Frequently Asked Questions
About the treatment
What is rTMS – in brief?
Repetitive Transcranial Magnetic Stimulation (rTMS) is a treatment in which magnetic pulses are used to influence activity in selected areas of the brain involved in the regulation of mood, pain, and behaviour.
The treatment is performed while you are awake, without anaesthesia and without the use of medication.
How does rTMS work on the brain?
rTMS stimulates specific brain areas where activity is reduced or dysregulated and helps the brain regulate itself more normally over time. In simple terms, the brain is gradually trained to function as it did before the illness. This occurs by influencing the brain’s ability to adapt and reorganise—also known as neuroplasticity.
What distinguishes rTMS from medication-based treatment?
rTMS acts directly on brain activity in selected regions, whereas medication affects the brain through the body’s chemical systems and often impacts the entire body.
For most people, rTMS causes fewer and milder side effects than medication and may be effective for patients who cannot tolerate or have not benefited sufficiently from pharmacological treatment.
What is the difference between rTMS and electroconvulsive therapy (ECT)?
rTMS is a gentle treatment performed while you are awake, without anaesthesia, and without negative effects on memory or thinking.
ECT is significantly more invasive, is administered under general anaesthesia, affects the entire brain, and can be associated with serious side effects, including memory problems. It is typically used in severe and acute conditions where a rapid effect is required.
Is rTMS an experimental treatment?
No. rTMS is a well-documented and evidence-based treatment that is used internationally and included in clinical guidelines for several conditions.
It is used, among other things, as a first-line treatment in Canada and Brazil.
How do I get started?
You can contact the clinic directly to book an initial consultation. After this, an assessment is made to determine whether rTMS is a relevant and safe treatment for you.
Effect and expectations
Who particularly benefits from rTMS?
rTMS is especially relevant for patients for whom medication and/or psychotherapy have not had sufficient effect, are not tolerated, or are not desired. The treatment is often chosen when a more targeted and specialised alternative is needed.
How effective is rTMS for depression?
The effect of rTMS varies from person to person. Many achieve full remission of their depression and become symptom-free, while others experience a significant reduction in symptoms and a substantially improved level of functioning. A smaller number of patients experience limited or no effect.
When can I expect to notice an effect?
Most patients notice an effect after 10–15 treatments. For some, improvement occurs earlier, after only a few sessions, while others do not experience noticeable improvement until later in the course, after about a month.
What does it mean if I don’t feel anything after the first sessions?
This is completely normal. A lack of early effect does not mean that the treatment will not work. For many, improvement emerges later in the course. The brain changes relatively slowly, and the condition has often had a long time to establish maladaptive changes in brain function.
Is the effect permanent?
For many, the effect lasts a long time or is permanent after completing treatment. For some, symptoms may gradually return, in which case maintenance treatment or a repeated course may be an option.
Can rTMS be combined with medication and psychotherapy?
Yes. rTMS can be used both alone and in combination with medication and psychotherapy, depending on the individual patient’s needs.
If you are already receiving treatment, it is important to discuss this with your own doctor or therapist.
The treatment
How does the first consultation take place?
The first consultation consists of a discussion of your medical history and an assessment of whether rTMS is a relevant and safe treatment for you. The consultation is arranged by appointment and takes place by phone, via video consultation, or in person at the clinic.
What does an rTMS treatment involve in practice?
You sit comfortably in a chair while a coil is placed against your head and delivers magnetic pulses to a specific area of the brain. The treatment typically lasts between 3 and 20 minutes depending on the chosen stimulation protocol, and you can go home immediately afterwards.
How long does one session take?
An rTMS session typically lasts 15–30 minutes, of which the actual stimulation may last as little as 3 minutes. There is no recovery time, and you can continue your day as usual afterwards.
How many treatments will I need?
A standard course consists of 30 treatments. The exact number is individually adjusted depending on response and need. Some patients require follow-up treatment, while others may achieve full effect after fewer sessions.
How often are the treatments given?
Treatments are generally given 5 times per week (every weekday) over several weeks, depending on the planned treatment course.
It is possible to receive two treatments per day with a one-hour break between stimulations, but this is only done under special circumstances.
What happens if I miss a session?
Missing a single session usually has no significance. If several sessions are missed, it may prolong the course or affect the outcome. Typically, the missed session is rescheduled so that the total number of treatments is maintained.
Safety and side effects
Is rTMS safe?
Yes. rTMS is a well-documented treatment with a high level of safety when used correctly and in accordance with current guidelines. At Neuroklinik Nord, we are highly specialised in delivering this treatment and always ensure that safety measures are in place.
Does the treatment hurt?
Most people experience only mild discomfort or a tingling sensation on the scalp during treatment. This discomfort often diminishes after the first sessions. A small number of patients experience the tingling sensation as more painful; in such cases, a gentler stimulation protocol can be selected.
What side effects may occur?
The most common side effects are mild headache, fatigue, or scalp tenderness, especially at the beginning of the treatment course. These symptoms are usually mild and short-lived, and serious side effects are very rare.
Is there a risk of permanent side effects?
No. rTMS is not associated with permanent side effects, and the treatment does not affect memory, thinking, or personality.
Can rTMS trigger seizures or worsen symptoms?
The risk of seizures is very low and occurs almost exclusively in individuals with known epilepsy or specific risk factors. Symptoms generally do not worsen, though some people may experience temporary fluctuations early in the course of treatment.
Who cannot receive rTMS?
rTMS is not recommended for individuals with certain types of metal or electronic implants in the head, or with specific neurological conditions. This is always carefully assessed during the initial consultation.
Target groups and indications
Can rTMS be used for treatment-resistant depression?
Yes. rTMS is commonly used for treatment-resistant depression, particularly internationally (France, England, Canada, etc.), and is a recognised treatment option when medication and psychotherapy have not had sufficient effect.
Can rTMS treat chronic muscle and joint pain?
rTMS may be effective for certain types of chronic muscle and joint pain, especially when the pain has been present for a long time and cannot be explained solely by tissue damage. The treatment targets the brain’s pain regulation and can reduce both pain intensity and pain-related tension in some patients.
Can rTMS treat chronic neuropathic pain?
rTMS has documented effectiveness in several types of chronic neuropathic pain. The treatment stimulates brain areas involved in pain perception and can lead to a noticeable reduction in pain intensity for many patients, particularly when other treatments have had limited effect.
Can rTMS be used for addiction or substance use?
rTMS has been studied in substance use disorders and may, in selected cases, be used as a supplement to other treatments. The effect varies, and treatment is always assessed on an individual basis.
Does rTMS work for anxiety?
rTMS may be effective for certain anxiety disorders when they occur alongside depression. Research into brain stimulation for different anxiety disorders is ongoing, and results are not yet conclusive. Treatment is always assessed individually, so please feel free to get in touch to learn more.
Does rTMS work for OCD?
rTMS may be used for OCD in selected cases. The effect varies, and the treatment is typically offered when other treatments have not had sufficient effect. Treatment is always assessed individually.
Are there age limits for rTMS?
rTMS is generally offered to adults (18+). Treatment of younger patients is assessed individually based on health status, symptoms, and current clinical guidelines.
Practical matters and daily life
Can I work or study during the treatment course?
Yes. You can continue working or studying during treatment, as rTMS does not require recovery time and does not affect concentration or functioning after sessions.
Can I drive after a session?
Yes. You can drive immediately after an rTMS session, as the treatment does not affect reaction time or consciousness.
Do I need to prepare before treatment?
No. No special preparation is required. It is simply recommended that you arrive well-rested and inform us of any changes in medication or health status.
What if I feel worse during the course of treatment?
Temporary fluctuations in symptoms may occur early in the course. If you experience worsening symptoms, the treatment will be adjusted and always discussed with your clinician.
Referral and payment
Do I need a referral?
No. You do not need a referral to receive treatment with us, as we are a private clinic.
Is the treatment covered by the public healthcare system?
No. rTMS treatment with us is not covered by the public healthcare system, as we are a private clinic. rTMS is offered to specific groups of patients with depression within regional psychiatric services. If you are currently receiving treatment in psychiatry, you may wish to ask about this option.
Can I receive reimbursement for the treatment?
No. The treatment is provided as a private service, and at present there is no reimbursement from the public healthcare system or from insurance providers.
How much does a course of treatment cost?
The price depends on the length of the course and the number of sessions. You will always receive a clear overview of costs at the first consultation, before treatment begins.
Results and follow-up
Can the treatment course be split or adapted?
Treatment sessions should be scheduled relatively close together to achieve the best and safest effect. However, we are very flexible and take effect, individual needs, and practical considerations into account. Please do not hesitate to contact us if you have specific requirements.
How do you measure whether the treatment is effective?
Effect is assessed continuously through conversations and standardised questionnaires, tracking changes in symptoms and level of functioning over time. Formal assessments are conducted at the first, midpoint, and final sessions.
What happens after the treatment course is completed?
After completion, the effect is evaluated together with you, and a plan is made for follow-up, possible maintenance, or further treatment as needed. Many patients no longer require additional treatment. If you are also receiving other treatment, coordination with your clinician is recommended.
Is maintenance treatment available?
Yes. Some patients benefit from maintenance treatment if symptoms gradually return. The need is assessed individually. Typically, this involves one treatment session per week or less frequently.
What if rTMS does not have the desired effect?
If the treatment does not produce sufficient benefit, the course is discontinued and relevant alternative treatment options or further planning are discussed with you.