Treatment Process

Treatment Process

The Treatment

Synapse TMS offers  Deep TMS  (dTMS ) with the use of H coils which are manufactured by Brainsway .

Patients will be contacted and an assessment will be scheduled with our psychiatrist after we have received the referral form.

The assessment is an important screening step to establish the diagnosis and to determine if TMS would be safe and appropriate for you. The assessment takes about an hour during which the psychiatrist will review your psychiatric and medical history, the treatment you have tried and the medications that you are taking. Once the psychiatric assessment has been completed, the psychiatrist will review the diagnosis and treatment options, including TMS.

  • If the patient is deemed suitable  for TMS and is willing to proceed with treatment, additional questions or concerns will be discussed, treatment consent forms are completed and the psychiatrist will create a treatment plan customized to meet your needs.
  • Patients do not need to commence any medications prior to beginning TMS treatments. It is advisable that the medication doses be kept stable at least 4 weeks prior to and during the course of the treatment.
  • During the TMS sessions the TMS technician will attend to you and check in with you on a daily basis to monitor any side effects as your treatment progresses.
  • Patients are reviewed by our psychiatrist on a regular basis while they are on treatment to monitor side effects and response to treatment.
  • Patients are  expected to continue to attend their routine follow up appointments with their  referring  psychiatrist or family physician during the course of their TMS treatment.

Treatment Frequency

Acute Phase

An index/acute course is the initial series of treatments given

to relieve acute symptoms of the illness.These  are 20 – 30 consecutive treatments conducted over a 4 to 6 week period with each session lasting about 10-30 minutes depending on the treatment protocol.

Treatments are scheduled Monday through Friday, not including statutory holidays.

Continuation /Maintenance Phase

When TMS is used for the treatment of an acute episode of depression , it is reasonable to consider continuation TMS (C-TMS) or maintenance (M-TMS) to prevent relapse of the current episode or recurrence of a new episode.

C-TMS is a course that begins after the index course and is designed to prevent relapse of the episode (return of the symptoms to full syndromal criteria before the end of the natural duration of the illness). 

M-TMS is a course that begins after the end of C-TMS and is intended to prevent recurrence of an episode (a new episode).This could be considered when other established methods of maintenance antidepressant therapy has failed to provide a satisfactory sustained pattern of clinical benefit in a patient with a history of frequent relapse (two or more in one year)

Our psychiatrist will discuss the various approach to continuation /maintenance treatment with you at the beginning of the  acute phase of TMS.

Treatment Evaluation
In addition to the patient’s subjective reports regarding their response to treatment, patients are assessed using validated outcome measures.

These instruments are administered prior to the start of treatment and throughout the course of the treatment.

Our psychiatrist will then discuss the progress and the recommendations for maintenance therapy with the patient and a progress report is sent to the referring psychiatrist or family physician to facilitate continued care .