What is TMS?

Transcranial Magnetic Stimulation (TMS) is a medical procedure for treatment of depression that uses magnetic pulses to stimulate nerve cells in the brain.

Many studies have shown that TMS can improve mood in patients with depression. It has been approved for treatment of depression under the Federal Government Medicare Benefits Schedule (MBS). Medicare has recognised the role of TMS in treatment of depression where antidepressant medications and psychological therapy have not resulted in satisfactory improvement*.
Factsheet-rTMS-Patient.25.10.21.pdf (mbsonline.gov.au)

TMS approved for treatment of depression
by Medicare

Check if you are eligible for the medicare rebate for rTMS.

  • Be at least 18 years of age;
  • Be diagnosed with major depressive episode;
  • Have failed to receive satisfactory improvement for the major depressive episode despite the adequate trialling of at least two different classes of antidepressant medications, unless contraindicated;
  • Have also undertaken psychological therapy unless inappropriate; and
  • Have not received rTMS treatment previously in either a public or private setting.

Where TMS is not funded by MBS, there may be other funding options that may apply to you.

How rTMS works

The term rTMS stands for repetitive TMS. In rTMS, we use modern brain stimulation devices to stimulate specific parts of the brain with magnetic pulses. In one session of rTMS, a person will receive hundreds to thousands of magnetic pulses. The rTMS devices are approved by the Australian regulatory authority, the Therapeutic Goods Administration.

rTMS is not the same as ECT (Electroconvulsive Therapy). rTMS uses only magnetic pulses, unlike ECT that uses brief electric currents.


TMS Journey

Stage 1. Reviewing your Referral

A staff member will contact the patient soon as possible after receiving your referral. An initial assessment will be scheduled with a psychiatrist who is trained in rTMS.

Stage 2. Initial Assessment with Psychiatrist

During the initial assessment, the psychiatrist will determine the suitability of rTMS for the patient, and this will involve clarifying diagnosis and ruling out any contraindications to rTMS. A safety screening will be conducted, and informed consent taken.

Stage 3. Resting Motor Threshold

Following the initial assessment, if rTMS has been deemed as a suitable treatment, the patient will be offered an appointment to determine the Resting Motor Threshold (RMT) and mapping for treatment coordinates. The RMT session informs the intensity of rTMS as well as the placement of the coil during treatment.

Stage 4. First Course of rTMS

During the initial course of rTMS treatment, the patient is advised to attend the clinic 3 to 5 days per week for treatment sessions. During this stage, the patient will have one consultation with the psychiatrist during the course to monitor the progress and response to treatment, and once after they have completed it.

Stage 5. Maintenance rTMS

For patients who have already completed an initial course of rTMS, some may require maintenance sessions. For these patients, a plan is drawn by the psychiatrist informed by the history of their mental illness and response to treatment.

Treatment Sessions

You sit in a comfortable reclining chair during the process and can simply relax or listen to music or a podcast.

rTMS generally includes daily sessions for 3 to 6 days each week over a number of weeks. Each session runs for 20 to 30 minutes and includes several series of stimulations.

It is a drug-free treatment with minimal side effects, which we will discuss with you before you get started.

If we find that TMS is a suitable treatment for you, our doctor will conduct a small test to determine the right intensity of the magnetic pulses for you. Based on this test, we will prescribe a course of TMS for you. The treatments are then delivered by a trained nurse at our clinic

Who can try TMS

We may recommend rTMS if you have depression, and antidepressant medications and psychological therapy have not worked. 

As with any treatment, there are potential risks. However, we will not recommend rTMS if we believe the risks will outweigh the benefits. 

TMS may not be suitable if you have:

  • metal anywhere in the head, other than the mouth
  • a pacemaker, unless the device is certified safe for magnetic simulation
  • medication pumps, unless the device is certified safe for magnetic simulation
  • serious heart disease, unless approved by your cardiologist
  • increased intracranial pressure, as diagnosed by your doctor
  • a history of seizures (special considerations apply for TMS in epilepsy and other seizure disorders)
  • If you use heavy alcohol or illicit drugs which increase risk of side effects such as seizure