PSYCHIATRY SERVICES

TMS FAQ FOR CLIENts and referral partners

A comprehensive guide to Transcranial Magnetic Stimulation therapy.

This FAQ is to help identify if you or someone you know would benefit from TMS.

Individual patient suitability for TMS should be determined through proper clinical evaluation.

General TMS Information

What is TMS?

Transcranial Magnetic Stimulation (TMS) is an FDA-approved, non-invasive treatment for depression and other mental health conditions. TMS uses targeted magnetic pulses to stimulate specific areas of the brain associated with mood regulation, particularly the left prefrontal cortex, for a medication-free treatment.

What conditions does TMS treat?

FDA-approved: Major Depressive Disorder (treatment-resistant depression)
FDA-approved: Obsessive-Compulsive Disorder (OCD)
FDA-approved for Anxious Depression and Smoking Cessation
Off-label uses: Anxiety disorders, PTSD, bipolar depression, and other psychiatric conditions

Who is a good candidate for TMS?

Adults with treatment-resistant depression (failed 2+ antidepressant trials)
Patients who cannot tolerate medication side effects
Those seeking non-pharmacological treatment options
Patients wanting to avoid systemic medication effects

Who is NOT a candidate for TMS?

Patients with metallic implants in or around the head (excluding dental fillings)
Those with implanted medical devices (pacemakers, cochlear implants, etc.)
History of seizures or seizure disorders
Pregnancy (relative contraindication)

What are the side effects?

Common (mild):

Scalp discomfort or pain at treatment site
Mild headache
Light headedness
Tingling or tension around the scalp area

Rare but serious:

Seizure (less than 0.1% risk)
Hearing loss (with proper ear protection, risk is minimal)

Our Treatment Approach

At Holme Wellness, we take a comprehensive, holistic approach to TMS therapy that addresses the whole person, not just symptoms. Our evidence-based treatment protocols are delivered by an experienced clinical team in a supportive, healing environment.

Equipment & Technology:

Apollo TMS System: We utilize the advanced Apollo TMS device, which provides precise, reliable magnetic stimulation with enhanced patient comfort features and consistent treatment delivery.

Clinical Team:

Our experienced clinical team provides personalized, expert care throughout your patient’s TMS treatment journey:

Dr. Jonathan Lauter, Board-Certified Psychiatrist: Provides comprehensive psychiatric evaluation and oversees all treatment protocols
Jack Spencer, Psychiatric Nurse Practitioner: Conduct ongoing assessments and monitor patient progress throughout treatment
Alex Grassett & Jonathan Mansbach, TMS Technicians: Specially trained, certified technicians who deliver daily treatments and ensure patient comfort

Our Treatment Protocol:

Personalized Targeting Each patient receives individualized brain mapping, motor threshold determination, and coil positioning on their first visit which takes about an hour.
Acute Treatment Phase
Treatment is typically delivered 5 days per week for 4–6 weeks (about 20–30 sessions total)
- Each session lasts about 20 minutes, depending on the protocol used.
Taper Phase
Following the initial phase, treatment is gradually reduced with 3–6 additional sessions over 2–3 weeks. This step helps reinforce and maintain your progress.
- Taper Phase: 5 additional sessions delivered over 2-3 weeks with gradually increasing intervals

Session Duration:

First session: 1 hour
Daily sessions: 30 Minutes

Making a Referral

When to Refer

Patient has tried 2+ antidepressant medications without adequate response
Significant medication side effects limiting treatment
Patient preference for non-medication treatment
Treatment-resistant depression with functional impairment

Required information:

Current medications, treatment history, recent psychiatric evaluation
Psychiatric history and diagnoses
Recent PHQ-9 or other depression scale scores
Any contraindications or concerns