TMS Therapy
Transcranial Magnetic Stimulation (TMS) is a breakthrough, non-invasive, FDA-approved treatment that uses gentle magnetic fields to stimulate nerve cells in the brain regions involved in mood regulation and depression. It is particularly effective for treatment-resistant depression, with response rates around 70% and remission in about 50% of patients. Sessions are outpatient, require no anesthesia or downtime, last 20-40 minutes, and typically occur daily (Monday-Friday) over 4-6 weeks. Most patients experience only mild scalp discomfort that decreases over time. Dr. Levinson offers personalized TMS with thorough evaluation and insurance support.
How TMS Works
- Magnetic coil positioned over the left prefrontal cortex
- Delivers focused magnetic pulses to stimulate brain cells
- Targets areas of the brain involved in mood regulation
- Helps restore normal brain activity patterns
- No effect on other parts of the body
Ideal Candidates
- Adults with treatment-resistant depression
- Those who haven't responded to 2+ antidepressant medications
- Patients experiencing medication side effects
- Adults seeking non-medication alternatives
- Those able to commit to daily treatment schedule
What to Expect
- Initial consultation and brain mapping
- Comfortable treatment chair during sessions
- Tapping sensation on the scalp
- Can read, listen to music, or relax
- Resume normal activities immediately after
Insurance Coverage
- Covered by most major insurance plans
- Medicare and Medicaid coverage available
- Pre-authorization typically required
- We handle insurance verification
- Financing options available
TMS Frequently Asked Questions
Most patients describe TMS as a tapping sensation on the scalp. Some may experience mild discomfort during the first few sessions, but this typically decreases as you become accustomed to the treatment. The procedure does not require any anesthesia.
Clinical studies show that approximately 70% of patients experience significant improvement in their depression symptoms, with about 50% achieving complete remission. Results may vary based on individual factors and treatment history.
TMS has minimal side effects compared to medications. The most common side effects are mild scalp discomfort and headache during or after treatment sessions. These typically improve after the first week of treatment.
Esketamine (Spravato®) Treatment
Spravato® is an FDA-approved nasal spray containing esketamine, designed for rapid relief in adults with treatment-resistant depression or major depressive disorder accompanied by acute suicidal thoughts or behaviors. Unlike traditional antidepressants, it works quickly—often within hours or days—by targeting different brain pathways. Administered in-office under close supervision with 2-hour monitoring, treatment starts intensive (twice weekly) and tapers to maintenance. It is used alongside an oral antidepressant for best results. Dr. Levinson ensures REMS-compliant care, including transportation planning and safety monitoring.
How Spravato® Works
- Blocks NMDA receptors in the brain
- Promotes new neural connections
- Different mechanism than traditional antidepressants
- Can provide relief within hours or days
- Used alongside oral antidepressant
Treatment Process
- Self-administered nasal spray in our office
- Comfortable monitoring area for 2 hours
- Vital signs checked regularly
- Must have transportation arranged
- Gradual return to normal activities
Who Benefits Most
- Adults with treatment-resistant depression
- Major depression with acute suicidal ideation
- Failed 2+ adequate antidepressant trials
- Seeking rapid symptom relief
- Stable enough for outpatient treatment
Safety Monitoring
- Administered only in certified clinics
- Continuous monitoring during treatment
- Blood pressure and mental status checks
- REMS program compliance
- Ongoing assessment for abuse potential
ECT (Electroconvulsive Therapy)
ECT remains one of the most effective and rapid treatments available for severe depression, treatment-resistant cases, catatonia, psychosis, or high suicide risk when other options have failed. Modern ECT uses controlled electrical stimulation under general anesthesia and muscle relaxants, with 80-90% effectiveness in appropriate patients. A typical course involves 6-12 sessions over 2-4 weeks, often on an outpatient basis, with close monitoring to minimize side effects like temporary memory changes or headache. Dr. Levinson coordinates pre-treatment evaluations and recovery support for safe, life-changing outcomes.
Modern ECT Process
- Brief general anesthesia and muscle relaxant
- Precisely controlled electrical stimulation
- Treatment lasts 5-10 minutes
- Continuous monitoring throughout
- Recovery in comfortable setting
Best Candidates
- Severe, treatment-resistant depression
- Catatonia or psychotic features
- High suicide risk requiring rapid response
- Previous positive response to ECT
- Medical clearance for anesthesia
What to Expect
- Pre-treatment medical evaluation
- Anesthesia consultation if needed
- Nothing by mouth after midnight
- Companion required for transportation
- Gradual improvement over treatment course
Managing Side Effects
- Temporary memory effects
- Minimized with modern techniques
- Headache and muscle aches possible
- Confusion typically brief
- Long-term memory usually preserved
Genesight® Genetic Testing
Genesight® is a simple cheek-swab genetic test that analyzes how your genes influence response to over 60 psychiatric medications, including antidepressants, antipsychotics, mood stabilizers, and more. Results—available in 2-3 days—help Dr. Levinson select more effective options with reduced side effects and trial-and-error. Color-coded reports guide decisions: green for standard use, yellow for caution, red for likely issues. It is a one-time test, often covered by insurance (max out-of-pocket around $330), and ideal for those with poor medication response, significant side effects, or complex histories.
How It Works
- Analyzes genes affecting drug metabolism
- Identifies genetic variants in key pathways
- Predicts medication response and side effects
- Provides color-coded medication guide
- Updated as new research emerges
Medications Analyzed
- Antidepressants (SSRIs, SNRIs, others)
- Antipsychotics (typical and atypical)
- Mood stabilizers
- ADHD medications
- Anxiety medications
Who Should Consider Testing
- Starting psychiatric medication for first time
- Poor response to previous medications
- Significant side effects from medications
- Family history of medication issues
- Taking multiple psychiatric medications
Understanding Results
- Green: Use as directed
- Yellow: Use with caution
- Red: Significant gene-drug interaction
- Detailed report for each medication
- Ongoing consultation with Dr. Levinson