There’s more
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than depression.

Deep TMS uses a helmet-shaped coil to stimulate brain regions involved in mood. Standard sessions take about 20 minutes, and shorter theta-burst options may also be available. Dr. Drell will help you choose a protocol suited to your needs.

Yes. BrainsWay Deep TMS is FDA-cleared for major depressive disorder, including associated anxiety symptoms, in adults who have not improved enough with antidepressant medication. It is also cleared as an adjunct treatment for depression in adolescents ages 15–21. Clearance and suitability depend on the device, protocol, and patient’s condition.

At your first session, a technician places a helmet-shaped magnetic coil over your head and measures your motor threshold—the stimulation level that produces a small thumb movement. This helps set your treatment intensity. The coil is then positioned over the dorsolateral prefrontal cortex, a brain region involved in mood regulation.

You will hear clicking and may feel tapping on your scalp. The standard protocol delivers two-second trains of pulses separated by 20-second rests, for a total of 1,980 pulses. Treatment takes approximately 20 minutes; allow about 30 minutes for a routine visit and approximately 60 minutes for the first session.

You remain awake without anesthesia or sedation and can generally drive yourself to and from appointments. Standard treatment usually involves weekday visits over six to nine weeks. Dr. Drell meets with you periodically to answer questions and coordinate your care.

In addition to the standard Deep TMS protocol above, we offer shorter treatments called theta-burst stimulation. Depending on the protocol, sessions take about three minutes or approximately ten minutes. Certain accelerated protocols allow several sessions in the same day, with planned breaks between treatments. BrainsWay’s three-minute theta-burst and approximately ten-minute accelerated protocols are FDA-cleared for depression, supported by studies showing comparable effectiveness to standard Deep TMS. Individual results vary. Insurance coverage depends on the protocol and your plan; accelerated schedules may not yet be covered. We will discuss coverage and costs before treatment begins.

Before your initial evaluation, our office asks for a copy of the front and back of your insurance card to check benefits for the consultation and TMS treatment. We review your coverage with you and submit claims when coverage is approved. You remain responsible for applicable deductibles, copayments, coinsurance, and services your plan does not cover.

Requirements vary by insurer and policy. They may include a documented diagnosis of major depression, symptom severity measured with a questionnaire such as the PHQ-9, and inadequate benefit from previous antidepressants. Some plans also require psychotherapy or an additional medication trial. Repeat treatment may require documentation that an earlier TMS course helped. Our team checks your plan’s current criteria; meeting clinical criteria does not guarantee coverage.

Yes, if Dr. Drell determines that TMS is clinically appropriate. Self-pay treatment may be an option even when insurance does not cover it. Contact the office to discuss rates and any available financing options.

Certain metal implants or electronic devices near the treatment area can make TMS unsafe. Tell the team about any implants, metal fragments, aneurysm clips, cochlear implants, or implanted stimulators. Standard dental fillings generally do not prevent treatment.

Also disclose seizures, epilepsy, stroke, brain injury or surgery, and any previous TMS treatment. These factors require individual assessment and are not all automatic exclusions. Dr. Drell reviews your screening form and the device’s safety requirements before recommending treatment.

The most common side effects include scalp discomfort and headache. Jaw discomfort or muscle twitching can also occur. Tell the technician if treatment is uncomfortable; adjustments may help. Ear protection is required. Seizure is a rare but serious risk. Dr. Drell will review the potential benefits, risks, and precautions with you.

TMS has an established safety record when appropriate screening and treatment protocols are followed. It requires no anesthesia, and memory impairment is not a typical side effect. However, no treatment is risk-free. Your medical history, medications, and any implants must be reviewed before treatment.

Many patients continue their medications during TMS. Tell Dr. Drell about all medicines and supplements you take and any changes during treatment, because these can affect stimulation settings or seizure risk. Do not change or stop medications on your own. Your current psychiatrist or prescribing clinician manages medication changes in coordination with Dr. Drell.

Yes, but general psychiatric consultations may have a several-month waiting list. Dr. Drell’s general psychiatric practice accepts patients ages 13–59. Appropriate TMS referrals ages 15–86 are prioritized when possible. TMS patients continue obtaining medications from their current psychiatrist or physician. Call the office for general psychiatry inquiries; the website’s appointment form is for TMS requests only.

Call (713) 464-4455 to ask questions or arrange a consultation. You can speak with a TMS technician, or with Dr. Drell when he is available.

Allow about 60 minutes for your first treatment visit and about 30 minutes for routine standard-protocol visits. We provide the earplugs required to protect your hearing. You may want to bring a comb or brush, since the treatment cap can affect your hairstyle. Avoid dyeing your hair within 24 hours before treatment and ask us about any hair products containing metal.

If you are concerned about discomfort, ask the team whether an over-the-counter pain reliever is appropriate for you. Follow their instructions and the medicine’s label rather than taking a routine dose without checking.

Electroconvulsive therapy (ECT) uses an electrical stimulus under anesthesia to produce a therapeutic seizure. TMS uses magnetic pulses without anesthesia and does not intentionally induce a seizure. TMS generally allows you to drive home and resume your day, while ECT requires recovery arrangements and may cause memory effects. Both can be useful treatments; the best option depends on your clinical needs.

TMS may be an option for people with major depressive disorder who have not improved enough with antidepressant treatment or have difficulty tolerating it. Dr. Drell reviews your symptoms, treatment history, medical conditions, and safety screening to determine whether TMS is appropriate. Insurance eligibility is a separate consideration.

Usually, yes. TMS does not require sedation or a routine recovery period, so most patients can return to work, school, and other activities after a session. Let the team know if you experience side effects that affect your plans.

Call Houston West TMS at (713) 464-4455 or request a TMS appointment online. Our team will explain the consultation, review your insurance information, and guide you through the next steps.