NeuroStar® TMS Therapy
FDA-cleared, non-medication depression treatment
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Telehealth for mental health care has become normalized and widespread recently due to the COVID-19 pandemic. But before leaping into telehealth mental health care as a default option, it's important for us to consider the quality of care offered and the pros and cons of telehealth.
In a rush to accommodate providers and their patients, the Centers for Medicare and Medicaid Services, a federal agency under the Department of Health and Human Services,
issued nationwide waivers to ease requirements that would have made telehealth problematic. Two months into the new normal, the American Psychiatric Association called for some of those
changes to be made permanent to "ensure continuity of care and continued improved access to mental health and substance use care."
That is an alluring prospect to many providers, as telehealth reduces overhead expenses and is generally more convenient. However, psychiatry is a medical specialty that, at times, requires face-to-face assessments. Telehealth has provided a necessary service during the COVID-19 pandemic; however, providers should still weigh its convenience against what is best for the patient.
Telehealth was originally designed for
patients who live in remote locations and have to travel long distances to meet with their provider. Because of the
shortage of behavioral health specialists in rural areas, mental health care often falls on primary care physicians. Although they can certainly handle first-line interventions, their skill set reaches its limit in treatment-resistant diseases or complex cases.
That's where sub-specialty expertise should be employed, and that's where the real value of telehealth mental health care is manifested. It brings sub-specialty expertise to people in areas where that otherwise may not be available. If a patient needs to drive two hours for a visit, they are not likely to give the doctor a good interview—and it's especially impractical if the patient is stabilized on a medication and just needs a check-in for a refill. Similarly, if a patient has weekly talk therapy appointments but has to drive hours to get there, their attendance may drop off. In this case and others, telehealth is just as good as an in-person visit.
However, there are also some challenges to telehealth. As many people have experienced during the pandemic, the availability of video telehealth services is predicated upon internet bandwidth, as well as in-home computer equipment. At worst, many people do not have reliable broadband internet access or suitable equipment to have a satisfactory appointment. For those who do have a workable setup, technology issues can still arise, with sound delays, lighting issues, and audio glitches.
What's more, patients often seek mental health care for what they believe is depression, but upon a medical examination, the physician may determine the patient is suffering from a neurological condition that can have a secondary symptom of depression. Without an in-person assessment, the root problem would be missed and the patient would be misdiagnosed.
Another concern about the push for telehealth is that providers may prefer the convenience of remote visits without accounting for patient preference. Telehealth should not be used as a service to the provider, but rather to the patient. At Greenbrook TMS, we offer telehealth mental health care appointments based on clinical suitability and patient preference. If you want to take advantage of telehealth and it is clinically appropriate, we will offer it to better accommodate your needs. If it's not clinically appropriate or if you don't have the resources or preference for that mode of therapy, you have the option of an in-person examination.
Greenbrook TMS has always promoted patient convenience and choice. So although the regulations for telehealth are relaxed, we've retained the option for face-to-face visits using various
hygiene and social distancing measures to maintain safety. Because
TMS is a hands-on procedure , you will come in for a visit eventually, but we want you to feel reassured with the knowledge that Greenbrook TMS offers the types of appointments that best serve you. If you are considering TMS therapy, you can
reach out to us for a consultation , and we will help you determine whether a telehealth appointment is right for you.
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NeuroStar Adult Indications for Use
The NeuroStar Advanced Therapy System is indicated for the treatment of depressive episodes and for decreasing anxiety symptoms for those who may exhibit comorbid anxiety symptoms in adult patients suffering from Major Depressive Disorder (MDD) and who failed to achieve satisfactory improvement from previous antidepressant medication treatment in the current episode.
The NeuroStar Advanced Therapy System is intended to be used as an adjunct for the treatment of adult patients suffering from Obsessive-Compulsive Disorder (OCD).
NeuroStar Adolescent Indications for Use
NeuroStar Advanced Therapy is indicated as an adjunct for the treatment of Major Depressive Disorder (MDD) in adolescent patients (15-21).
Important Safety Information
NeuroStar Advanced Therapy is only available by prescription. A doctor can help decide if NeuroStar Advanced Therapy is right for you. Patients’ results may vary.
The most common side effect is pain or discomfort at or near the treatment site. These events are transient; they occur during the TMS treatment course and do not occur for most patients after the first week of treatment. There is a rare risk of seizure associated with the use of TMS therapy (<0.1% per patient).
Visit neurostar.com for full safety and prescribing information.
Important Safety Information
What is the most important information I should know about SPRAVATO®?
SPRAVATO® can cause serious side effects, including:
Do not take SPRAVATO® if you:
If you are not sure if you have any of the above conditions, talk to your healthcare provider before taking SPRAVATO®.
Before you take SPRAVATO®, tell your healthcare provider about all of your medical conditions, including if you:
Tell your healthcare provider about all the medicines that you take, including prescription and over-the-counter medicines, vitamins and herbal supplements. Taking SPRAVATO® with certain medicine may cause side effects.
Especially tell your healthcare provider if you take central nervous system (CNS) depressants, psychostimulants, or monoamine oxidase inhibitors (MAOIs) medicine. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine.
How will I take SPRAVATO®?
What should I avoid while taking SPRAVATO®?
Do not drive, operate machinery, or do anything where you need to be completely alert after taking SPRAVATO®. Do not take part in these activities until the next day following a restful sleep. See “What is the most important information I should know about SPRAVATO®?”
What are the possible side effects of SPRAVATO®?
SPRAVATO® may cause serious side effects including:
See “What is the most important information I should know about SPRAVATO®?”
Increased blood pressure. SPRAVATO® can cause a temporary increase in your blood pressure that may last for about 4 hours after taking a dose. Your healthcare provider will check your blood pressure before taking SPRAVATO® and for at least 2 hours after you take SPRAVATO®. Tell your healthcare provider right away if you get chest pain, shortness of breath, sudden severe headache, change in vision, or seizures after taking SPRAVATO®.
Problems with thinking clearly. Tell your healthcare provider if you have problems thinking or remembering.
Bladder problems. Tell your healthcare provider if you develop trouble urinating, such as a frequent or urgent need to urinate, pain when urinating, or urinating frequently at night.
The most common side effects of SPRAVATO® include:
If these common side effects occur, they usually happen right after taking SPRAVATO® and go away the same day.
These are not all the possible side effects of SPRAVATO®.
Call your doctor for medical advice about side effects. You may report side effects to Johnson & Johnson at 1-800-526-7736, or to the FDA at 1-800-FDA-1088.
What is SPRAVATO® (esketamine) CIII nasal spray?
SPRAVATO® is a prescription medicine used:
SPRAVATO® is not for use as a medicine to prevent or relieve pain (anesthetic). It is not known if SPRAVATO® is safe or effective as an anesthetic medicine.
It is not known if SPRAVATO® is safe and effective for use in preventing suicide or in reducing suicidal thoughts or actions. SPRAVATO® is not for use in place of hospitalization if your healthcare provider determines that hospitalization is needed, even if improvement is experienced after the first dose of SPRAVATO®.
It is not known if SPRAVATO® is safe and effective in children.
Please see full Prescribing Information, including Boxed WARNINGS, and Medication Guide for SPRAVATO® and discuss any questions you may have with your healthcare provider.
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