Express TMS case from San Diego Express TMS case from San Diego

TMS Therapeutics in San Diego: 3 min Express TMS is advantageous for social distancing

An interview with Brian Miller, MD and Medical Director of TMS Therapeutics in San Diego, California, USA

quote sidebox dr miller

Dr. Brian Miller, MD and Medical Director of TMS Therapeutics in San Diego has, for the past close to 10 years, provided TMS therapy to many, many patients suffering from severe, treatment-resistant depression. With the results he has seen for his patients – he thus describes himself a “wholehearted believer in TMS therapy.”

Dr. Miller has also closely followed the development of every new TMS device as they came to market and has for several years used MagVenture TMS Therapy: “MagVenture has always appealed to me, given its presence in the research arena even before becoming commercially available. I prefer the versatility and flexibility of their figure of 8 coils as well as the stimulator’s ability to adapt to advances in TMS techniques.”

Brian Miller

In recent years, Dr. Miller has increasingly used the Theta Burst (or Express TMS®) protocol for his depression patients, a protocol which cuts treatment time from the standard 37 or 19 minutes down to just 3 minutes per session. The safety and efficacy of TBS have been documented in the largest randomized controlled TMS trial to date, known as the THREE-D trial from 2018, which compared the standard 37 minute protocol with the 3 minute Theta Burst (TBS) protocol. The researchers found similar efficacy – and safety – between the two, with 27% and 32% achieving full remission, respectively. The results were published in The Lancet and led to an FDA clearance of the TBS protocol for MagVenture in 2018.

Increased need for mental health services

To Dr. Miller, the pandemic outbreak of Covid-19 “has clearly caused an exacerbation of ongoing illnesses as well as leading people to seek treatment for the first time. Given the variety of associated stressors it is reasonable to expect a greater demand for mental health services for the foreseeable future,” predicts Dr. Miller, while further mentioning that he, even before the pandemic, had already adopted TBS for the majority of his patients.

Theta Burst now standard of care treatment 

As a direct result of the pandemic outbreak TBS is now offered to his patients as the standard TMS Therapy: “TBS is markedly advantageous for social distancing and the comfort of staff wearing PPE,” he says, and mentions that the longer protocols are still offered but as the second-line option. As far as reimbursement, Dr. Miller has not had any issues with TBS, reimbursement is granted in the same degree as standard TMS.

Pre-screenings, testing, social distance 

Due to universal masking and availability of rapid testing, TMS Therapeutics in San Diego has managed to continue providing TMS throughout the pandemic. Several adjustments have, however, been applied, he says: “We reviewed all existing patients carefully to adjust the frequency of treatment based on risk of exposure to both our patients and staff. New consults are now done remotely. Patients entering the clinic are screened at each treatment, and – as mentioned – our staff uses PPE. The layout of the office and treatment schedules have also been changed to maximize social distancing.”

Convenient for the patient 

According to Dr. Miller, his patients also like the shorter protocol: “The convenience of TBS has been a major advantage for many patients. It has become practical to have a treatment in the middle of the workday without too much disruption. Some patients really miss the extended treatments when they used to watch TV, movies, or just talk with the technician. I try to look at other ways to increase their socialization, and use it as an opportunity to remind people that it's OK to carve out some time for themselves every day.”

  More information about TMS Therapeutics in San Diego 

The views and opinions expressed in this article do not necessarily reflect the official policy or position of MagVenture or any of its affiliates. The usage of rTMS for any other purpose than the cleared indication, in the country in which the product is intended to be used, is considered investigational.

Covid-19|Corona: Please follow the guidelines from your local government and/or health authorities.



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