Transcranial Magnetic Stimulation

About NeuroStar TMS Therapy®

NeuroStar TMS Therapy is the first FDA cleared non-invasive, non-drug, depression treatment to be cleared by the United States Food and Drug Administration (FDA) for patients who have not previously benefited from traditional drug therapy.
NeuroStar TMS (transcranial magnetic stimulation) Therapy is similar to magnetic resonance imaging (MRI).  TMS uses precisely targeted magnetic pulses to stimulate key areas of the brain that are found to be underactive in patients with depression.

TMS Therapy is administered within the practice.  During treatment, patients are awake and alert and can go back to their normal daily activities immediately after treatment.  The in-office treatment takes around 20 minutes and is administered 5 days a week, for between 6 to 8 weeks.

One description of how TMS Therapy works can be seen in: This NeuroStar Video

TMS has been featured in multiple news publications highlighting its success in treating depression: Dr. OzTIME MagazineThe Wall Street JournalEveryday HealthBehavioral Healthcare, to name a few.

For more information, see the list of Frequently Asked Questions below and the TMS Coordinator at 828-254-9494. 

Do you take insurance?

Most insurance companies will cover TMS for the treatment of Major Depressive Disorder when the patient has failed at least 4 different medications and has not benefited from traditional talk therapy.  To find out if TMS is a covered service, it is best to contact your insurance company directly.   If it is a covered service, you will likely be responsible for a co-pay for each treatment session.  

How often do I have to receive treatment?

TMS treatment is typically a course of 36 sessions that occur Monday through Friday for the first 6 weeks, and then will be tapered off over the last 2 weeks. 

How long is each treatment?

Treatment length will vary based on the amount of stimulation your brain needs to respond, but will typically be between 18 and 20 minutes. 

What are the side effects?

The most common side effect of TMS is scalp discomfort at the treatment area while pulses are being delivered.   Some patients develop a mild to moderate headache following treatment, but the headache is typically short lived and does not generally occur past the first few treatment sessions.   During treatment, you might experience some minor twitching around the eye or facial muscles, but this goes away when not receiving stimulation. 

What is treatment like?

During treatment, you will receive a series of pulses (40 over 4 seconds), followed by a rest period.   This cycle repeats until a total of 3000 pulses are delivered.   You are completely awake and will be monitored closely by your TMS technician the entire time. 

What do I do during treatment?

Most patients find it helpful to have a positive distraction during treatment.   You might opt to listen to music, an audiobook, or a podcast, or focus on mindful breathing and meditation.   Some patients have read books/magazines, or opted to bring a flash drive with photos or videos.  While you are in your treatment, the space is yours and we will try to make you as comfortable as possible.   You can bring a friend or family member to your sessions if you would like the extra support.

How soon will I see results?

Most patients see noticeable results between 4 and 5 weeks.  Every patient is different, though, and some might respond earlier or later.  Often, the TMS technician or a family member will notice changes well before the patient.   Not all patients will respond to treatment. 

Welcome, Sandy Sun, F.N.P., P.M.H.N.P.!

We are happy to welcome Sandy Sun, F.N.P., P.M.H.N.P. to the Pisgah team! Ms. Sun is double board certified as a psychiatric and family nurse practitioner.  She employs an integrative approach to treatment, using both medication therapy and a lifestyle approach...

Welcome, Ross Wiedemann, M.D. & Eliot Steer, Ph.D.!

We are happy to welcome Ross Wiedemann, M.D. & Eliot Steer, Ph.D. to the Pisgah team! Dr. Ross Wiedemann is a board-eligible psychiatrist specializing in general outpatient practice. His main areas of interest include treatment of major depression, anxiety...

Accepting Referrals for Psychological Assessments

The Pisgah Institute is happy to provide a range of psychological assessment services. Diagnostic clarification assessments provide insight into potential diagnoses and help develop effective treatment plans. Testing can clarify if someone may be experiencing:  more...

Welcome, Samantha Isakson Lyerly, Ph.D.!

We are happy to welcome Samantha Isakson Lyerly, Ph.D., as a clinician at The Pisgah Institute! Dr. Isakson Lyerly treats children, adolescents, and adults. She began her practice in the public school systems, state hospitals, and residential-treatment programs. She...

Facilitating Forgiveness Group

All of us, at some time or another, have been offended, insulted, demeaned, disappointed, or attacked by someone, which means that we have also likely struggled to forgive that someone. Forgiveness is a lot easier wished for than done, and whatever it is, it is a...

Good Faith Estimate Notice

The No Surprises Act (NSA) requires that health care providers supply an estimate for the expected cost/charges to uninsured or self-pay individuals for services. • You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental...

Mindfulness for Stress Management

A Wellness Group Wednesdays at 5pm via Zoom *Starting early November 2021* Mindfulness is a skill that can be useful to anyone. It can help build and bolster coping skills that can be applied in many different ways. If you find yourself struggling with negative mood,...

Welcome! Michael Poggioli, Psy.D. & Erin Morrison, D.O.

We are happy to welcome Michael Poggioli, Psy.D. & Erin Morrison, D.O. to the Pisgah team! Dr. Poggioli is a psychologist who takes an empowerment philosophy towards mind and body wellness. He combines evidence-based approaches such as cognitive-behavioral,...

Update your 2023 Insurance Information

Although we are not able to see you in the office, we still need current insurance information and a copy of your insurance card to file your visits to your insurance provider. If you need assistance completing the following form, please call the office.

How to Get the Most Out of Your Remote Therapy Session

Remote sessions are not the same thing as what happens when we meet in person. They are also not the same as a typical phone conversation or SKYPE or FaceTime calls you have with friends and family. Listed below are some guidelines for how to get the most benefit from...