If you have tried antidepressants and still feel stuck, or the side effects were hard to live with, TMS is another option to talk through with a provider. It uses no medication and no sedation, and you drive yourself to and from every session.
Mind Spa's Apollo TMS system is FDA-cleared, not FDA-approved. Read the FDA information.
Maybe you have been through two or three antidepressants. Maybe one helped for a while and then stopped. Maybe the side effects, like fatigue, weight changes, or feeling emotionally flat, made it hard to keep going. Some days, getting to an appointment takes everything you have.
None of that means you failed. It means the treatments you tried did not fit. TMS works differently from medication, and it is worth understanding before you decide.
Transcranial Magnetic Stimulation (TMS) uses a magnetic coil held against your scalp to send focused magnetic pulses, similar in strength to an MRI (magnetic resonance imaging) scanner, to the prefrontal cortex. That brain region is involved in mood regulation.
TMS is generally well tolerated. The most common side effects are mild and tend to fade over the course:
Seizure is a rare but serious risk when TMS follows established safety protocols. Your provider screens for it before you start.
A standard course is 36 sessions, five days a week, over about seven weeks. Here is what to expect along the way.
A licensed psychiatric provider reviews your history and confirms TMS fits. We verify your benefits and submit the prior authorization for you. TRICARE approval typically takes about two weeks.
We find your motor threshold, the pulse strength set for your brain, and recheck it during the course.
Headache or scalp discomfort is most common early and usually fades. If improvement comes, it is usually gradual, so early weeks may not feel different.
Five days a week, 36 sessions in all. Your provider checks in on your symptoms along the way and adjusts the plan if needed.
Your provider reviews how you are doing with you and talks through what comes next.
Three options people with treatment-resistant depression often weigh. Mind Spa offers all three, so one team can help you choose and change course if needed.
| TMS | Antidepressants | IV ketamine | |
|---|---|---|---|
| How it is given | Magnetic pulses to the scalp in the clinic | Daily pills at home | IV infusion in the clinic |
| Sedation | None | None | None, but you may feel detached during the infusion |
| Drive yourself after | Yes | Usually | No. Not until the next day |
| Time commitment | 36 sessions over about 7 weeks | Ongoing, adjusted over months | 6 infusions over 2 to 3 weeks |
| FDA status for depression | Apollo system is FDA-cleared for major depressive disorder | Many FDA-approved options | Off-label |
| Insurance | Covered by many plans, including TRICARE, when criteria are met | Usually covered | Generally not covered |
TMS for depression has been studied in large trials that compare real treatment with a sham, an inactive imitation that looks and sounds the same. These are study results, not Mind Spa outcomes.
A multisite sham-controlled trial in adults who had not responded to antidepressants reported greater improvement with active TMS on several measures.
O'Reardon et al., Biological Psychiatry (opens the study in a new tab)An NIH-funded (National Institutes of Health) trial of daily left prefrontal TMS found a significant antidepressant effect for active TMS compared with sham.
George et al., Archives of General Psychiatry (opens the study in a new tab)Intermittent theta burst stimulation, about 3 minutes per session, performed comparably to standard 10 Hz TMS, about 37.5 minutes.
Blumberger et al., The Lancet (opens the study in a new tab)A multicenter sham-controlled trial of deep TMS for OCD reported greater symptom reduction than sham. This trial used a different device than Mind Spa's.
Carmi et al., American Journal of Psychiatry (opens the study in a new tab)TMS for depression is covered by many insurance plans, including TRICARE, when their criteria are met. Most require prior authorization. Mind Spa prepares and submits it for you, so you are not stuck chasing paperwork.
See Does TRICARE cover TMS? and TMS cost in Denver for details.
| Standard | Accelerated | |
|---|---|---|
| Schedule | One session a day, five days a week | Multiple sessions per day |
| Length | About 7 weeks | 1 to 2 weeks |
| FDA status | Within the Apollo FDA clearance | Off-label schedule |
| Payment | Covered by many plans, including TRICARE, when criteria are met | Typically self-pay; some plans have begun to cover it |
Mind Spa offers both on the Apollo system. Your provider reviews the off-label status of the accelerated schedule with you.
TMS is the foundation of Inner Armor, our 7 to 12 week outpatient program for TRICARE Prime, Select, and Reserve Select beneficiaries. It combines 36 TMS sessions, 6 ketamine infusions, and 36 HBOT sessions, plus medication management and therapy as needed. Standard TRICARE copays and cost-shares apply, and we review your expected costs with you before you begin.
Mind Spa is an independent clinic in network with TRICARE West and is not affiliated with or endorsed by TRICARE, the Defense Health Agency, or the Department of Veterans Affairs.
Yes. You are awake and alert for every session, need no sedation, and can drive yourself and return to work or home right after.
Patient experiences vary. Improvement is usually gradual, and some patients see little or no change. If that happens, your provider reviews other options with you, which can include medication changes, therapy, or ketamine. Mind Spa offers all of them under one team.
Treatment-resistant depression generally describes depression that has not improved enough after trying antidepressants at an adequate dose and length of time. Your provider reviews your history to decide whether that applies to you.
Transcranial Magnetic Stimulation (TMS) uses focused magnetic pulses to stimulate the prefrontal cortex, a brain region involved in mood regulation. It is non-invasive and requires no anesthesia or sedation.
TMS devices are FDA-cleared rather than approved. Mind Spa uses the Apollo TMS Therapy System, which is FDA-cleared for major depressive disorder in adults who have not improved on antidepressants, and for OCD. TMS for PTSD, anxiety, and TBI is off-label.
Most people feel a tapping sensation on the scalp. Mild headache or scalp discomfort is common early in treatment and usually fades over the course.
The most common side effects are headache, scalp discomfort at the treatment site, tingling or twitching of facial muscles, and lightheadedness. Seizure is a rare but serious risk, and your provider screens for it before you start.
A standard course is 36 sessions, five days a week, over about seven weeks. Your provider tailors the protocol to your diagnosis and response.
Yes. TMS requires no sedation or downtime, so you can drive yourself and return to work right after each session.
TMS for depression is covered by many insurance plans, including TRICARE, when their criteria are met. Criteria usually include a diagnosis of major depression and prior antidepressant trials. Most plans require prior authorization, which Mind Spa submits for you.
Yes, for eligible beneficiaries 18 or older with severe major depressive disorder who have not responded to a less intensive treatment. Prior authorization is required, and approval typically takes about two weeks. TRICARE For Life beneficiaries are covered for TMS through Medicare.
Yes, on the Apollo system, with multiple sessions per day over 1 to 2 weeks. Its FDA clearance covers standard daily treatment, so the accelerated schedule is off-label. It is typically self-pay, though some insurance plans have begun to cover it.
TMS for PTSD is off-label, meaning it is not part of the device's FDA clearance. Research on TMS for PTSD is ongoing, and your provider can tell you whether it fits your plan.
Electroconvulsive therapy (ECT) uses anesthesia and an intentionally induced seizure. TMS uses magnetic pulses while you are awake, needs no anesthesia, and you can drive yourself home.
Complete the new patient paperwork or call 303-327-0350. We verify your benefits and handle the prior authorization.
Peer-reviewed sources for the information on this page.
Start your new patient paperwork or call our team. We verify your benefits and walk you through the prior authorization.
Mind Spa, 5340 S. Quebec St., Suite 230S, Greenwood Village, CO 80111. Open Monday to Friday, 9am to 5pm. Mind Spa provides care to patients located in Colorado. Your first visit is in person at our Greenwood Village clinic, and some follow-up visits are available by telehealth.
Mind Spa uses the Apollo TMS Therapy System, which is FDA-cleared for major depressive disorder and OCD. TMS for PTSD, anxiety, and TBI is off-label, and accelerated schedules with multiple sessions per day are off-label. Individual results vary and are not guaranteed.
All treatment at Mind Spa is subject to the medical decision-making of a licensed psychiatric provider. Mind Spa is not a crisis service. If you are in crisis, call or text 988. Veterans can dial 988 and press 1.
