TMS Transcranial Magnetic StimulationIMPORTANT UPDATE: We now can provide Theta Burst Stimulation (TBS), a type of TMS treatment in lieu of traditional TMS protocols that can significantly decrease time and potentially increase efficacy of TMS treatments. 

Depression is debilitating. It drains the enjoyment from everyday events, deteriorates relationships, and interferes with work. Although antidepressants help many people, often they don’t work, or cause intolerable side effects. Fortunately, there are proven, FDA-approved, and virtually side-effect free treatments for depression, even when medications have failed or are no longer an option.

Transcanial Magnetic Stimulation (TMS) has been in existence since 1985, FDA approved in 2008 for treatment of depression, and APA (American Psychiatric Association) recommended as well for treatment of depression. With multiple large trials proving its efficacy in randomized, blinded trials as well as open label studies, TMS has clearly demonstrated itself to be a novel treatment of depression that can augment or replace traditional medication management of depression. APT was the first medical clinic to offer TMS treatments in Hawaii, paving the way for patients to stay in the islands while receiving treatment rather than having to fly to the mainland. Over these years, we have achieved statistically consistent outcomes that are in-line with remission rates in top TMS research.

The true advantage of TMS, however, is its relative absence of side effects, the most common side effect being a mild, temporary, treatable headache. As there is no actual pharmacologic agent that distributes throughout the body, the treatment is more precise, making it a great alternative for those who are very sensitive to medications. TMS is not for everyone, however. Consultation with one of our Psychiatrists, and ongoing evaluations are necessary to assure safe and effective use.

Treatments are provided in a comfortable, relaxing, and private suite. Typically, 20-30 treatments are required to obtain the full effect, with treatment times ranging from 6 minutes to 50 minutes.  Traditional TMS has usually required about 30-45 minutes in duration for each treatment, but recently theta-burst technology (TBS) has shortened the duration for many patients dramatically, down to 6-7 minutes.  During treatments, patients can engage in therapy, meditation, or simple relaxation to gain further benefit from multiple treatment modalities, or if entertainment is preferred, patients can watch TV or movies on the big screen TV, listen to music.

Almost every insurance company now covers TMS.  Although TMS could potentially benefit someone with no exposure to antidepressants, insurance companies in Hawaii require at least four medication attempts (during this depressive episode) before they will authorize and cover treatment.  However, if insurance blocks treatment, we are willing to discuss payment options for out of pocket coverage of this procedure.  

There is no need to change psychiatrists to benefit from TMS at Advanced Psychiatric Therapeutics. We are happy to consult with your current psychiatrist. However, if you do not have a psychiatrist, or would prefer to have us be your primary psychiatry treatment team, we would be happy to help. Please contact us to set up a confidential consultation to determine if TMS is right for you.

Please see our resources below for articles on TMS studies, news reports, and links. Also refer to our FAQs for more information about the treatment process.


Magstim Theta Burst treatments:

Dr. Oz talks about TMS: An excellent and easy to understand explanation of TMS. How it works, what it is, and why it is effective as a treatment for depression.
Part 1 and Part 2

Interview with Dr. Jeremy Roberts (of Advanced Psychiatric Therapeutics) on Oahu’s own Olelo TV Show “The Genie Show”. Genie Joseph interviewed Dr. Roberts in July of 2012 about the current state of TMS, and asked him to explain the treatment.

Part 1: Part 2:

E Street TMS Feature Story by AARP featuring Dr. Morales, with whom Dr. Roberts trained under his guidance in Boston at McLean Hospital. The information is mostly current still, however, one pleasant development is that most insurance companies are now covering TMS treatment at least in part.