Frequently Asked Questions

  • TMS, or Transcranial Magnetic Stimulation, is a safe, effective, FDA approved treatment for depression.

    TMS uses a targeted, pulsed magnetic field (similar to what an MRI machine uses), to stimulate the right prefrontal cortex, which tends to be under-active in patients with depression.

  • A typical acute phase of TMS consists of 36 treatments. For the first 30 sessions, most patients will come in Monday through Friday for 6 weeks. Then, for the last 3 weeks, they’ll taper off—3 sessions the first week, 2 the next, and 1 session in the final week.

    The first appointment will take about an hour-and-a-half to 2 hours. But after that, each session shouldn’t take more than 30 minutes—starting from when you walk in the door, to when you leave the office.

  • The sensation of the pulses is an unfamiliar feeling to most patients, but they often relate it to a moderate to more intense tapping sensation. That being said, many patients who found it uncomfortable in the beginning barely notice it within a few sessions. Your comfort will always be our priority, though, so we will work with you to make your treatment as easy as possible.

  • Because no two people are alike, each person will have a different experience. In general, most people will start to notice a difference between 2-3 weeks of treatments.

    However, some have reported a difference from the first day, and others have reported not noticing a difference until after the 36 treatments were over.

  • The major contraindications (or conditions that would make TMS unsuitable for you) are the following:

    +Seizure disorder, or a history of seizures

    +Magnetic-sensitive metal in your head that cannot be removed, such as aneurysm clips or coils, stents, electrodes, ferromagnetic implants in your ears or eyes, or (heaven forbid) bullet fragments

    +Implanted stimulators in or near the head, which may include deep brain stimulators, cochlear implants, or vagus nerve stimulators

  • In a study published about patients who received treatment with the NeuroStar® device, 58-83% of patients experienced an improvement of symptoms, and 28-62% experienced symptom relief or remission. Since treating our first patient at Advanced Psychiatry & TMS Clinic, we has seen comparable results with all of our patients.

  • The effects of TMS will last beyond the 36 sessions, with many patients reporting improvements even after the full course of treatment is complete.

    Although long term data is rare, one study by David Dunner, MD, found that out of the people who respond to TMS, more than two-thirds reported feeling just as much relief a year after the treatment was complete.

  • As a treatment for depression, TMS is a noninvasive method of delivering mild electro-magnetic pulses to the part of the brain that regulates mood. During treatment, a cushioned coil is placed on a specific spot of the scalp. Then, a rapidly alternating current passes through the coil, which produces a magnetic field that converges on the left dorsolateral prefrontal cortex. Depending on stimulation parameters (frequency, intensity, pulse duration, stimulation site, etc.), repetitive TMS (rTMS) for the treatment of depression, increases the excitability of the affected brain structures.

    The procedure is carried out in an outpatient setting and does not require anesthesia or analgesia.

    As an antidepressant therapy, TMS produces a clinical benefit without the systemic side effects indicated with standard oral medications.

    TMS does not have adverse effects on cognition.

    All treatments are administered by a qualified psychiatrist or under the direct supervision of the psychiatrist.

  • The most common side effects are pain or discomfort at or near the treatment site, or a mild headache. However, these side effects are temporary, and usually subside after the first week.

    Our treaters will always work with you to ensure your treatment is as comfortable as possible.

    There is an extremely rare risk of seizure associated with TMS therapy, which has been reported in less than 0.1% of patients.

  • TMS is indicated as a treatment for Moderate to Severe Major Depressive Disorder.* Most insurances will require prior authorization before they will pay for treatment.

    On average, insurances will want proof of the severity of your symptoms, that you have tried between 2 and 4 antidepressant medications, and that you have been working with a therapist.

    Each insurance is different, though, so it will be important to talk to our office staff to find out what your insurance will require specifically. In certain cases, your insurance may even require less.

    *For questions about OCD treatment, please see the bottom section of this page.

  • Most insurances do cover Transcranial Magnetic Stimulation, but each insurance plan is different. When you call our office, we can do an inquiry with your insurance company to find out if your plan covers it, if you have a co-pay or co-insurance, and if you will need a prior authorization.

  • Even though TMS is usually covered by insurance, many insurances will expect the patient to pay a portion of the cost. This will depend on your specific plan, whether or not you have a co-pay, a deductible, how much of the deductible has been met, etc.

    Our office staff will be happy to contact your insurance and let you know how much of the cost will be your responsibility before you start treatment so you won’t have any surprises.

  • Because of the nature of TMS and the number of times you visit the office within a short period of time, we understand that many patients will find their portion of the cost to be prohibitive.

    We will be happy to discuss payment options with you.

  • Currently, Medicaid does not cover TMS.

  • Only a doctor can prescribe TMS, but since Dr Kirby is right here, he can determine if it would be an appropriate treatment for you and prescribe it from the office.*

    That means, if you think TMS would be right for you, you can contact us directly at 208-202-2424, and we can help determine your next steps for getting approval from your insurance.

  • It can be difficult to watch a client, week in and week out, continue to struggle with depression, even after trying many methods of therapy.

    But just as you might recommend that they visit their prescribing physician to seek medication, you can also suggest that they look into TMS by calling their local TMS provider.

    We always encourage our patients to continue working with their counselors, during and after treatment, and those who do tend to have better results.

    A good candidate will be a patient who has already tried 2-4 medications and is scoring a 15 or higher on a PHQ-9.

    Please call us with any specific questions, including which insurances we’re currently accepting. 208-202-2424

  • At this time, Dr Kirby focuses solely on Transcranial Magnetic Stimulation at Advanced Psychiatry & TMS Clinic, and does not prescribe medication from this practice.

  • If you aren’t covered by insurance, or your insurance won’t cover TMS, we do have self-pay options available. Please call our office for more information. 208-202-2424

  • It is not recommended that you sleep or do anything that would cause you to move much, but you are free to chat with the treater, listen to music or a podcast,* meditate, or watch TV.

    At Advanced Psychiatry & TMS Clinic, we have several premium streaming services. You’ll have endless options of things to watch and listen to.

    *We recommend using low-tech earbuds. Over-the-ear headphones will interfere with the placement of the coil, and we can’t guarantee that nice Bluetooth earbuds won’t be damaged by the electromagnetic pulses.

  • Of course!

    Many patients, especially on their first visit, feel more comfortable bringing a loved one, and we absolutely encourage it.

    But you’re the patient, so you’ll be in charge of who’s allowed to be there.

  • Most insurances require that a patient be at least 18 years old. However, one local insurance will accept patients as young as 15, as long as they meet the other requirements.

  • We can treat Obsessive Compulsive Disorder, but it is a process that is slightly different than treating depression. Since NeuroStar® gained FDA approval in 2022 for treating OCD, a few insurance companies have started to cover TMS as a treatment option, and the list is slowly growing.

    If you have more questions about TMS for OCD, please call us at 208-202-2424.