TMS

TMS stands for Transcranial Magnetic Stimulation. TMS uses non-invasive electromagnetic fields, similar to those produced by an MRI machine, to stimulate or inhibit the brain. During TMS therapy, a magnetic field is administered in very short pulses to a specific part of the head to activate or inhibit those underlying brain cells. The course of treatment may vary depending on the target symptoms; it may be about 3 min to 19 minutes per session, 3-5 times a week, over 6 weeks.

FDA APPROVED

No Weight gain

INSURANCE COVERED

No sexual Side effect

SAFE IN PREGNANCY

No Memory side effects

TMS

FDA approved

Major Depression

Obsessive Compulsive Disorder

Nicotine Addiction

Fibromyalgia

Off label use

PTSD

Generalized Anxiety

ADHD

Substance Use disorder

Contraindication

Metal Implant in head or neck

Epilepsy

Cardiac Pacemaker & Defibrillator

Vagal Nerve Stimulator

What happens during TMS treatment

You do not need any anesthetics or sedation for your TMS therapy, as it’s entirely noninvasive. You also do not need to alter or stop any currently prescribed medications. You sit in a comfortable treatment chair listening to music in a spa like atmosphere. The TMS coil is placed above a specific area of your head, sending the magnetic pulses to your brain.

You might hear the TMS coil making a clicking noise and feel a slight tapping against your head during the treatment. Most people describe it as a wood pecker sound.

TMS treatment is not painful, but afterward, you might experience mild scalp irritation or get a headache. A TMS treatment session takes about 3 minutes or 19 minutes, based on your treatment plan and you are free to talk or watch TV throughout the session.

Your TMS Therapy specialist is present during the entire treatment, monitoring the TMS machine and ensuring you are comfortable.

Most patients need an average of three to five TMS treatment sessions per week over a six-week period. This could vary depending on your condition and how well you progress during the treatment.

Can I continue my medication?

The clinicians will carefully review your treatment regimen and work with you to help optimize your treatment and reduce any risks associated with psychiatric medications. In general, you can continue to take your regular medications during your TMS series. However, some medications may need to be stopped or reduced prior to initiating TMS to avoid the risk of seizure.

How well does TMS work?

TMS is a durable treatment for depression with sustained responder rates of 50% up to 1 year after a successful induction course of treatment. All known antidepressant treatments require a maintenance regimen to sustain initial responses. TMS also follows this general rule. The research on TMS as a maintenance therapy is very limited. After your initial TMS series and a short TMS taper, you will be advised to monitor symptoms closely with your primary psychiatrist and therapist to evaluate for any worsening mood. If you and your providers determine that maintenance TMS is warranted, we will work with you on creating a maintenance schedule that meets your needs.

More then 5000 TMS treatment given.

Our TMS team will assist you.
you can reach us
443 910 7299 for TMS appointment.

Ravi Bhalavat MD,D.F.A.P.A
Board Certified Psychiatrist
Board Certified Addiction Medicine

After completing his medical education at the Medical College, Bhavnagar, India, Dr. Bhalavat completed his training in psychiatry at Louisiana State University Health Sciences Center, Shreveport, Louisiana. He worked with University of Maryland-Upper Chesapeake medical center as a Psychiatrist.

He treated various psychiatric patients of all ages in Inpatient, Outpatient, Consultation-Liaison, and Emergency psychiatric services.

He has been working with American Psychiatric Care serving Harford, Baltimore, Howard and Montgomery county for last ten years.

Dr. Bhalavat is Board certified in Psychiatry by the American Board of Psychiatry and Neurology and American Board of Addiction Medicine.

Dr. Bhalavat has been certified by Harvard Medical School for an Intensive course on Transcranial magnetic stimulation. Dr. Bhalavat has a special interest in treating with Depression and anxiety diagnosis.

Dr. Bhalavat has been affiliated with the University of Maryland Health System, Johns Hopkins Hospital and Adventist Health Hospital.

Dr. Bhalavat is a Distinguished Fellow of the American Psychiatric Association, a Member of the Maryland Psychiatric Society.

Education & Training

1995-2001

MBBS, Medical College, Bhavnagar India

2008-2012

Residency in Psychiatry, Louisiana State University Health Science Center, Shreveport, Louisiana

2014

TMS training, Harvard Medical School, Boston, Massachusetts

Affiliation

University of Maryland ,Upper Chesapeake health Hospital

Howard County General Hospital, John Hopkins Health

White Oak Adventist Health Hospital, Adventist Health

Membership

Distinguished fellow of American Psychiatry Association.

Member of Maryland Psychiatric Society

Research Publications

Coma falsely attributed to Lyme disease

Neuroborreliosis has very low prevalence in Kentucky and coma due to Lyme disease is uncommon in North America. A patient diagnosed with Lyme disease in Kentucky, based on coma, typical inflammatory changes on brain imaging, and a positive ELISA resulted in an erroneous clinical impression. Diagnosis should have been confirmed by a positive result on Western Blot, polymerase chain reaction (PCR), or real-time polymerase chain reaction (RT-PCR) testing. Physicians must apply careful consideration before diagnosing a rare disease in areas where that condition is uncommon without first eliminating other differential options. Neuroborreliosis clinicalfindings are nonspecific and often require confirmatory testing, especially in nonclassical case presentations.

Suicidal and homicidal behaviors related
to dextromethorphan abuse in a middle-aged woman

Over-the-counter medications available without prescriptions are generally viewed safe for public consumption. However, when used in excess, these medications can lead to adverse consequences. There are multiple over-the-counter medications that have potential for abuse, and dextromethorphan is one such drug. We describe a case of a middle-aged woman who presented to the psychiatric emergency service after recent use of excessive amounts of dextromethorphan. The patient had developed severe psychotic symptoms and had attempted to kill both herself and her relative. This case highlights the importance of careful reviewing of both prescribed and nonprescribed medications that are being used by patients, especially in the emergency care setting.

DSM-IV-TR in A Nutshell

IsHak, WW; Lee, E; Bhalavat, R; Vasa, M: “The DSM-IV in a Nutshell: A Practical

Approach to Psychiatric Diagnosis.” Appendix III in the Guidebook of Sexual Medicine.

Edited by IsHak, WW. Beverly Hills A&W Publishing, 2008, pp 229-234.

Case Report

Parkinsonism induced by Drug Interaction between Risperidone and Paroxetine

The Journal of the American Association for Emergency Psychiatry: 2011

TMS