Scott Webb (Host): Transcranial magnetic stimulation, or TMS, is an outpatient option for people who are suffering from depression, and my guest today is here to tell us more. I'm joined today by Dr. Lukmanafis Babajide. He's a psychiatrist with Eisenhower Behavioral Health.

This is Living Well with Eisenhower Health. I'm Scott Webb. Doctor, it's nice to have you here today. We're going to talk about TMS, and we're going to get to the truth, if you will, about transcranial magnetic stimulation. And it's so much easier to say TMS, of course. So, let's start there. What is TMS?

Dr. Lukmanafis Babajide: Yeah. So, TMS is, as you said, transcranial magnetic stimulation. It's basically where we put a magnet right on your head in order to send magnetic pulses to your brain for treatment for things like depression, anxiety, and many other things.

Host: Yeah, it's very interesting and I'm glad to have you on and benefit from your expertise. I just want to get a sense and give listeners a sense like where are these machines located?

Dr. Lukmanafis Babajide: We have machines located in the office. Usually, the machines are located in an outpatient office or facility where you can get the actual treatment in that office. And it's kind of like a barber chair or salon chair, how it's often described. And people just sit there and get treatment.

Host: But we can't do one-stop shopping, right? We can't also get a haircut. It's just the TMS in the office, yeah?

Dr. Lukmanafis Babajide: Yeah, it's just the TMS, unfortunately.

Host: Right. So, is this—I don't know, is this for everyone? Like, are there some specific requirements? Like, who's the right candidate for TMS?

Dr. Lukmanafis Babajide: For most places, TMS is going to be for people who have experienced depression, major depression specifically, and that has been resistant to other forms of treatment. So, that would be things like medication, several different types of medication, therapy. And after trying all of these, if you still have an unrelenting depression, TMS is a good consideration for you.

Host: Okay. Give us a sense as best you can, like how does it work? You explained, all right, you sit in the barber-ish chair and it's a magnet, you know, that's on our heads. But, like, how does the treatment work? How long does it take? Like, what can folks expect?

Dr. Lukmanafis Babajide: Yeah. So, the treatment that we provide works in a way where we send smaller magnetic pulses to the brain over a longer period of time. So, that's broken up into different days. So first, you just get mapped to show where the treatment area is going to be, where we're going to be sending those magnetic pulses.

And then, you'll come in about five days a week for six weeks, and you'll get about a 20-minute course of those smaller magnetic pulses to that area of the brain, the treatment area.

Host: Okay. Yeah. So obviously, there's a serious, you know, investment of time, but for folks who've tried lots of other things, medications and otherwise, this may be the thing finally, right, that helps them. So then, let's talk about the benefits, I guess, and what can patients expect? Like, where should they set their expectations anyway?

Dr. Lukmanafis Babajide: Yes. So, the way I see it is that the TMS is going to be a tool for long-term relief. So, the benefits are hopefully going to be most ideally remission of your depression. However, what you can most likely expect more readily from the TMS is a what people describe as a levity of a heaviness or emotional weight. They can also describe more energy coming from TMS treatment and having a change in their outlook on life or their situation.

Host: It's so interesting. Science, medicine, technology, it's so cool. Are there any, let's say, pain or side effects that might be associated with this treatment?

Dr. Lukmanafis Babajide: Yes, there are. However, the great thing about this is that the side effects are not major. There's one rare side effect that could be major that would disqualify a person from TMS, which would be having a seizure during TMS. However, that's very, very rare. Rarely ever happens in one in 60,000.

But otherwise, all of the other side effects are minor and self-limited. This could include a bit of pain, specifically at the site, a little bit of muscle twitching or fatigue in the first couple of weeks, and also headaches because we're doing it straight to the head.

Scott Webb: Right. Yeah. Yeah, that just makes sense. I would assume, "Yeah, I might get a headache." But as you say, the long-term benefits are really what patients are in for and what you're hoping for as their provider. I want to get a little better sense if I can, I don't know about maybe the history of TMS, but just like how does this work? Like, how did they determine that these magnets and the current would help people with things like depression?

Dr. Lukmanafis Babajide: So, I'm not going to have as much of a satisfactory answer for this one. Sometimes in medicine, we don't know the intricate way in which something works, but we just know it does.

Host: Okay.

Dr. Lukmanafis Babajide: But we do know that this is kind of getting at neuroplasticity and the promotion of BDNF, brain-derived neurotrophic factor, which bolsters neuronal connections and helps with neuronal growth. So, that's kind of the endpoint and how we're hoping CMS will help patients.

Host: Right. As you say, like sometimes things just work, right? And we don't necessarily have to know why they work as long as we know they do work and that they're safe and effective for most. Just trying to understand, you know, you gave us a sense, five days a week, for six weeks, something like that. But ultimately, though, the results, the benefits, like how long do they last? Is it like forever? Are patients cured, if you will? Will they have to come back in for a checkup, so to speak? Just give us a sense like how long do the benefits last?

Dr. Lukmanafis Babajide: That's a very good question. So as I alluded to before, TMS is going to be a tool. So as I was talking about the way in which it works regarding its endpoint what continues to reinforce the better neuronal pathways that grow are the actions of the patient. So, you putting in the work and making sure you're bolstering, strengthening those pathways are going to make TMS last longer.

However, for people who don't do that or just maybe take it passively, they still can get benefit from anywhere from six months to about a year before they see possibly a bit more of a decline. But for those who are active participants, what I would describe as active participants in their mental health hygiene while using TMS as adjunctive to that, they can experience long-lasting relief from depression and even remission.

Host: Wow. That's amazing. So, you know, the million-dollar question, Doctor, always with all this great science and technology is does insurance cover these treatments?

Dr. Lukmanafis Babajide: Yes. Who's going to pay for it? Most insurances do cover this if you meet specific requirements, like you meet the criteria for treatment-resistant depression and everything like that. And the copays are minimal to nothing. When you do get accepted for TMS, we have people who go over all of those things so that you're not going in blind. You go in eyes wide open, and you can make a decision as to whether you want to do TMS or not

Host: Sure. Well, this has been really educational. And, Doctor, I could keep you on for hours and really roll up my sleeves, but I won't do that to you and to listeners. Let's just finish up today and talk about, like, how long before folks begin to feel some improvement. Is it, like, after the first time, the tenth time? Ballpark it for us. Like, how long does it take them to feel like, "You know what? This is working. I'll see you tomorrow"?

Dr. Lukmanafis Babajide: Absolutely. As you kind of alluded to already, it's going to be patient-specific. It's going to depend on the individual. But people start feeling better in a matter of weeks, like a couple of weeks. As I said, there are some side effects that come through, and they usually are self-limited, and it's usually in those first couple weeks where you experience those side effects that you might not experience the full benefits. But usually by the first month or week three, people start noticing some benefit. There are people who notice benefit right away. There are some people who are a little bit longer, but I would say ballpark about two weeks before you start noticing something

Host: It's just incredible. The science technology for folks who've tried everything else. This is definitely an option that's on the table. And as you say, if they are active participants, right, in this process, in their own mental hygiene, iit could ultimately lead to remission, right?

Dr. Lukmanafis Babajide: Absolutely. Absolutely.

Host: That's great. Well, I appreciate your time and your expertise today. Thanks so much.

Dr. Lukmanafis Babajide: Thank you. Thank you for having me.

Host: And for more information, go to eisenhowerhealth.org/services/behavioral-health. and if you found this podcast helpful, please share it on your social channels and check out the full podcast library for additional topics of interest. I'm Scott Webb. And this has been Living Well with Eisenhower Health. Thanks for listening. .