We aim to provide better outcomes for you, the patient. You’re the whole reason we are here.

We understand the crucial role that each member of your existing healthcare team play in the treatment process. We believe that collaborative care is the best strategy. That’s why we work hard to include you and your existing GPs, neurologists, neurosurgeons, nurse practitioners, psychiatrists, and psychologists in your care.

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FAQs

What is TMS?

TMS (Transcranial Magnetic Stimulation) is a non-invasive treatment that uses magnetic fields to stimulate nerve cells in the brain.

During TMS, a small device called a coil is placed against the scalp. The coil sends magnetic pulses to the brain, which can help to alleviate symptoms of depression. TMS is an TGA-approved treatment for depression, and is often used when other treatments, such as medication or therapy, have not been effective.

For a picture of what this looks like, please visit Nexstim’s site

What is Neuronavigational TMS or "nTMS" (and why does it matter)?

Neuronavigational TMS (nTMS) is an advanced form of Transcranial Magnetic Stimulation (TMS) that uses computer-guided navigation to target specific areas of the brain with greater precision than the existing hand-held or even the cap-based devices (Caulfield et al, 2022).

We use Nexstim‘s SmartFocus® nTMS technology. It is designed to provide more precise and effective treatment for depression, compared to TMS. nTMS is designed to provide more accurate and effective treatment by identifying the specific areas of the brain that are associated with depression.

This technique involves using a specialised MRI scan to create a 3D “map” of the patient’s brain. This map is uploaded to the TMS machine and is used to guide the TMS coil to the exact location that requires treatment (like GPS).

What conditions can you treat with nTMS?

In some countries, including Australia, TMS has been approved for other conditions like obsessive-compulsive disorder (OCD), smoking cessation, and chronic pain.

Ongoing TMS clinical trials are also being conducted for conditions such as Alzheimer’s disease, Parkinson’s disease, anxiety, and post-traumatic stress disorder (PTSD). While TMS is often associated with depression treatment, it has shown promise in treating a range of neurological and psychiatric conditions.

At HHC, we see patients with depression, particularly treatment-resistant depression. These are patients who have been treated for depression with medication, but their symptoms haven’t improved.

How do I access nTMS?

  • NB: nTMS stands for neuronavigational rTMS (repetitive TMS). nTMS uses repetitive pulses provided by the magnetic coil as part of its therapeutic benefits, and uses neuronavigation – like GPS for the brain – to locate where we should stimulate.
  • We use a map of your brain (provided by an MRI and our technology) to locate the right area for stimulation. This is called neuronavigation.
  • Please discuss with your GP or Psychiatrist and ask them to refer you to Human Health Clinics for rTMS. You can self-refer (see below). For your safety, you’ll also need to consult with our experienced psychiatrist and health professionals who specialise in rTMS (Repetitive Transcranial Magnetic Stimulation).
  • To qualify for Medicare subsidised rTMS, you need to be over 18 yrs old, be diagnosed with Major Depressive Disorder and have tried 2 antidepressant medications and a psychological treatment without success.
  • If you do NOT qualify under Medicare, please speak to us about other arrangements, such as NDIS, private payment or select health funds.
  • Once we have your referral, our friendly, our highly trained staff will contact you to discuss whether rTMS is the best treatment for you and whether you have any conditions that are contraindicated. This is also an opportunity for you to ask any questions.
  • We will then book an appointment with our consultant Psychiatrist to meet and answer any questions you have
    If you decide to proceed, we will provide you with a referral for a brain MRI (additional costs applies).
  • Your MRI scan of your brain can be transferred to our clinic on a physical disc (CD) or via upload
  • We will arrange for you to have a mapping session for rTMS.
  • You will still see your usual doctors and HHC will communicate with you and them regarding your treatment.

Can I self-refer?

  • Yes, please fill out our Patient enquiry form below ⬇️ to get started.
  • We’ll call you for a chat to see if rTMS and our other services at HHC are right for you. For your safety, you’ll also meet with our expert psychiatrist and team who know all about rTMS.
  • We will arrange for you to have an MRI and mapping session for rTMS.
  • You will still see your usual doctors and HHC will communicate with you and them regarding your treatment.

Do you see children?

We do not see children (people under the age of 18), although we are able to refer you to services that may be able to assist you.

If you have a child for whom you are considering TMS in a clinically-regulated, but  investigational setting, this trial into TMS for Autism (in Australia) may be suitable for you. Every patient and every situation is unique and the trial coordinators will have their own criteria for eligibility. We do not offer this service at HHC.

How much does it cost?

  • We offer telehealth and in-clinic services, with some services at Medicare or attracting an out-of-pocket fee (if you don’t meet the requirements for Medicare).
  • Medicare requirements for repetitive transcranial stimulation are listed here on http://www.mbsonline.gov.au/, under “rTMS – Patient factsheet – 25 October 2021” (PDF).
  • Our neuronavigated TMS machine, Nexstim, is the only machine of its kind available in Australia. To attain its accuracy, you will need an MRI of your brain, for which the radiology company will charge a fee (typically $240 – $350). HHC does not receive any part of this fee.
  • If you’d like to request a callback to discuss making an appointment or whether you’d qualify for Medicare, or the out-of-pocket costs, please fill in the form below.

Every patient and every situation is unique: you (and your loved ones) will need to make a decision balancing the cost of an outpatient clinic against the alternative of hospital admission and in-patient treatment.

HHC offers an advanced technology (neuronavigational TMS) to provide higher accuracy in targeting, per latest research. This additional technology attracts additional fees. To read more about neuronavigational TMS, see:

  • Caulfield, K. A., Fleischmann, H. H., Cox, C. E., Wolf, J. P., George, M. S., & McTeague, L. M. (2022). Neuronavigation maximizes accuracy and precision in TMS positioning: Evidence from 11,230 distance, angle, and electric field modeling measurements. Brain Stimulation, 15(5), 1192-1205. https://doi.org/10.1016/j.brs.2022.08.013
  • Pieramico, G., Guidotti, R., Nieminen, A.E., D’Andrea, A., Basti, A., Souza, V.H., Nieminen, J.O., Lioumis, P., Ilmoniemi, R.J., Romani, G.L., Pizzella, V., & Marzetti, L. (2023). TMS-Induced Modulation of EEG Functional Connectivity Is Affected by the E-Field Orientation. Brain Sciences, 13(3), 418. https://doi.org/10.3390/brainsci13030418
  • List of Nexstim whitepapers (Nexstim is the manufacturer of the TMS device we use at HHC).

How can patients pay for treatment?

Human Health Clinics sees private or self-funded patients, so there will be an out-of-pocket for our services. In most cases, Treatment Resistant Depression will be covered by Medicare and DVA as long as a patient has failed 2 or more antidepressants due to inadequate responses or intolerable side effects. The relevant Medicare numbers for TMS are for Depression only (14217 – 14220) and have requirements. Other indications for TMS may be covered by DVA and Work Cover. Australia Defence Force personnel may also be covered under BUPA.

What if I don't have a psychiatrist?

You can ask your GP to refer you for TMS, or you can see our Mental Health nurse practitioner if you don’t have a GP and/or a psychiatrist.

A nurse practitioner is a “registered nurse who has completed specific advanced nursing education and training in the diagnosis and management of medical conditions and holds endorsement as a nurse practitioner” (source). You can find out more about their qualifications and requirements here and what they can do, particularly in the context of mental health (see PDF). In summary, they can diagnose, order MRIs, prescribe medications and intervene when treatment is not working out (eg treatment-resistant depression).

Our mental health team consists of psychiatrists, GPs, nurse practitioners, nurses and doctors who all hold current Ahpra registration and appropriate qualifications.

What happens after I ask for a call-back?

  • Once we have your request, our friendly, highly trained staff will contact you within two work days to discuss rTMS with you and whether you have any conditions that are contraindicated. This is also an opportunity for you to ask any questions.  
  • If you already have a Psychiatrist, then you can ask them to email us a referral to manager.niddrie@humanhealthclinics.com.au. Please note, your existing psychiatrist will remain your main point of contact and treatment for all of your mental health care. 
  • If you have a GP (but not yet seen by a Psychiatrist), one of our team can support you in booking a telehealth consultation with one of our mental health team.  
  • We will then book an appointment with our consultant Psychiatrist to review your mental health journey with you and answer any questions you have.
  • If you decide to proceed, we will provide you with a referral for a brain MRI (additional costs applies).  
  • Your MRI scan of your brain can be transferred to our clinic on a physical disc (CD) or USB. 
  • We will arrange for you to have a mapping session for rTMS.  
  • You will still see your usual doctors. The HHC team will communicate with both you and them regarding your treatment. 

What can I expect when having nTMS at Human Health Clinics?

When undergoing transcranial magnetic stimulation (TMS) treatment, here are some things our patients can expect:

Preparation: You will be greeted by our highly trained staff, who will confirm your details and recent health status (eg any ill health, medication changes, recent stressful events), offer you ear plugs, and then invite you to recline in the specially designed, comfortable chair. You will have a removable navigational tracker applied to your forehead via a non-adhesive sticker – this is for orienting the brain and locating the therapeutic target – and non-invasive EMG stickers applied to your hand to test for muscle conductivity – to set the resting motor threshold. You can see the treatment map on the patient screen at the same time as the doctor.

Session Length: A typical TMS session lasts around 20-30 minutes.

Treatment sessions: During the treatment, you will hear a clicking sound as the magnetic pulses are delivered to your brain. You may also feel a tapping or tingling sensation on your scalp. These sensations are generally mild and well-tolerated. You will be offered ear plugs for your comfort.

During the treatment, you are invited to relax, and can also watch TV/spend time on your phone if you wish.

Once the treatment is finished, our staff will take the stereotactic tracking device off and you are free to go about your day!

Whilst it is safe to drive and engage in your usual activities as long as you feel well afterwards, you are welcome to relax post treatment in our comfortable/relaxing/luxurious clinic if you wish.

Frequency of Treatment: The frequency of TMS treatments depends on your specific treatment plan. Typically, patients receive treatment five days a week for four to six weeks, followed by tapering off the frequency of treatments.

Side Effects: TMS is generally considered a safe and well-tolerated treatment, and most patients do not experience any serious side effects. However, some people may experience mild headaches, scalp discomfort, or muscle twitching during or after the treatment.

Improvement of Symptoms: Over the course of treatment, many patients report improvement in symptoms such as depression, anxiety, or chronic pain. It is important to remember that individual responses to TMS treatment can vary, and it may take several weeks before you notice a significant improvement in your symptoms.

TMS is a non-invasive and generally well-tolerated treatment.  If you have specific questions or concerns about the treatment, we welcome you reaching out to our staff and letting them know as soon as possible.

I'm a business owner / super busy / parent / working during the week. How can HHC help?

Typically, TMS is prescribed and administered whilst in hospital, to help cover the otherwise significant costs of administering TMS. The in-hospital course is usually one-hour session(s), six times a week for three to five weeks, as an inpatient. An in-hospital treatment plan may not be convenient for everyone.

Whilst every patient is an individual, with unique requirements, HHC may be able to help people a number of ways:

  • We offer a telehealth service, Australia-wide: We can review medications, diagnose, prescribe and treat mental health conditions. Combined, our team has 70 years of experience and multiple qualifications in the fields of mental health.
  • We operate an in-person outpatient clinic in Melbourne, Victoria: the significance of this is… no in-hospital stay for weeks on end whilst you wait to receive your daily one-hour treatment. Come into our HHC clinic for your treatment, then you can drive yourself afterwards (as long as you’re feeling well).
  • Where possible, we try to bulk-bill. If you have a Medicare card, we can often offer our services bulk-billed (there are a number of conditions related to accessing bulk-billing / Medicare services). If not, it’s a small out-of-pocket fee. We also will help uninsured, non-Medicare, private insurance, DVA or Workcover patients.

We have a deep empathy (as business owners and clinicians) for patients who are busy with life and responsibilities and trying to “get out from underneath” (as one patient put it) of their current condition, whilst still staying as active and functional in their lives as possible.

Our services are structured especially for those who seek a return-to-work / return-to-routine course for their situation.

Have you heard about Dr Daniel Amen, Dr Peter Attia, Dr David Sinclair or Dr Peter Diamandis?

Yes, absolutely! Our book club and membership tiers are deeply inspired by the work of these renowned experts in the fields of health, longevity, and wellness.

  • Dr. Peter Attia is a central figure in our book club, as he is the author of “Outlive,” one of the three books we dive into. His insights into longevity and health optimization are pivotal to our discussions and learning.
  • Dr. David Sinclair‘s groundbreaking work on aging, as presented in “Life Span,” another key book in our program, provides us with a foundation for understanding the science behind aging and longevity.
  • Dr. Peter Diamandis, co-author of “Life Force,” brings an innovative perspective on health technology and regenerative medicine, enriching our exploration of cutting-edge health advancements.
  • Dr. Daniel Amen, though not directly covered in our primary book selections, is a well-respected board-certified adult and child psychiatrist, and founder of Amen Clinics. His work complements the themes we explore, especially in our webinars and workshops included in the membership tiers.

In our membership tiers, we offer various opportunities to delve into the teachings and philosophies of these experts:

  • Bronze Membership provides an introduction to these ideas through limited webinar access and a basic Joy Pack that encourages a journey towards better health and wellness.
  • Silver Membership includes the Eight Week Discovery Program based on the books by Dr. Attia, Dr. Sinclair, and Dr. Diamandis. Members also receive monthly webinars and workshops that may include discussions around topics championed by these experts.
  • Gold Membership takes this further with one-on-one coaching sessions where members can deep dive into specific areas of interest inspired by these doctors, such as personalised health optimisation or the latest in medical technology.

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