TMS Informed Consent

What is TMS?
Transcranial Magnetic Stimulation (TMS) is a non-invasive, painless and safe treatment used primarily to relieve treatment-resistant depression and Obsessive-Compulsive Disorder. TMS directs recurring magnetic field energy pulses to stimulate nerve cells in the brain.
Procedure
TMS therapy involves a series of treatments, given per day, 5 times per week, over a period of 4-6 weeks. Before beginning the TMS procedure, you will be asked to remove any metal or magnetic sensitive objects (e.g., jewelry, keys, credit cards). The insulated magnetic coil will be gently placed over the side or on top of your head. During the procedure, you will hear a clicking sound and feel a tapping sensation on your scalp. Because TMS produces this clicking sound with each pulse, you may wear earplugs for your comfort and care. A trained clinician will be monitoring you during your treatment. You may stop the procedure at any time.
Are there any risks?
As with any medical treatment, TMS carries a risk of side effects. However, TMS is generally well-tolerated. During the treatment, you may experience facial twitching or uncomfortable sensations at the treatment site while the magnetic coil is turned on. You should inform your clinician if this occurs. The treatment staff may then adjust the stimulation settings or make changes to where the coil is placed in order to help make the procedure more comfortable for. In addition, patients treated with TMS may experience headaches. Both discomfort and headaches tend to get better over time and the headaches generally respond very well to over- the counter pain medications. Because the TMS device produces a loud click with each pulse, you have the option to wear earplugs during treatment to minimize any risk of hearing impairment. As with all antidepressant treatments, there is a small risk for the emergence of mania with TMS therapy. If you notice these symptoms, you should alert your doctor immediately. The most serious known risk of TMS is the production of a seizure – this risk is extremely small. You should let your doctor know if you have a history of a seizure disorder, as it may influence my risk of developing a seizure with this procedure. The TMS team follows up- to date safety guidelines for the use of TMS that are designed to minimize the risk of seizures with this technique. Any signs or symptoms of worsening depression should be reported immediately to your doctor. You may want to ask a family member or caregiver to monitor your symptoms to help you spot any signs of worsening depression. There are no known adverse cognitive (thinking and memory) effects associated with TMS therapy. There are alternatives to TMS – please feel free to ask if you have any further questions.