS script,
and the treatments are applied by well
trained TMS technicians.

There are no absolute contraindications to TMS, although every patient is assessed for relative contraindications first.

A psychiatrist needs to decide on your suitability. Your
own psychiatrist can refer
you, or if you self refer, a Rewire psychiatrist will first meet with you to determine the

best path forward.

Rewire clinics are in the Northern Suburbs (Willow Way, Durbanville) and the Southern Suburbs (Lavender Lane, Wynberg) of Cape Town, and in Poortview, Roodepoort, Gauteng

(Cat's Corner).

Medical aids are increasingly recognising the value of TMS, and most schemes will now consider funding applications submitted with motivation from the treating psychiatrist.

Most treatment protocols are in the region of R44 000 for the entire course. That works out to roughly R800 per session, depending on the protocol.

Yes, TMS is effective in bipolar depression.

At Rewire clinics we treat patients from 16 years to 100
years of age.

A typical course is 30 to 50 sessions. Some people feel a benefit after the first session, while others notice an improvement a month after the course is completed.

ECT remains the gold standard for severe mental illness, but it is more invasive and requires an anaesthetic. TMS is pro-cognitive, with no memory problems. Patients stay awake throughout and
can drive afterwards.

TMS is FDA approved for depression and refractory OCD, with very positive data in anxiety disorders and PTSD. The response in tinnitus is variable, but well described.

In a simple depression the efficacy of TMS is similar to that of an SSRI, without the side effects of taking a chronic medication.