Frequently asked questions about rTMS

We understand that you may have many questions about rTMS. Below you will find frequently asked questions about rTMS treatment and how we work.

  • How effective is rTMS in treating depression and OCD?
  • How is rTMS that effective?
  • Can I get rTMS alone without psychotherapy?
  • How many sessions do I need?
  • Why should I choose neuroCare Netherlands?
  • Is the treatment reimbursed?
  • Does rTMS have any side effects?
  • Is rTMS painful?
  • Does rTMS have a long-term effect?
  • What is the difference with electroshock therapy (ECT)?
  • What is the difference between rTMS and Neurofeedback?
  • Is a bipolar disorder or anxiety also treatable with rTMS?
  • Can I still drive a car independently after a treatment?
  • Should I stop taking antidepressants?
  • Why is the QEEG assessment mandatory?
  • Can anyone have rTMS treatment?
  • Do I need a referral from the general practitioner?
  • Is there a waiting list?
  • Do I have to be admitted to treatment?
How effective is rTMS in treating depression and OCD?

Our research results for clients with treatment-resistant depression show that after an average of 21 sessions, 66% of the client group responded well to the treatment (at least a halving of the symptoms) and 56% of the total group even reached remission (depression could no longer be diagnosed in them). In the client group with therapy resistant OCS, the treatment method is effective at 55%. These results are based on a combination of rTMS and conversation therapy.

How is rTMS that effective?

This is due to the combination of the rTMS with conversation therapy in order to achieve a better and long-term effect.

Can I get rTMS alone without psychotherapy?

This is a possibility, but we do not recommend it, as there are indications from scientific research that the combination of rTMS with conversation therapy has better long-term effects and probably a better effectiveness.

How many sessions do I need?

On average, people with depressive symptoms need about 30-40 sessions. People with OCS symptoms usually need 25-35 sessions to achieve a long-term effect.

The best effect of the rTMS treatment is achieved by following an average of 2-3 sessions per week. Usually there should be a noticeable effect within 10-15 sessions.

Why should I choose neuroCare Netherlands?

Since 2001, neuroCare Nederland (formerly Brainclinics) has been focusing on research and treatment of depression, coercion and sleeping problems, among other things. Through years of treatment and research experience in this field, we are regarded nationally and internationally as a specialised treatment centre and research institute. Clients from home and abroad know where to find us for these reasons.

We only offer treatment methods for which thorough scientific research is available and we also do a lot of research ourselves. We carry out this research in collaboration with (inter)national scientists associated with various (inter)national universities. So we know better than anyone about the state of the art behind our treatment methods. We also regularly carry out pilot projects in which we use and evaluate new treatment methods or new applications of existing methods in a small setting. Only in this way will science and its applicability in healthcare progress. neuroCare Nederland was the first practice in Europe to apply rTMS to depression and OCD. In the meantime, we have successfully treated hundreds of people with rTMS.

Our multidisciplinary team looks at our client’s complaints from different angles and comes up with a personalized treatment plan. This broad view is greatly appreciated by many clients; we adapt our treatment protocol to your complaints and personal situation.

First of all, we do an extensive intake to get an accurate picture of you and your complaints. For example, things like sleep are also taken into account. Also during your treatment, we keep a close eye on the course of the treatment and adjust it if necessary. Our personal and professional approach as well as short internal lines of communication are reasons for many to choose neuroCare Netherlands.

Our therapists are all university+ educated and thoroughly trained in the treatment methods they apply. We are affiliated with important professional associations such as the Netherlands Institute of Psychologists (NIP) and the Dutch Association of Educators and Educationalists (NVO). Regular training keeps our knowledge and skills up to date.

Is the treatment reimbursed?

To get an answer to this question we refer you to the page with rates and fees of the branch where you want to be treated.

Does rTMS have any side effects?

The use of rTMS as a treatment can have side effects. The most common side effect is the development of a short period of light muscular tension headache as a result of the stimulation. This can often be easily remedied with a light painkiller.

During the discharge of the coil one hears a ‘click’ sound, the volume depends on the strength of the stimulation, and this can cause a temporary lowering of the hearing threshold. You can choose to use earplugs.

Furthermore, during the research phase of rTMS, an epileptic seizure has occurred in a test subject. What is the risk of an attack? This risk depends, among other things, on individual characteristics. People with a medical history that is known to have an increased risk of having an epileptic seizure also have an increased risk of having an epileptic seizure as a result of the rTMS treatment. These risk groups include (but are not limited to) epilepsy or history of an epileptic seizure. The information obtained from the intake interview, QEEG examination and consultation with the treating medical specialist determines whether treatment with rTMS is indicated and safe to apply.

We adhere to the internationally established safety guidelines, as a result of which the risk of an epileptic seizure in people without a medical history of epilepsy or any other disorder as mentioned above, is very limited.

Is rTMS painful?

Usually our clients describe the ‘magnetic taps’ as irritating, but not painful. Also, our experience is that the feeling gets used to the sessions.

Does rTMS have a long-term effect?

If the symptoms return over time, the positive effect can be regained through 5-15 sessions. Some clients opt for fixed maintenance sessions once a month or once every 2-3 months. For clients with a relapse we will also advise maintenance sessions to prevent further relapse.

What is the difference with electroshock therapy (ECT)?

We sometimes compare a depression with an electrical failure in a computer in a large apartment building on the fifth floor in room 23. In Electroshock therapy or Electroconvulsive Therapy (ECT), the plugs of the entire apartment building are removed to solve the problem. With rTMS we don’t have to pull out all the plugs. We know exactly on which floor, in which room we should be. This prevents side effects, such as memory problems.

What is the difference between rTMS and Neurofeedback?

Neurofeedback is a method that has been extensively studied in the treatment of ADHD, sleep problems and epilepsy. rTMS has been extensively studied in the treatment of depression and OCS. An average of 40-50 sessions are needed for neurofeedback, an average of 20-30 sessions for rTMS in depression and an average of 25-35 sessions for rTMS in OCS.

Is a bipolar disorder or anxiety also treatable with rTMS?

rTMS treatments work complaint-oriented, so focus on gloom and depression and work best in unipolar depression. If there is a bipolar disorder with prolonged depressive periods, rTMS can also be applied. Anxiety and depression often occur together. rTMS focuses on the depression and the anxiety complaints are further treated by means of conversation therapy.

Can I still drive a car independently after a treatment?

rTMS does not affect your ability to drive, as some medications do. However, it is possible that you experience the treatment as intensive and therefore more tired. If you are in doubt about your driving ability, it is wise to bring someone along with you.

Should I stop taking antidepressants?

rTMS therapy can be a good addition to the reduction of antidepressant medication or to prevent relapse. It is not necessary to reduce or stop your medication before starting treatment. For stopping or discontinuing your medication we always refer you to your prescribing psychiatrist or family doctor for advice.

Why is the QEEG assessment mandatory?

This is for two reasons. The first is safety. On the basis of the QEEG examination, we determine whether you are eligible for the treatment. In about 5% of the population there is activity in the brain that can be dangerous to stimulate with rTMS. Then the risk of an epileptic seizure is higher. (If this activity is found in you, there will be approval from a neurologist before we proceed to treatment).
The second reason for this examination is the possibility to further personalize the treatment.

Can anyone have rTMS treatment?

If you have depressive or compulsive complaints, you may be eligible for rTMS treatment. You are not eligible for rTMS if:

  • You are pregnant or want to become pregnant in the short term;
  • You have a cochlear implant;
  • You have a pacemaker;
  • If you have epilepsy you will need to consult one of our rTMS experts.
Do I need a referral from the general practitioner?

Do I need a referral letter from my family doctor? A referral letter is not required to come to us for treatment. A referral for specialist mental healthcare is a prerequisite for the partial reimbursement of the treatment from your health insurer. Without a referral, the costs of the entire process are for your own account.

Is there a waiting list?

The length of the waiting list varies. The waiting time does not depend on diagnosis and does not differ per insurer. A monthly update of the current waiting times takes place (see registration procedure). In general, the more flexible you are in your time, the sooner we can schedule an appointment for you.

Do I have to be admitted to treatment?

No, the treatment is outpatient, i.e. without admission.

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