The landscape of mental health treatment is rapidly evolving, and Transcranial Magnetic Stimulation (TMS) is at the forefront of this transformation. Traditionally used as a secondary or last-resort treatment for individuals who did not respond to antidepressant medications, TMS is now being considered a first-line treatment option for depression by many psychiatrists and clinics. The shift towards TMS is driven by its growing body of clinical evidence, superior safety profile, and potential for long-term relief. The Case for TMS as a First-Line Treatment For decades, antidepressant medications have been the primary treatment for major depressive disorder (MDD). However, not all patients respond positively to these medications, and many experience adverse side effects such as weight gain, fatigue, and sexual dysfunction. Moreover, medications often need to be taken over a long period, and in some cases, patients must try multiple drugs before finding one that works, if they find relief at all. TMS offers an alternative. It is a non-invasive, drug-free treatment that uses magnetic pulses to stimulate areas of the brain involved in mood regulation. Multiple studies have demonstrated that TMS can achieve higher remission rates in patients with depression, with significantly fewer side effects compared to antidepressants. A large-scale clinical trial showed that TMS was more effective than additional antidepressants for treatment-resistant patients, and the success of TMS in this challenging population is contributing to its growing acceptance as a primary treatment option. Long-Term Relief with Minimal Side Effects A key reason behind the increased adoption of TMS is the long-term relief it offers. A typical TMS treatment protocol involves daily sessions over several weeks, and patients who respond positively often maintain their improvements for months or even years. Studies have shown that 68% of patients who benefit from TMS continue to experience positive outcomes for at least 12 months, reducing the need for ongoing treatments or medications. Moreover, TMS has a low side-effect profile. The most common side effects include mild scalp discomfort or headaches, which generally subside after the first few sessions. This contrasts with the more severe and persistent side effects often associated with antidepressant medications, making TMS an appealing option for those who prioritize quality of life and minimizing treatment-related discomfort. The Future of TMS As TMS continues to gain recognition, its potential to revolutionize depression treatment is becoming clearer. Advancements in TMS technology, including the development of more precise stimulation techniques and individualized treatment protocols, are improving its efficacy and accessibility. Additionally, insurance companies are expanding coverage for TMS, which is further removing barriers for patients seeking this cutting-edge therapy. With more clinics offering TMS and its success rate continuing to rise, it’s no surprise that psychiatrists are considering it as a first-line treatment for depression. The non-invasive nature, minimal side effects, and long-lasting relief make TMS a valuable tool in the fight against depression, offering hope for individuals who may have previously found their options limited. TMS is reshaping the future of depression treatment. As a first-line treatment, it holds significant promise for individuals suffering from MDD who are seeking effective, non-drug alternatives to traditional therapies. With more research supporting its efficacy and accessibility on the rise, TMS is poised to become a mainstay in the treatment of depression. Sources:
The History and Impact of the 10 Hz TMS Protocol: A Decade of Healing
Since the FDA approved the 10 Hz transcranial magnetic stimulation (TMS) protocol in 2008, this groundbreaking treatment has offered relief to tens of thousands of patients suffering from treatment-resistant depression worldwide. The 10 Hz protocol, targeting the left dorsolateral prefrontal cortex (DLPFC), has become a cornerstone of non-invasive brain stimulation therapies. Despite the advent of newer technologies like theta burst stimulation (iTBS), the 10 Hz protocol remains a highly effective and widely-used treatment in the field of psychiatry. The Origins of the 10 Hz Protocol The foundation for the 10 Hz TMS protocol was laid with several pioneering studies, but the gold standard study is the one conducted by O’Reardon et al. in 2007, which demonstrated that daily sessions of 10 Hz TMS were significantly more effective than sham treatments in reducing depression symptoms. This landmark study led directly to the FDA approval of TMS in 2008 as a treatment for major depressive disorder (MDD) in patients who had not responded to conventional treatments. How the Protocol Works The 10 Hz protocol involves delivering high-frequency pulses to the left DLPFC, an area of the brain associated with mood regulation. Each session traditionally lasted 37.5 minutes, delivering 3,000 pulses, but advancements in TMS technology have shortened session times to roughly 19 minutes over the years, improving patient comfort while maintaining the protocol’s efficacy. Proven Efficacy Over the Years The 10 Hz protocol’s ability to offer consistent and meaningful relief for individuals with depression has been proven in countless studies and patient experiences. Even after 16 years of clinical use, it continues to demonstrate high rates of remission and symptom reduction, helping patients who have not responded to antidepressants and psychotherapy. As noted in studies such as George et al. (2010), the protocol is especially beneficial for those with less treatment-resistant forms of depression, with remission rates significantly higher than sham treatments. The Rise of New Technologies: Theta Burst and Beyond In recent years, new neurostimulation technologies like intermittent theta burst stimulation (iTBS) have emerged, offering even shorter treatment times (as little as 3 minutes per session) without sacrificing efficacy. For example, the Blumberger et al. (2018) study highlighted the effectiveness of iTBS as a non-inferior alternative to 10 Hz, making it an attractive option for some clinics and patients( Additionally, recent advancements, such as those discussed in this 2021 study, continue to explore different TMS approaches. Yet, despite these innovations, the 10 Hz protocol remains a trusted and reliable option for clinics around the world. The Blossom TMS Device: Combining Tradition with Innovation For clinics looking to incorporate TMS therapy efficiently, the Blossom TMS device is an ideal solution. With its advanced cooling technology, it prevents overheating during sessions, allowing for shorter treatment times without sacrificing performance. The Blossom TMS device is designed to make the 10 Hz protocol more accessible by reducing the logistical barriers clinics often face, such as long session times or machine downtime. For any clinic ready to get TMS up and running quickly, the Blossom TMS device offers the perfect combination of efficiency and proven effectiveness. A Decade of Healing Since its introduction, the 10 Hz protocol has been pivotal in helping tens of thousands of patients around the globe. While the field of brain stimulation continues to evolve, the 10 Hz protocol remains a gold standard. It has stood the test of time, offering patients a reliable and effective treatment for over a decade. Even with the rise of faster protocols like iTBS, the 10 Hz protocol’s consistent ability to alleviate the debilitating symptoms of depression has ensured its place in the arsenal of treatments for MDD. As we look to the future, the 10 Hz protocol remains a symbol of hope and progress in the treatment of depression. It is a reminder that while new technologies will always emerge, sometimes the original solutions continue to provide the relief that patients need. The protocol’s success over the years speaks for itself, and it will undoubtedly continue to be a cornerstone of depression treatment worldwide.
TMS: It’s Covered!
Exploring the Journey of Insurance Coverage for Transcranial Magnetic Stimulation in the USA Transcranial Magnetic Stimulation (TMS) has emerged as a revolutionary treatment for various mental health conditions, offering hope to those who have not responded to traditional therapies. While the effectiveness of TMS has been well-documented, its accessibility has significantly hinged on insurance coverage. In this blog post, we delve into the history and evolution of insurance coverage for TMS in the United States, highlighting the milestones that have made this treatment more accessible to patients nationwide. Understanding TMS: A Brief Overview Before exploring the insurance landscape, it’s essential to understand what TMS entails. TMS is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain, primarily used to treat depression and other mental health disorders. Approved by the FDA, TMS has proven effective for patients who have not found relief through medication or psychotherapy. The Early Days: Limited Recognition and Coverage 2008: FDA Approval Marks a Turning Point The journey of insurance coverage for TMS began in earnest in 2008, when the U.S. Food and Drug Administration (FDA) granted approval for its use in treating major depressive disorder (MDD) in adults who had not responded to antidepressant medications. This approval was a significant milestone, providing clinical validation for TMS and setting the stage for discussions around insurance coverage. 2009-2012: Initial Hesitancy and Gradual Acceptance Following FDA approval, insurance companies exhibited caution in adopting coverage for TMS therapy. The high cost of treatment and limited long-term data contributed to initial hesitancy. However, as more studies demonstrated the efficacy and safety of TMS, some regional and smaller insurance providers began to offer coverage on a case-by-case basis. Expansion and Standardization: Broadening Access 2012-2015: Major Insurers Come Onboard Between 2012 and 2015, several major insurance companies recognized the benefits of TMS and started providing coverage for eligible patients. Notable milestones during this period include: These decisions were influenced by accumulating clinical evidence, positive patient outcomes, and advocacy from mental health professionals emphasizing the need for diverse treatment options. 2016: Medicare Coverage Elevates Accessibility A significant breakthrough occurred in 2016 when Medicare started covering TMS therapy for depression. This development was pivotal for several reasons: Recent Developments: Wider Acceptance and Diverse Applications 2017-2020: Coverage for Additional Conditions As research expanded, demonstrating the efficacy of TMS for conditions beyond depression, insurance coverage began to reflect these findings: 2021-Present: Embracing Innovation and Accessibility In recent years, the landscape has continued to evolve positively: The Impact: Empowering Patients and Providers The progressive expansion of insurance coverage for TMS has had profound impacts: Looking Ahead: Continuing the Momentum While significant strides have been made, ongoing efforts are essential to further enhance coverage and access: The journey of insurance coverage for TMS in the United States reflects a dynamic interplay between clinical innovation, advocacy, and policy development. From initial skepticism to widespread acceptance, TMS has secured its place as a valuable tool in the mental health treatment arsenal, thanks in large part to evolving insurance policies that recognize its efficacy and importance. At SEBERS Medical, we are committed to staying at the forefront of these developments, ensuring that our patients have access to the most effective and innovative treatments available. TMS is not just a covered service; it’s a covered promise for better mental health and improved quality of life. For more information on TMS therapy and insurance coverage, feel free to contact us or visit our services page. Together, we can navigate the path to optimal mental health care.
The Quiet Power of Innovation: 3 Key Features of the Blossom TMS Device
When it comes to Transcranial Magnetic Stimulation (TMS), the technology behind the treatment is as critical as the therapy itself. At SEBERS Medical, we’ve taken every aspect of TMS therapy into consideration when designing the Blossom TMS device, ensuring it not only meets but exceeds the expectations of clinicians and patients alike. Here are three standout features that set the Blossom TMS device apart from the competition. 1. Plug-and-Play Simplicity: Powered by Standard 120-Volt Outlets One of the most significant advantages of the Blossom TMS device is its compatibility with standard 120-volt outlets. This feature simplifies installation and setup, making it incredibly easy for clinics to incorporate TMS therapy without needing expensive electrical modifications. Whether you’re in a large medical facility or a smaller outpatient clinic, the Blossom TMS device can be powered up and ready to go with the simple plug-and-play convenience. 2. Shhhh: Significantly Quieter Operation Several TMS devices rely on air cooling, which necessitates a hollow coil to allow airflow. While they can be effective, this design has a significant downside: it can be noisy. The Blossom TMS device, however, utilizes an innovative oil-cooling system that effectively suppresses this noise. The oil within the coil acts as a sound barrier, resulting in a much quieter operation. This quieter performance not only enhances patient comfort but also creates a more serene environment for both patients and clinicians. 3. Cool and Consistent: Maintaining Optimal Temperature with Oil Cooling Running cool is essential for any TMS device. The Blossom TMS device’s oil-cooling system isn’t just about reducing noise; it also ensures the coil remains at an optimal temperature throughout treatment. Our oil-cooled design maintains a consistent, cool temperature, promoting better performance and longevity. This feature not only safeguards the device’s internal components but also enhances the overall safety and effectiveness of each treatment session. The Blossom TMS device is a testament to the power of thoughtful design and engineering. With its ability to plug into standard outlets, operate quietly, and maintain a cool temperature during use, it’s clear that our focus is on delivering a superior experience for both clinicians and patients. These three key features highlight the innovation behind the Blossom TMS device, making it an ideal choice for any TMS provider looking to offer the best in patient care and clinical outcomes. About SEBERS Medical SEBERS Medical is a leading manufacturer of innovative medical devices, specializing in the production of the Blossom TMS device. Our mission is to advance mental health treatment through cutting-edge technology and exceptional quality. With a dedicated team of experts and a commitment to excellence, we strive to make a positive impact on the lives of those we serve. Contact Us: If you have any questions or would like more information about our products, please don’t hesitate to contact us. We are here to help! Stay connected with us for more updates and news by following our blog at https://sebersmedical.com/news/
Announcing the Digital Version of Blossom TMS Magazine!
We are thrilled to announce that the digital version of our acclaimed Blossom Burst TMS magazine is now available online! You can access the latest issue directly at https://blossomtms.com/tms-blossom-burst-magazine/ This digital edition is packed with insightful articles, expert opinions, and the latest advancements in TMS technology and mental health care. What You Can Expect In-Depth Articles: Our magazine features comprehensive articles on the latest trends and developments in Transcranial Magnetic Stimulation (TMS) therapy. From scientific breakthroughs to patient stories, we cover it all. Expert Insights: Read exclusive interviews and commentaries from leading professionals in the field of TMS and mental health. Gain valuable perspectives that can enhance your understanding and practice. Innovative Techniques: Learn about cutting-edge techniques and new applications of TMS therapy. Stay ahead of the curve with the most recent research and clinical practices. Highlights from the Latest Issue rTMS Therapy for Depression: This article delves into the effectiveness of repetitive Transcranial Magnetic Stimulation (rTMS) for treating depression. It provides an in-depth look at clinical trials, patient experiences, and expert opinions on this promising treatment method. Innovative Applications of TMS: Explore the latest research on how TMS is being used to treat a variety of mental health conditions beyond depression. This article highlights new studies and potential future applications of TMS technology. Expert Interview with Dr. Jane Smith: In this exclusive interview, Dr. Smith shares her insights on the evolution of TMS therapy and its impact on mental health treatment. Her perspectives offer valuable knowledge for both practitioners and patients. Instant Access Click here and get the latest issue delivered right to your inbox!! About SEBERS Medical SEBERS Medical is a leading manufacturer of innovative medical devices, specializing in the production of the Blossom TMS device. Our mission is to advance mental health treatment through cutting-edge technology and exceptional quality. With a dedicated team of experts and a commitment to excellence, we strive to make a positive impact on the lives of those we serve. Contact Us: If you have any questions or would like more information about our products, please don’t hesitate to contact us. We are here to help! Stay connected with us for more updates and news by following our blog at https://sebersmedical.com/news/
Blossom TMS Spotlight: Interview with Dr. Alex Lazar – Bliss TMS
Welcome to the Blossom Provider Spotlight series, where we highlight outstanding providers in the mental health field. This week, we’re thrilled to feature Dr. Alex Lazar, a highly experienced psychiatrist based in Encino, California. With over two decades of practice in adult and child psychiatry, Dr. Lazar has recently expanded his treatment offerings to include Transcranial Magnetic Stimulation (TMS), providing his patients with cutting-edge care for treatment-resistant depression and other mental health conditions. Interview with Dr. Alex Lazar – Bliss TMS Blossom TMS: What inspired you to pursue a career in psychiatry and mental health? Dr. Alex Lazar: My interest in psychiatry and mental health began during my medical school rotations. Psychiatry quickly became one of my favorite fields because I enjoyed talking to people about their stories and lives. It was fascinating to me, and that fascination led me to specialize in this area. Blossom TMS: How long have you been in practice, and where is your current practice located? Dr. Alex Lazar: I completed medical school in 1996 and went on to train in adult psychiatry at UCLA San Fernando, followed by child psychiatry at Cedars-Sinai Medical Center. I’ve been in private practice since 2001, so for about 23 years now. My practice is located in Encino, California, a suburb of Los Angeles. Blossom TMS: What first sparked your interest in TMS therapy, and how has your experience been so far? Dr. Alex Lazar: I had been practicing medication management and therapy for years, but I was always interested in exploring new treatment modalities. Although TMS has been around for a while, I initially had concerns about the barriers to entry, such as the cost of the machine and the learning curve. However, once I researched more and found a suitable machine and space in my office, I decided to move forward with it. My experience so far has been positive, and it’s rewarding to have another effective treatment option to offer my patients. Blossom TMS: Can you share any specific patient stories that highlight the impact of TMS therapy? Dr. Alex Lazar: I’ve had many patients who have seen significant improvements with TMS, especially those who were struggling with severe depression and had not responded to other treatments. One case that stands out is a young college student who began feeling much better after just 7 to 10 sessions. Another was a woman who had lost a child and was deeply depressed; she also experienced substantial improvement. While not every patient responds, the majority do, and the results can be quite profound. Blossom TMS: What do you find unique about the patient experience with TMS compared to other treatment modalities? Dr. Alex Lazar: One of the unique aspects of TMS is the frequency of visits, which allows for a closer connection with patients. Having them come into the office regularly helps build a stronger therapeutic relationship. However, the real effectiveness lies in the TMS treatment itself. It’s not just the increased interaction; TMS genuinely works for many patients. Blossom TMS: How has the scheduling of TMS sessions worked out for your patients? Dr. Alex Lazar: While TMS typically requires patients to come in five days a week, I’ve found that flexibility is key. Some patients can only manage three days a week due to their schedules, but they still see improvements. The important factor seems to be the total number of sessions rather than strictly adhering to a five-day-a-week schedule. Blossom TMS: What are your thoughts on the future of TMS therapy? Dr. Alex Lazar: I’m excited to see TMS being applied to more conditions beyond treatment-resistant depression and OCD. There’s ongoing research into its use for conditions like smoking cessation, tinnitus, migraines, and anxiety. I’m particularly interested in seeing how it might be used to treat bipolar depression, as I’ve had some promising results with that in my practice. Blossom TMS: What drew you to the Blossom TMS device, and how has it performed in your practice? Dr. Alex Lazar: The Blossom TMS device was a great fit for my practice because of its compact design, which is ideal for my smaller treatment room. The team at Blossom has been incredibly supportive and responsive, which made the transition smooth. The machine is user-friendly, and any issues I’ve encountered were quickly resolved. I’ve been very happy with my decision to go with Blossom. Blossom TMS: Is there anything else you’d like to share about your experience with TMS and Blossom? Dr. Alex Lazar: I’d just like to emphasize how pleased I am with both the results I’m seeing in my patients and the support I’ve received from Blossom TMS. The device is affordable and reliable, which makes it accessible for more providers and patients. I believe TMS has a bright future, and I’m glad to be part of that journey. To learn more about Blossom TMS, visit Seber’s Medical.
Understanding Theta Burst Stimulation
Excerpt from our magazine: This blog post is an excerpt from our magazine. For a free digital or print version to read the full article and much more, visit us at https://sebersmedical.com/ In the evolving landscape of psychiatric treatment, particularly in the realm of depression therapy, few names stand out as prominently as Dr. Khaled Bowarshi. As the vanguard at Florida TMS Clinic, Dr. Bowarshi has pioneered the integration of Transcranial Magnetic Stimulation (TMS) into a comprehensive program of depression care. His expertise, underpinned by over a decade of clinical psychiatry experience and specialized training from prestigious institutions such as Duke and Emory Universities, has positioned Florida TMS Clinic as the premier destination for those seeking advanced treatment modalities beyond traditional medication. Theta Burst Stimulation Made Simple Dr. Bowarshi’s article on understanding theta burst stimulation (TBS) in TMS sheds light on one of the most innovative and encouraging advancements in mental health treatment, underscoring his commitment to both clinical excellence and patient education. Modern pulse patterns in TMS enable accelerated treatment options, allowing for more effective and efficient care. Let’s break down the basics of TMS and the revolutionary theta burst stimulation. Classification of TMS Based on Pattern TMS can be classified into single-pulse TMS (used in mapping during a TMS therapy session or for migraine treatment) and repetitive TMS (rTMS). Repetitive TMS can be either intermittent or continuous. Intermittent rTMS involves pulsations that occur for a set period followed by a break, known as a “train” and “inter-train interval” (ITI) respectively. Continuous rTMS delivers pulsations without interruption and is used for treatments such as anxiety. Classification of rTMS Based on Frequency Repetitive TMS can also be categorized based on frequency: high-frequency (5 Hz or above) and low-frequency (below 5 Hz). For instance, the common high-frequency rTMS protocol for depression involves delivering magnetic pulses at a frequency of 10 Hz to the dorsolateral prefrontal cortex (DLPFC). Each train of 40 pulses is delivered in 4 seconds, with breaks between trains. This protocol delivers 3000 pulses per session. Low-frequency rTMS, used for depression and/or anxiety, involves continuous pulsations at 1 Hz for 15-30 minutes, delivering 900 to 1800 pulses per session. From Alpha to Theta: The Evolution of TMS Frequencies Traditional rTMS has focused on the alpha wave frequency, with 10 Hz being a common choice. However, theta waves, which range from 4 to 7 Hz, are now gaining attention. Theta waves are crucial for memory formation and deep meditation, indicating their potential effectiveness in brain stimulation. Introducing Theta Burst Stimulation (TBS) Theta burst stimulation combines frequency and pattern modifications. It involves delivering a triplet of pulses at 50 Hz, repeated at 5 Hz, which falls within the theta wave frequency. This intermittent pattern (iTBS) enhances stimulation efficiency. A typical iTBS session involves 600 pulses, delivered in 20 trains with 8-second breaks between each train. Effectiveness of Theta Burst Stimulation Research has shown that iTBS is as effective as 10 Hz rTMS, as demonstrated in the THREE-D trial, which led to FDA approval for theta-burst stimulation in 2018. The trial proved that iTBS, delivering 600 pulses in just over 3 minutes, is a viable and more efficient alternative to the traditional 10 Hz rTMS protocol, which requires 3000 pulses and takes significantly longer. Intermittent theta burst stimulation (iTBS) offers a unique and efficient pattern of repetitive TMS, delivering triplets of pulses at 50 Hz in bursts at a frequency of 5 Hz. This method is not only time-efficient but also highly effective, potentially offering superior results in higher dosages. About Dr. Khaled Bowarshi Dr. Khaled Bowarshi, leading Florida TMS Clinic, is a distinguished figure in psychiatric treatment, particularly in TMS therapy for depression. With a medical degree from Damascus University and extensive training in psychiatry, TMS, ECT, and Ketamine treatments from Duke and Emory, Dr. Bowarshi has significantly advanced mental health care. He is an elected director at the Clinical TMS Society and a clinical assistant professor. Florida TMS Clinic, based in Tampa and Wesley Chapel, Florida, is renowned for its FDA-cleared, medication-free treatment methods, supported by major insurance providers. For more information about Dr. Bowarshi and the groundbreaking work at Florida TMS Clinic, visit Florida TMS Clinic.
Blossom Provider Spotlight: Interview with Nicholas Goodwin of Goodwin Health Cafe
Welcome to our first installment of the “Blossom Provider Spotlight,” where we feature insightful conversations with the exceptional providers using the Blossom TMS device. This week, we had the pleasure of speaking with Nicholas Goodwin, a psychiatric nurse practitioner and the founder of Goodwin Health Cafe in Spokane, Washington. Tell us a little bit about your background in the field of mental health. I’m Nicholas Goodwin, a psychiatric nurse practitioner. I obtained my nurse practitioner degree and doctorate in nursing practice from Washington State University in 2019. Before opening my private practice, Goodwin Health Cafe, I worked as a psychiatric nurse in a state hospital for five years and taught undergraduate psych nursing. I also have experience working in residential treatment centers for adolescents, dealing with both mental health and substance use programs. What led you to incorporate TMS into your practice? I started with esketamine (SPRAVATO) treatments, which allowed for in-office visits where patients could see the same staff regularly, fostering a collaborative and therapeutic environment. The success of these treatments led me to explore Transcranial Magnetic Stimulation (TMS), which shares a similar in-office treatment model. The non-invasive, drug-free nature of TMS, along with its high efficacy rates, made it a perfect addition to my practice. Can you elaborate on the importance of patient compliance and in-office treatments? One significant advantage of esketamine and TMS is that they require patients to come into the office for their treatments. This increases compliance and ensures patients receive their treatment as prescribed. The in-office model fosters honesty and transparency, allowing us to address issues promptly. This approach also has a strong therapeutic aspect. Patients build rapport with the staff, from casual interactions with front-end staff to more therapeutic engagements with nurse practitioners. Sometimes I wonder if patients come more for the therapeutic environment than the treatment itself! What inspired you to pursue a career in mental health? A series of events led me to the field of mental health. My mother was a social worker, which influenced my interest in helping others. During nursing school, I realized I wanted to specialize in psychiatric nursing because I found it both challenging and fulfilling. The connection I felt with patients and the opportunity to make a significant impact on their lives solidified my commitment to this career path. What has been your favorite part about introducing TMS into your clinic? I enjoy the in-office visits and the opportunity to offer more treatment options for patients with treatment-resistant depression. TMS machines are fascinating, and their non-pharmacological approach is a significant advantage, especially for patients who have had negative experiences with medications. Providing an effective treatment that doesn’t involve daily medication is a tremendous benefit for both the patients and the clinic. Why did you choose the Blossom TMS device over other manufacturers? Several factors influenced my decision to choose the Blossom TMS device. The Blossom machine is compact and easily movable, which is essential for our small office space. Additionally, it doesn’t require a special electrical setup, unlike some other machines. The simplicity and user-friendliness of the Blossom device were also major selling points. After researching and comparing different machines, I found Blossom to be the best fit for our clinic’s needs. What advice would you give to other providers considering adding TMS to their practice? I recommend visiting a facility where multiple TMS machines can be seen in action, preferably without the influence of sales representatives. Investing time and money in understanding the technology and its practical applications is crucial. Additionally, ensure that your state’s regulations and insurance policies are favorable for TMS treatments. Speaking with other clinics that have experience with different machines can provide valuable insights and help make an informed decision. What are your hopes for the future of mental health treatment? I hope to see more innovative treatments that go beyond traditional pharmaceuticals. The potential of psychedelics, for example, is fascinating, as they seem to offer significant benefits not always captured by conventional efficacy measurements. As we learn more about these treatments and how to measure their impact on well-being, I believe the overall effectiveness of mental health care can improve. My goal is to continue providing cutting-edge treatments and quickly adopt new, effective approaches as they become available. Thank you, Nicholas, for sharing your experiences and insights with us! Stay tuned for more interviews in our “Blossom Provider Spotlight” series. For more information about Goodwin Health Cafe, visit Goodwin Health Cafe.
Blossom Provider Spotlight: An Interview with Casey Dubravcic from Revitalize Ketamine Clinic
Welcome to the Blossom Provider Spotlight series, where we highlight exceptional providers in the mental health field. This week, we’re excited to feature Casey Dubravcic, owner and operator of Revitalize Ketamine Clinic. Based in Flagstaff, Arizona, with additional locations in Sedona and Prescott Valley, Casey and his team are dedicated to offering innovative treatments like Ketamine infusions and Transcranial Magnetic Stimulation (TMS) to their patients. Interview with Casey Dubravcic Blossom TMS: What got you into mental health, and can you tell us a little about your background? Casey Dubravcic: My name is Casey Dubravcic, and I’m the owner and operator of Revitalize Ketamine Clinic, along with my wife, Jill Dubravcic. We’re based in Flagstaff, Arizona, with additional clinics in Sedona and Prescott Valley. We recently started offering TMS in our Flagstaff and Prescott Valley locations. My journey in healthcare began in 2004. I worked in ICU, CDICU, and pre-op PACU, and initially thought I wanted to be a certified registered nurse anesthetist. However, after spending time in the operating room, I realized my true passion was in psychiatry and mental health. Working in the ICU, I found great reward in helping the families of patients, which sparked my interest in mental health. Blossom TMS: What led you to establish Revitalize Ketamine Clinic? Casey: My wife and I founded Revitalize Ketamine Clinic to provide innovative and effective treatments for mental health conditions. Our primary focus has been on Ketamine infusions, which have shown great promise in treating conditions like depression and anxiety. We’ve always been passionate about mental health, and expanding our services to include TMS has been a natural progression for us. Before we started offering TMS ourselves, a dear friend of mine, a military veteran, experienced a complete turnaround in his chronic suicidality after undergoing TMS, and he’s been symptom-free since the treatment. This was very inspiring to see. Blossom: Why did you choose the Blossom TMS technology for your clinic? Casey Dubravcic: We chose Blossom TMS technology for several reasons. Firstly, the Blossom TMS machine is incredibly durable and effective, with an oil-cooled system that ensures it can handle continuous use without issues. It’s a real workhorse. Another significant factor was the CEO of Blossom TMS. He isn’t just a business person but has a deep understanding of what makes a good TMS machine. His expertise and hands-on approach gave us confidence in the technology. Moreover, the aftercare and support provided by the Blossom team have been outstanding. When making a substantial capital investment, you want to ensure you’ll have ongoing support, and Blossom has exceeded our expectations in this regard. Blossom TMS: How has your experience been with offering TMS at your clinic so far? Casey: The experience has been very positive. We’re seeing a lot of interest in TMS. TMS is an appealing alternative because it doesn’t require medication and has minimal side effects. Patients appreciate the short, unobtrusive appointments and the fact that they can drive themselves to and from sessions. It’s exciting to offer a treatment that can significantly improve their quality of life. Blossom TMS: What do you like most about TMS compared to other treatments? Casey: One of the things I love about TMS is that it offers a non-pharmacological treatment option that is highly effective. The treatment resonates with people because it combines the science of neuromodulation with a holistic approach to mental health. There’s also compelling evidence supporting its effectiveness, and it’s encouraging to see patients benefit from a treatment that doesn’t involve medication. TMS offers a unique way to help people achieve better mental health without the side effects associated with traditional medications. Additionally, the positive, supportive environment we create at our clinic plays a huge role in patient recovery. Blossom TMS: Can you address some common misconceptions about TMS? Casey: A common misconception is that TMS is painful or invasive. In reality, most patients only feel a tapping sensation on their scalp, and it’s generally well-tolerated. Another misconception is that TMS is similar to electroconvulsive therapy (ECT), but it’s quite different. TMS is non-invasive and doesn’t require anesthesia. It’s also important to note that many people believe they need to have tried multiple medications before qualifying for TMS, but that’s not always the case. Many patients who have tried just one or two medications, or even those who have primarily relied on therapy, can be good candidates for TMS. Blossom TMS: What misconceptions did you have about TMS as a provider, and how did your views change? Casey: Initially, I had concerns about TMS being perceived as a placebo or “snake oil” treatment. I wondered if the benefits were largely due to patients spending time with an engaged provider rather than the treatment itself. However, after diving into the science behind TMS and witnessing the motor threshold determination and actual patient outcomes, my perspective changed. Seeing the tangible effects has helped me understand the genuine impact of TMS. Additionally, I realized how straightforward it is to administer the treatment and how well patients respond to it. This experience has reinforced my confidence in TMS as a robust, effective treatment modality. Blossom TMS: What are you most excited about for the future of TMS? Casey: I’m excited about the increasing accessibility of TMS. As more people become aware of its benefits and as insurance coverage expands, more individuals will have the opportunity to improve their mental health with this treatment. The prospect of TMS becoming a more common and accepted treatment modality is incredibly promising. It’s a great time to be involved in this field, and I’m looking forward to seeing how TMS continues to evolve and help more people. Blossom TMS: Thank you, Casey, for sharing your insights and experiences with us! We look forward to seeing the continued success of Revitalize Ketamine Clinic and the positive impact it will have on the community. … Learn More Revitalize Ketamine Clinic, led by Casey Dubravcic, is making significant strides in the mental health field by offering innovative treatments like Ketamine infusions and TMS. We are proud to feature such dedicated providers in our Blossom Provider Spotlight series, showcasing their
Blossom Burst Magazine Feature: rTMS Therapy for Depression
A Primer on Its Physical Principles, Practicalities, Protocols and Evidence Base Authors: Leo Chen and Linda L. Carpenter Excerpt from our magazine: This blog post is an excerpt from our magazine. For a free digital or print version to read the full article and much more, visit us at https://sebersmedical.com/. Introduction Repetitive transcranial magnetic stimulation (rTMS) has gained global recognition as an effective and safe treatment for depression. Initial research trials conducted nearly 30 years ago demonstrated its potential, leading to extensive investigations into its physiological and therapeutic effects. Today, rTMS is a well-established treatment for major depressive disorder, particularly for patients who do not respond to antidepressant medications. Fundamental Principles of rTMS rTMS operates by applying electromagnetic pulses to stimulate nerve tissue beneath the stimulation coil and indirectly affecting remote brain areas through connections. The process involves discharging a pulsed electrical current from a stimulator to a TMS coil, producing a transient electromagnetic field. This field induces electrical fields in neurons located near the coil, resulting in increased or decreased neuronal excitability. Repeated rTMS sessions enhance neuroplastic effects, which are believed to contribute to its therapeutic efficacy. Practical Application of rTMS During rTMS therapy, patients remain awake, comfortably seated in a reclinable chair. Anesthesia or sedation is not required. The initial session involves locating the stimulation target, typically the left dorsolateral prefrontal cortex (DLPFC), and calibrating the stimulation intensity based on the patient’s motor threshold. Treatment sessions range from a few minutes to half an hour, usually conducted once daily for four to six weeks, followed by a tapering phase. Evidence-Based Efficacy of rTMS rTMS is endorsed by various clinical practice guidelines as an effective treatment for depression. Seminal trials have established the efficacy of 10 Hz rTMS delivered to the left DLPFC for treatment-resistant depression (TRD). Subsequent studies and meta-analyses have consolidated the evidence, confirming rTMS’s antidepressant efficacy, tolerability, and safety. Comparisons with other treatments, such as electroconvulsive therapy (ECT) and pharmacological augmentation strategies, have shown rTMS to be a highly effective intervention. Alternative rTMS Protocols Research has explored various rTMS protocols, including different stimulation frequencies and targets. Studies have shown that 1 Hz rTMS to the right DLPFC and sequential bilateral rTMS are also effective for treating depression. The H-coil, which stimulates broader cortical areas, has demonstrated superior efficacy in some trials. These findings highlight the versatility and adaptability of rTMS in clinical practice. Future Directions As rTMS continues to evolve, future research aims to address knowledge gaps, optimize treatment protocols, and personalize therapy through neuroimaging. The ongoing development of accelerated rTMS protocols and advancements in targeting specific brain regions hold promise for improving treatment outcomes and expanding the application of rTMS to other neuropsychiatric conditions. About the Authors Dr. Leo Chen is a Senior Research Fellow and Head of the Brain Stimulation Lab at Monash University, Melbourne, Australia. He is a Consultant Psychiatrist at Alfred Mental and Addiction Health and has contributed extensively to the field of therapeutic brain stimulation through clinical trials, peer review, and the development of clinical practice guidelines. Professor Linda L. Carpenter is the Director of the TMS Clinic and Neuromodulation Research Facility at Butler Hospital and a Professor of Psychiatry at Brown University. Her research focuses on developing new treatments for depression, including device-based therapies, and she has served as Principal Investigator on numerous clinical trials. For more detailed information and references, please refer to the original article published in our magazine. This blog post provides an overview of the key points and highlights the significant contributions of rTMS therapy in treating depression. Contact Us
