Maverick Psychiatry

What does TMS Treat?

*Three (3) conditions* are currently FDA-approved:

1) Treatment-Resistant Depression (MDD)

2) Treatment-Resistant Obsessive Compulsive Disorder (OCD)

3) Treatment-Resistant Nicotine Addiction

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What is “Treatment-Resistant”?

In general, most insurance plans define “treatment-resistant” as meeting both of the following criteria:

• Having already failed TWO (2) adequate dose/duration trials of FDA-approved medications
  • ex = Zoloft/sertraline, Lexapro/escitalopram, Effexor/venlafaxine, Wellbutrin/bupropion, Remeron/mirtazapine, etc…)

• … in at least TWO (2) different medication classes:
  • SSRIs
    • Zoloft/sertraline, Prozac/fluoxetine, Lexapro/escitalopram, Paxil/paroxetine, Celexa/citalopram, Luvox/fluvoxamine
  • SNRIs
    • Cymbalta/duloxetine, Effexor/venlafaxine, Pristiq/desvenlafaxine
  • TCAs
    • Pamelor/nortriptyline, Elavil/amitriptyline, Silenor/doxpepin, Tofranil/imipramine, Anafranil/clomipramine
  • MAOIs
    • Nardil/phenylzine, Partnate/tranylcypromine, Emsam/selegeline, Marplan/isocarboxazid
  • NDRIs
    • Wellbutrin/bupropion
  • NaSSA
    • Remeron/mirtazapine
  • SARIs
    • Trintellix/vortioxetine, Viibyrd/vilazodone

Some insurance companies might also require additional criteria be met

…. such as:

• At least one (1) prior failed trial of an adjunctive medication (= a medication taken at the same time as a standard antidepressant in effort to enhance the therapeutic properties). Common examples of adjunctive medications are:
  • Abilify/aripiprazole, Vraylar/carpirpazine, Caplyta/lumateperone Seroquel/quetiapine, Zyprexa/olanzapine, Geodon/ziprasidone, Latuda/lurasidone, Wellbutrin/bupropion, and more.
• A prior failed trial of psychotherapy (ex = CBT, DBT, psychoanalysis, etc.)

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There is a growing body of evidence suggesting TMS *may* benefit a variety of other conditions as well. Including, but not limited to:

Anxiety Disorders

ADHD/Attention-related disorders

Dementia & Age-related cognitive decline

TBI (Traumatic Brain Injury)

Addiction Disorders (alcohol, gambling, cocaine, etc)

...an important note: while some initial academic/clinical studies have shown positive results for these indications, TMS is not currently FDA-approved for these particular conditions.

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Dr. Janik offers TMS through:

Kayenta TMS