Transcranial Magnetic Stimulation (TMS)

Transcranial Magnetic Stimulation is an evidenced based treatment for depression and uses powerful electromagnetic fields to repetitively stimulate underlying brain cells aiming to generate sustained changes in the neuronal circuits implicated in depression.

If suitable for an individual a course of TMS involves a mapping session where the treatment location and magnetic field strength (dose) is individualized to the patient. 

Then a series of treatment sessions are undertaken in our offices up to five days a week for at least five weeks aiming to alleviate the symptoms of depression

There are different treatment protoccols that can be applied involving the right or left pre-frontal cortex that are evidenced based treatments for Depression.

Numerous studies support its effectiveness for patients who have not responded to previous trials of antidepressant medications although it is important to note that just like medication and psychological treatments for Depression, not all patients respond to TMS.  

TMS like all medical treatments does require a patient to be informed of potential side effects as well as potential benefits so they can make an informed choice whether to proceed. Patients are educated by our psychiatrists during the assessment session to enable them to consider whether TMS is right for them .

There are some medical reasons why TMS may not be suitable and this is ascertained during an initial assessment where a patient's medical history is taken by one of our psychiatrists. 

If patients are referred with a valid medicare referral to our doctors by their treating doctor (GP or Psychiatrist) or nurse practitioner the initial consultation attracts a Medicare rebate to partially reimburse some of the costs of the initial assessment, however there will be an out of pocket 'Gap' fee payable as well. 

Additionally there is a medicare subsidy in Australia for Treatment Resistant Depression to partially assist with the funding costs of TMS treatment with AxonPsychiatry, but there will be a gap payable for treatments with our Service. The medicare reimbursement only applies if a patient meets certain eligibility criteria for MBS item 14216/14217 MBS online:  MBS Online - MBS Online  . This is explored and explained to patients at the initial consultation. 

Esketamine is an antidepressant medication adminstered via intra-nasal spray that acts via NMDA glutaminergic pathways and has a different mechanism of action compared to standard oral medications. 

If suitable for esketamine a treatment session involves self-administation of the medication under close medical supervision in one of our two accredited locations, whilst the medication is active in a patient's system and until it wears off. It is recommended that this be undertaken twice a week for a month before treatments are spaced out.  

Esketamine has an evidence based to support that it can be of benefit to patients who have not responded to previous trials of antidepressant medications however just like medication and psychological treatments for Depression not all patients respond.

Esketamine like all medical treatments has side effects and patients are educated on these during the initial consultation by our psychiatrists, as well as on potential benefits so they can make an informed choice whether Esketamine is appropriate for them. 

There are some medical reasons why Esketamine may not be suitable and a comprehensive medical history is undertaken at the initial assessment with our psychiatrists to determine this.

If patients are referred with a valid medicare referral to our doctors by their treating doctor (GP or Psychiatrist) or nurse practitioner the initial consultation attracts a Medicare rebate to partially reimburse some of the costs of the initial assessment, however there will be an out of pocket 'Gap' fee payable as well. 

In Australia Esketamine has recently been approved under the Pharmaceutical Benefits (PBS) Scheme for patients with treatment resistant depression who meet eligibility criteria. This has assisted in bringing the cost of this medication down however there is no medicare subsidy for the required monitoring that is essential for the treatment to occur.  A facility fee that is privately funded is payable for each treatment with Esketamine.