Tms

[prominence]

I'd love to hear about people's experiences adminstering TMS.

What are your thoughts on how effective TMS is?

How lucrative can it be for a private psychiatric practice?

Any feedback would be welcome. Thanks in advance!

---

Members don't see this ad.

 

[whopper]

I've never administered it but I've talked to someone who does on a few occasions who is one of my bosses. I don't know how lucrative it's going to be given that only a very limited population will be able to afford it, and I was told that treatment-resistant patients aren't good candidates for it. Only one insurance company (that pretty much no one I've ever seen has) will reimburse for it.

Using it allegedly causes a rubber band sensation on the upper forehead akin to having a rubber band snapping but not in an uncomfortable manner.

If you want to get into TMS, I'd recommend aligning yourself with one of the few institutions that offer it. Most I know have the clinician who is administering it also doing research on it.

 

[TexasPhysician]

My thoughts: TMS is currently useless for any practice. It's effectiveness is minimal, it has few indications, and it costs too much.

Until researchers uncover much more useful info, the TMS machine probably wouldn't be worth getting for free. I'd rather fill an extra office with a therapist than a TMS machine at my practice.

 

[whopper]

Hate saying it but I agree.

$4 antidepressant or treatment that costs thousands of dollars?

 

[OldPsychDoc]

Hate saying it but I agree.

$4 antidepressant or treatment that costs thousands of dollars?

But you put it on your head.
And it clicks!
And tingles...your BRAIN!!!

 

[notdeadyet]

But you put it on your head.
And it clicks!
And tingles...your BRAIN!!!

No kidding. I was half-joking with a colleague the other day that adding an ingredient to SSRIs that gave a mild headache might improve response rates based on patients thinking, "Hey, it's working!"

 

[whopper]

That's an argument Peter Breggin, the anti-psychiatrist, brings up citing that psychotropic double-blinded placebo control studies are BS--because if the subject gets a side effect, they now know they aren't on the placebo.

But, what Dr. Breggin fails to mention is this same problem goes with all medications in double-blinded placebo controlled studies, but he selectively attacks psychiatric meds.

 

[vistaril]

That's an argument Peter Breggin, the anti-psychiatrist, brings up citing that psychotropic double-blinded placebo control studies are BS--because if the subject gets a side effect, they now know they aren't on the placebo.

But, what Dr. Breggin fails to mention is this same problem goes with all medications in double-blinded placebo controlled studies, but he selectively attacks psychiatric meds.

well it's also what Kirsh says, who really first broke the story when he got access to the complete trials.....

I suspect if you mention this to people like Kirsh and Marcia Angell, they would agree that in cases where a *minor* benefit is shown between the active drug and placebo that the "superplacebo" effect is at work there too with other non-psych drugs......the thing is not all non-psych drugs have noticeable side effects though, so that would matter.