TMS Therapy in Anaheim, California

Devices used at our clinic. Healing TMS Clinic operates Brain Ultimate M Series and Sabers Medical Blossom rTMS systems for standard depression and TRD protocols, and the BrainsWay Deep TMS system specifically for FDA-cleared OCD and anxious-depression protocols. Each device is FDA-cleared for its respective indications; the right device is chosen by your treating clinician based on diagnosis and protocol requirements.

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive, FDA-cleared neuromodulation therapy for major depressive disorder and treatment-resistant depression. At Healing TMS Clinic, rTMS is delivered under direct psychiatric supervision at our Anaheim office, serving patients across Orange County. Treatment requires no anesthesia, no sedation, and no recovery period.

What TMS therapy treats

The FDA has cleared rTMS for the following indications:

• Major depressive disorder (MDD) — original 510(k) clearance issued in 2008 for adults who have not benefited from at least one prior antidepressant trial in the current episode.¹
• Treatment-resistant depression — defined as inadequate response to at least two antidepressant trials of adequate dose and duration. This is the most common referral indication.

rTMS is also studied off-label for depression with comorbid anxiety, postpartum depression, and PTSD. Off-label use is decided case-by-case based on published evidence and prior treatment history.

How TMS works

rTMS operates on the principle of electromagnetic induction. A treatment coil against the scalp generates rapidly alternating magnetic pulses of approximately 1.5–2 Tesla, which pass unimpeded through the skull and induce focal electrical currents in the underlying cortex.² In depression protocols the coil targets the left dorsolateral prefrontal cortex (DLPFC) — a region with reduced metabolic activity in depressed patients and dense functional connectivity with subcortical mood-regulating structures including the subgenual cingulate and amygdala.

Repeated high-frequency stimulation (typically 10 Hz) produces long-term potentiation-like changes at the synaptic level, restoring excitability in the targeted cortex and normalizing activity across cortico-limbic networks implicated in depression.² The effect is local at the stimulation site but distributed across the connected network, which is why symptom improvement is typically gradual rather than abrupt.

Who is a candidate for TMS?

rTMS is most often indicated for adults with MDD who have not responded adequately to standard pharmacotherapy. Candidacy is established during psychiatric evaluation and typically includes:

• Confirmed diagnosis of MDD per DSM-5-TR criteria.
• Failure of at least one (FDA-cleared) or two (insurance-typical) antidepressant trials at adequate dose and duration in the current episode.
• Intolerance to antidepressant side effects, or documented preference for a non-systemic treatment.
• Medical stability without the contraindications listed below.

Contraindications and precautions include any ferromagnetic implant within 30 cm of the coil (cochlear implants, deep brain stimulators, aneurysm clips), active or unstable seizure disorder, and intracranial pathology that lowers seizure threshold. Personal or family seizure history, seizure-threshold-lowering medications (bupropion, clozapine, tramadol), and pregnancy are evaluated individually rather than treated as absolute exclusions.³ Concurrent psychotropic medication is generally continued — medication management runs alongside rTMS.

What to expect during treatment

A standard rTMS course follows the protocol established in the original FDA pivotal trials and reaffirmed by the CMS National Coverage Determination: approximately 36 sessions delivered five days per week over six to nine weeks, with a brief taper at the end.⁴

• First session (motor threshold mapping): the clinician determines the patient's resting motor threshold — the minimum stimulator output that produces a visible thumb twitch — and the treatment dose is calibrated as a percentage of this individualized threshold.
• Treatment sessions: the patient sits upright, awake and alert. The coil is positioned over the left DLPFC. Patients hear a clicking sound and feel tapping on the scalp. Session length varies by protocol — standard rTMS courses run approximately 37 minutes per session; iTBS (intermittent theta-burst stimulation) protocols are offered at our clinic and run approximately 3 minutes per session.
• No anesthesia, no sedation, no recovery period. Patients return to normal activity — including driving — immediately after each session.
• Accelerated and intermittent theta-burst (iTBS) protocols compress the course. The THREE-D non-inferiority trial demonstrated that 3-minute iTBS produces outcomes comparable to standard 37-minute rTMS.⁵ .

Treatment is operated by certified technicians under psychiatric supervision.

Evidence and outcomes

Efficacy of rTMS for treatment-resistant depression has been established in sham-controlled trials and real-world registries.

• The original multisite sham-controlled trial reported a statistically significant antidepressant effect of active rTMS versus sham in medication-resistant MDD.⁶
• The OPT-TMS naturalistic registry (n=307) reported a clinician-rated response rate of approximately 58% and a remission rate of approximately 37% following an acute course.⁷
• The Lancet THREE-D trial established non-inferiority of iTBS to standard 10 Hz rTMS, with comparable response and remission rates.⁵

These outcomes are reported in patients who had failed prior antidepressant trials — a population in which the expected remission rate on a third or fourth medication trial drops below 15%. .

Safety profile

Common side effects are mild and transient: scalp discomfort at the treatment site (peaks in the first week, resolves by session 5–7), headache responsive to over-the-counter analgesics, and lightheadedness or facial muscle twitching during stimulation.

The most serious documented risk is induced seizure. Under the international consensus screening and dosing protocol, seizure risk is approximately 1 per 30,000 sessions or lower.³ Every patient is screened against the Rossi 2009 safety checklist before the first session. rTMS does not require anesthesia, does not induce a therapeutic seizure (unlike ECT), and has not been shown to cause memory impairment in published trials.

Insurance coverage for TMS

Medicare and most major commercial insurers cover rTMS for FDA-cleared treatment-resistant depression when medical-necessity criteria are met (typically documented failure of two to four antidepressant trials).⁴ Verify your TMS coverage to receive a written benefits estimate before scheduling.

Begin TMS at Healing TMS Clinic in Anaheim, California

Healing TMS Clinic provides FDA-cleared TMS therapy to patients across Orange County — including Anaheim, Placentia, Fullerton, Yorba Linda, Buena Park, Orange, Garden Grove, Brea, La Habra, La Palma, Cypress, and Anaheim Hills. Treatment is supervised by a psychiatrist at 5475 East La Palma Avenue, Suite 204, Anaheim, CA 92807.

To schedule a consultation, book an appointment or call (657) 656-5611. New-patient visits include diagnostic review, candidacy assessment, and benefits verification.

FAQ

Will TMS work for me if antidepressants haven't? rTMS was developed for patients who have not responded adequately to antidepressants. In the OPT-TMS registry, approximately 58% of medication-resistant patients achieved clinical response and 37% achieved remission.⁷ Individual response cannot be predicted, but the published rate in treatment-resistant populations is substantially higher than the expected response to a third or fourth medication trial.

Does TMS hurt? Most patients describe the sensation as firm tapping on the scalp. Scalp discomfort and mild headache are the most common side effects, peak in the first week, and resolve over the course of treatment.

Will my insurance cover TMS? Medicare and most major commercial insurers cover rTMS for FDA-cleared treatment-resistant depression when medical-necessity criteria are met.⁴ Benefits verification and prior authorization are completed before treatment begins.

How is TMS different from ECT? Both treat depression but differ in delivery. rTMS uses focal magnetic pulses, requires no anesthesia or induced seizure, has no documented effect on memory, and allows same-day return to driving and work. ECT requires general anesthesia, induces a therapeutic seizure, and carries a documented risk of transient memory impairment. ECT remains more effective for the most severe presentations.

Can I drive after sessions? Yes. rTMS does not impair alertness, motor function, or reaction time. Patients drive themselves to and from sessions.

What if I'm already on medication? Most patients continue existing psychotropic medication throughout the course. Antidepressants, mood stabilizers, and antipsychotics are generally compatible; seizure-threshold-lowering medications (bupropion, clozapine, tramadol) may require dose adjustment before starting. Ongoing medication management is coordinated with the prescribing clinician.

References