Frequently Asked Questions

TMS

Who is a candidate for TMS therapy?

TMS is ideal for individuals seeking a non-invasive, medication-free option or those who haven’t benefited from traditional treatments. It’s FDA-approved for treatment-resistant depression (TRD) and increasingly used for conditions like anxiety, OCD, and PTSD. Candidates typically include:

  • Patients who experience intolerable medication side effects.

  • Those with partial or no response to antidepressants.

  • Individuals preferring to avoid systemic medications (e.g., during pregnancy).
    A consultation with our clinical team will determine your eligibility based on medical history and treatment goals.

What does "treatment-resistant" mean?

A condition is labeled “treatment-resistant” if symptoms persist despite trying multiple evidence-based therapies. For example, depression is considered treatment-resistant after failing at least two antidepressant medications (at adequate doses and durations) combined with psychotherapy. This doesn’t mean you’re “out of options”—it simply guides us toward advanced therapies like TMS.

Is TMS backed by scientific research?

Yes. TMS has been studied for over 30 years and is FDA-approved for depression (since 2008) and OCD (since 2018). It’s endorsed by organizations like the American Psychiatric Association (APA) and the National Institute for Mental Health (NIMH). Thousands of peer-reviewed studies confirm its safety and efficacy, with ongoing research exploring its use for chronic pain, PTSD, and more.

What side effects should I expect?

Most patients experience only mild, short-lived effects, such as:

  • Scalp discomfort or tingling during treatment (often resolves after the first few sessions).

  • Temporary mild headache or fatigue.
    Serious risks like seizures are extremely rare (<0.1% of cases) and typically occur only in those with pre-existing risk factors (e.g., epilepsy, certain medications). We screen thoroughly to minimize risks and monitor you closely throughout treatment.

Can I continue my current medications during TMS?

Yes! TMS can be safely combined with most medications. In fact, many patients use it alongside antidepressants or mood stabilizers. Never stop or adjust medications without consulting your prescribing provider first.

How long is a TMS session, and what does it feel like?

Each session lasts 15–30 minutes. You’ll sit comfortably, awake and alert, while the magnetic coil delivers gentle pulses to targeted brain regions. Most describe the sensation as a light “tapping” on the scalp. You can listen to music, read, or relax during the process—no anesthesia or recovery time is needed.

How soon will I notice results?

Improvements often begin within 2–3 weeks, with peak benefits appearing by weeks 4–6. However, responses vary: some report rapid mood lifts, while others see gradual progress. We track symptoms weekly to personalize your treatment plan.

Is TMS covered by insurance?

Most private insurers (e.g., Aetna, Cigna, Blue Cross) and Medicare cover TMS for FDA-approved conditions like TRD. Coverage depends on your plan and prior authorization requirements. Our team handles insurance verification, prior authorizations, and offers flexible payment plans for self-pay patients.

Will I need maintenance sessions after my initial treatment?

Some patients opt for periodic “booster” sessions to sustain results, similar to follow-up therapy or dental cleanings. We’ll create a personalized maintenance plan based on your progress and long-term goals.

Can TMS be combined with therapy or other treatments?

Absolutely! Many patients pair TMS with cognitive-behavioral therapy (CBT), lifestyle changes, or nutritional support for enhanced results. We collaborate with your existing care team to ensure a holistic approach.

Are there any contraindications for TMS?

TMS is not recommended if you have:

  • Metal implants in or near the head (e.g., cochlear implants, aneurysm clips).

  • A history of seizures unrelated to controllable triggers.

  • Certain neurological conditions (e.g., Parkinson’s, ALS).
    We conduct a detailed screening to ensure your safety.

What makes TMS different from ECT (electroconvulsive therapy)?

Unlike ECT, TMS requires no anesthesia, doesn’t induce seizures, and has no risk of memory loss. It’s gentler, with minimal downtime, making it easier to integrate into daily life.

How do I prepare for my first session?

  • Avoid caffeine beforehand (it can heighten scalp sensitivity).

  • Remove magnetic-sensitive items (e.g., jewelry, credit cards).

  • Wear comfortable clothing—you’ll relax in a chair during treatment.

What is the success rate of TMS?

  • Studies show 50–60% of TRD patients achieve significant symptom reduction, with about 30% experiencing full remission. Success rates are higher when combined with therapy and lifestyle modifications.

Can adolescents or older adults receive TMS?

  • TMS is FDA-approved for adults 18+, but emerging research supports its use for adolescents under strict supervision. Older adults are excellent candidates, provided they meet safety criteria.

Still have questions?

  • Contact our TMS coordinators at [email protected] for a free consultation. We’re here to help you make an informed, confident decision about your care!

Ketamine

How does ketamine therapy work for depression and other conditions?

Ketamine acts on the brain’s glutamate system—a neurotransmitter critical for mood regulation and neural plasticity. Unlike traditional antidepressants, which take weeks to affect serotonin or norepinephrine, ketamine rapidly stimulates the regrowth of synaptic connections in the prefrontal cortex. This “reset” can alleviate symptoms of depression, PTSD, anxiety, and chronic pain within hours. Think of it as repairing a faulty circuit: ketamine jumpstarts healing where other treatments stall.

Why is ketamine considered better than traditional antidepressants?

  • Speed: Relief in hours vs. weeks.

  • Precision: Targets glutamate pathways, often effective when serotonin/norepinephrine medications fail.

  • Versatility: Helps treatment-resistant depression, bipolar disorder, postpartum depression, and even chronic pain.

  • Side Effects: Fewer long-term issues (e.g., no weight gain or sexual dysfunction).

For those with suicidal thoughts, ketamine’s rapid action can be life-saving.

What conditions can ketamine therapy treat?

Beyond depression, ketamine shows promise for:

  • PTSD: Reduces hypervigilance and flashbacks.

  • OCD: Eases intrusive thoughts.

  • Chronic Pain: Alleviates nerve-related pain (e.g., fibromyalgia).

  • Addiction Recovery: Curbs cravings and supports emotional resilience.

Is ketamine therapy safe?

Yes, when administered by trained professionals in a clinical setting. Ketamine has a 60-year safety record as an anesthetic. For mental health, we use sub-anesthetic doses and monitor:

  • Vital signs (heart rate, blood pressure) during sessions.

  • Medical history to rule out contraindications (e.g., uncontrolled hypertension).

Common short-lived side effects: Mild dissociation, dizziness, or nausea. These typically fade within 1–2 hours.

Can ketamine cause addiction?

No. At the low doses used for mood disorders, ketamine is non-habit-forming. Studies suggest it may even help break cycles of addiction by reducing cravings and improving emotional regulation. Full transparency about substance use history ensures your safety.

Are there risks for patients with a history of seizures?

Ketamine may lower seizure thresholds in predisposed individuals. We screen thoroughly and adjust protocols (e.g., avoiding IV infusions) for at-risk patients.

Is ketamine therapy covered by insurance?

  • SPRAVATO® (esketamine nasal spray): Often covered for treatment-resistant depression. Requires in-clinic administration under FDA’s REMS program.

  • IV/IM Ketamine: Rarely covered, but we offer sliding-scale fees and payment plans.

Pro Tip: We handle prior authorizations for SPRAVATO® and provide superbills for possible out-of-network reimbursement.

Can I drive after a session?

No. Ketamine may temporarily impair coordination or cognition. Arrange a ride home, and avoid driving/machinery for 24 hours.

What happens during a ketamine session?

  • Setup: Recline comfortably in a private room with calming music/lighting.

  • Administration: Receive IV, IM, or nasal spray ketamine.

  • Monitoring: Our team tracks your response and adjusts dosing in real time.

  • Duration: 40–60 minutes for IV; 20 minutes for SPRAVATO®.

Most patients describe the sensation as a “floaty” dissociation, often paired with vivid mental imagery.

What are integration sessions, and why are they important?

After each ketamine session, you’ll meet with a therapist to:

  • Reflect: Discuss insights or emotions that arose during treatment.

  • Apply: Create actionable steps to reinforce healing (e.g., mindfulness practices, journaling).

  • Support: Maintain progress with ongoing therapy or community resources.

Example: A patient battling PTSD might use integration to process traumatic memories uncovered during ketamine therapy.

How many sessions will I need?

  • Initial Phase: 6–8 sessions over 3–4 weeks.

  • Maintenance: Monthly or quarterly boosters, depending on symptom recurrence.

50% of patients sustain benefits for 6+ months after a full course.

Who is a good candidate for ketamine therapy?

Ideal if you:

  • Have treatment-resistant depression, anxiety, or PTSD.

  • Can’t tolerate antidepressant side effects.

  • Need rapid relief (e.g., acute suicidal thoughts).

Contraindications: Uncontrolled heart conditions, psychosis, or pregnancy.

How do I prepare for my first session?

  • Avoid alcohol/caffeine 24 hours prior.

  • Eat lightly 2–3 hours beforehand to reduce nausea.

  • Bring a trusted companion for emotional support and transportation.

Still Have Questions?

  • Contact TMS Village in Montclair at [Phone/Email] for a free consultation. We’ll clarify doubts, review your history, and tailor a plan to help you reclaim your life.