FAQS
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How long is an individual session and what is the patient's experience with it?Once assessed and the appropriate treatment protocol is determined, the treatment session typically lasts less than 5 minutes. This is achieved using a revolutionary software upgrade to the treatment called ‘Theta Burst Stimulation (TBS) which allows us to administer three rapid treatment sessions in a single 15 minute appointment. As a consequence, the total treatment course can be completed from Mon-Friday over ten working days. Clients are at all times sitting comfortably and alert. For this reason we encourage individuals to engage with therapy whilst receiving their treatment. During treatment the magnetic coil is suspended over the appropriate region of the person’s scalp. The client perceives a series of clicking noises followed by a pause as the magnet rapidly turns on and off gently pulsating activating energy to the desired brain region. Following treatment, the client can immediately resume daily activities.
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Who is suitable TMS candidate and who is not?An individual may be suitable for TMS if he or she: has a diagnosis of depression (especially treatment resistant depression) has had difficulty coping with some of the side effects of medication does not wish to take medication does not wish to undergo Electroconvulsive Therapy (ECT) suffers with any of the other disorders listed earlier (see section what is TMS used for?) As a general rule, TMS works best when it is given relatively early in the course of the illness, and results are better if the treatment course is completed. Our experience shows it works remarkably well, even for clients with a high level of treatment resistance. Given its mechanism of action, TMS cannot proceed if the person is pregnant, has a personal or family history of seizure (or other neurological) disorder, has active alcohol or drug dependency, has ANY metal fragments in the brain, eye, ear or heart or is younger than 16 years of age.
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What does the research indicate?To date over 100 peer reviewed publications investigating TMS in depression, including three multicentered randomised sham controlled trials, have been completed. The evidence is consistent regarding the effectiveness and safety of TMS in depression (Clinical TMS Consensus Review 2016). Please visit the Evidence and Research page for medical articles.
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I am already prescribed medication or undertaking therapy. Will I need to stop these?No. TMS is primarily recommended for treatment resistant illness and in that context, is intended to be an adjunctive (additional) treatment. That being said, given repose rates and tolerability, increasingly clients are opting for TMS earlier in the course of their illness prior to trying medication. While receiving TMS, we would ask that no medication changes be undertaken if at all possible. For those that thereafter achieve either complete remission or significant improvement, it is important that any changes to medication proceed under the supervision of your usual treating team.
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How much is TMS?A typical TMS session is $100 to $117. Major Insurance companies will sometimes help cover some of the cost under your Mental Health Plan we fall under the catagory of Psyciatrist or Couselling. We also offer payments plans thru Medicard from 6 months to 6 years, making it affordable for all budgets. We also work with WCB, Vetrans Affairs and Disability. Please call so we can discuss a personel option for you as we are here to help in every situation even if you feel you can not afford we can help or give you other options. 587 860 1880
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Is TMS safe?Yes! It is approved by Health Canada (2005), Food and Drug Administration (FDA), United States (2008) and the National Institute for Health and Clinical Excellence (NICE), United Kingdom (2015).
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Is TMS New?The core scientific principles of TMS (electromagnetic induction) are well established. Research into its physiological/clinical applications began in the 1980s leading to its approval by Health Canada (2002), as a safe and effective treatment for depression. Since it received FDA approval in the United States, TMS is now covered by insurance policies in 41 of 50 states. TMS is now covered by insurance in all 50 States in the United Sates’. In Canada some insurance companies consider part payment of the treatment on a case by case basis.
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Is the treatment well-tolerated?
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What is Treatment Resistant Depression (TRD)?Treatment resistant depression (TRD) is depression that has failed to respond in any meaningful way to conventional treatment (medication/psychological therapy). Depression itself is a complex illness that can diminish a person’s enjoyment or engagement with his/her loved ones, friends, education or career. In addition to the psychological feelings of despair and guilt, it can have a physical basis and adversely affect one’s sleep pattern, energy levels and sex drive, as well as other symptoms such as muscle pain. For some, coping with this illness can become difficult and they can become hopeless, even suicidal. For these reasons, the World Health Organisation recognises depression as the illness with the greatest morbidity. TMS is helping to turn treatment resistance into recovery attainment.
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What is Transcranial Magnetic Stimulation (TMS)?TMS is an effective process in which a focused magnetic field stimulates under-active brain cells, activates them to work more efficiently and transforms lives through symptom reduction.
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What is Transcranial Magnetic Stimulation (TMS) used for?TMS is particularly effective when used to treat depression, anxiety and burnout that has not fully responded to conventional treatments (medication/therapy). Also can be used for PTSD, ADHD and OCD along with Migraines. We now have a specific FDA approved Coil for OCD.
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How long do the benefits of TMS last?This ultimately depends on the individual. Patients commonly report sustained improvement several months following treatment. For some in whom depressive symptoms recur, an individualised maintenance program can maintain recovery without having to repeat the initial induction course.
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What if I am pregnant?There has been a lot of studies on the effects of rTMS and pregnancy, rTMS has proven to be safe when used on pregnant woman suffering with Depression and or Anxiety.
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Is TMS the same as Electro Convulsive Therapy (ECT)?TMS Hospital admission not required (out-patient) Non invasive indirect application of magnetic pulse Awake & alert throughout No recovery time needed after treatment (the patient can drive and return to work immediately) Side effects – mild and uncommon. Seizure occurrence is rare, with no impact on memory function Research suggests potentially as effective as ECT ECT Usually performed in hospital (admission required) Invasive Direct application of low amplitude electrical current General anaesthesia required (carries a rare mortality risk) Period of recovery time and nursing observation required after treatment Seizure induced (integral to mechanism of action) & can cause long-term damage to memory Historical gold standard treatment of depression
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How many treatment should a patient receive?The average number of treatment sessions is 30 over a period of two weeks. We now offer 40 treatments over the two weeks as we use the most up to date protocols.
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Your First Ketamine SessionAll of our ketamine sessions are held in the Sitting Room at Neuromend Clinic located at 2532 Ellwood Dr SW, Edmonton, Alberta. T6X0A9..We are located inside the Insight Building. You will not be permitted to drive after your session so it is important that you are dropped off for your session. At the front desk, press the Sitting Room bell on the left side of the desk. You will be brought to the room and welcomed by one of The Sitting Rooms psychedelic coaches. Remember to bring your ketamine with you to your first appointment. You will also need the prescription receipt that shows your name, dosage, prescribing physician, pharmacy, etc. Prior to starting your ketamine session, we will go over your intake form and ensure that you are ready and that everything is in order. We will answer any further questions you have, support you in getting ready for your session and stay with you for the entire time your ketamine session lasts. Your ketamine session is scheduled for up to three hours. Depending on the person, the time of the session can vary. You will not be permitted to leave until it is safe for you to do so and your designated driver has arrived to pick you up. Following your session, you may find that you feel tired, slightly dizzy or even a bit nauseous. This is normal and your body’s way of saying you need a good night’s rest. Should you have any urgent questions following your session, please contact your Psychedelic Practitioner at The Sitting Room. If you have any medical questions or concerns, please contact Claire at Neuromed Clinic and she can book you in to talk to Dr Leicht. If you have urgent medical concerns or are experiencing medical distress, please call 911 and go to your nearest emergency department.
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Subsequent SessionsFollowing your first session call to book a follow up call with Dr. Leicht to see how your session went. Depending on how you are feeling, you and Dr Leicht may decide on a course of ketamine sessions that will be optimal for you. If you choose to continue with ketamine sessions, Dr Leicht will make arrangements for another prescription. Additionally, you will need to book your next Ketamine session appointment(s) through www.thesittingroom.ca Once your appointments are booked, you will follow the same process as you did for your first session.
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Making your First AppointmentIf you choose to proceed with your ketamine session you will need to make an appointment for your first session. Book your appointment by going to www.thesittingroom.ca. Choose a ketamine session time that works best for you. While making your appointment, you will be prompted to complete an intake form. This form is confidential once completed. The information you provide will allow the staff at The Sitting Room to provide you with a positive and supportive experience. Each Ketamine session is $650.00 for about 3 hours.
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Medical ConsultationPrior to starting ketamine, Dr. Krista Leicht will meet with you to determine your suitability and eligibility for ketamine. Depending on your medical history, you may need to complete additional blood work and or testing. If you and Dr. Leicht agree that ketamine is right for you, then Dr. Leicht will provide a prescription for ketamine to a designated pharmacy. The cost for this is a $99.00 yearly Admin fee for the Sitting Room only. All other clinics are a $499.00 1 time admin fee.
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On-Going SupportMany people find that after one to six sessions, the primary symptoms that were being addressed with ketamine have subsided. However, some people find that they require maintenance sessions on an as needed basis. You and your doctor are in the best position to determine if further sessions are required.
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Questions or ConcernsIf at any time you have questions or concerns about ketamine, psychedelic coaching or integration, please do not hesitate to reach out to us. Dr Leicht, Neuromed Clinic and along with the staff from The Sitting Room and Insight Psychological are here to help you along your journey. Thank you for choosing The Sitting Room, Neuromed Clinic and Insight Psychological to support you in this important work.
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IntegrationIntegration is the key to ensuring that the benefits for ketamine sessions are maximized. Integration uses the learning from your session to inform future practices that will support your well-being. Your physician or psychologist can provide you with detailed information on how to get the most out of the integration process. “research indicates that the efficacy of ketamine or any psychedelic therapy, is significantly increased when paired with psychological therapy” therefore we recommend booking in with one of our partners at Insight Psychological, for before and after care. Phone 780 461 1717 to do that.
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Can I take Ketamine at home?One of the most significant barriers to Ketamine treatment is the need to have a trained person sit with you while you are medicated. At Neuromed, we want to ensure that you are properly prepared so that you can take this medication at home with a trusted adult supporter. We work with trained and experienced coaches to support you through the process of taking this medication safely and provide you appropriate training. We would also recommend using the services of a professional certified coach, psychologist, or psychiatrist to support you with the integration work following your session.
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What are the long-term side affects to taking Ketamine?Ketamine has been proven safe when used as directed. It is important to be aware of potential side effects including bladder and urinary issues.
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Why have I been prescribed Ketamine for my depression?Ketamine has been proven to be effective in alleviating the symptoms in patients suffering with severe depression. Ketamine is usually prescribed when other treatments have been ineffective. You and your doctor will have had a conversation about the potential risks and benefits of Ketamine and Ketamine assisted coaching.
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How often would I have to take Ketamine?Most people see significant results after six sessions. Patients may require additional sessions depending on response. Patients may also learn that Ketamine is not helpful and can discontinue at any time.
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When is Ketamine not the right treatment?Ketamine may not be right for you if you are pregnant, experiencing high blood pressure, or experience psychotic episodes.
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What can I expect on the day I take Ketamine?Plan to be unavailable from work or home duties for the entire day. You will need to make arrangements for a responsible adult to pick you up after your session. The medicine works best on an empty stomach. Your doctor will prescribe Ketamine in tablet form. Your dose is determined by your body weight and your individual medical need. At the start of your session, the staff member will obtain your consent for the session and help you get comfortable. While every patient’s experience is different, you may experience changes in perceptions—like seeing bright colours or movement. You might feel physically disoriented and experience floating sensations. Some report what is referred to as a “dissociative”, or “out of body” experience. Others report a feeling of vulnerability and openness. You may also notice that thoughts and feelings are heightened. Some people prefer to be quiet and reflective, while others want to talk about what is happening as they go through it. Staff will guide and support you through the entire session, so you are safe and get the most out of your session. You will be monitored to ensure that you are safe to return home. It is essential that a responsible adult pick you up. Once you return home you may be tired and want to lie down. You are legally impaired following a treatment and must not drive, operate machinery, or engage in significant decision making until the following day.
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What is the Sitting Room?The Sitting Room is where the Psychedelic Practitioners do their work. It is a safe place located in the heart of the Neuromed Clinic. It is where people can receive coaching and, if recommended by a doctor, experience Ketamine with trained staff. Staff are certified Executive Coaches with extensive knowledge, experience, and training in psychedelic coaching, including the use and effects of Ketamine. Staff work in partnership with, and under the supervision of, a professional psychiatrist.
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What happens during a Ketamine Assisted Coaching Session?When you arrive at the Sitting Room, you will be asked to complete a brief questionnaire to ensure you are prepared for the session. We will help you get comfortable while you take your prescribed medicine. During the session, we will support you so that you get the most out of your experience. After the session, we will help you to integrate and make meaning out of your session and support you as the medication wears off. Once you are ready to go, we will release you into the care of the person who will be responsible for your transportation home.
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What is the role of the prescribing Physician?Ketamine can only be prescribed by a psychiatrist who will work with the staff in the Sitting Room to ensure the dosage, frequency and outcome is medically appropriate.
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What does it feel like during a Ketamine session?Some people experience altered perceptions like seeing bright colours, while others report what is referred to as a “dissociative”, or “out of body” experience. Most people tolerate the experience with no trouble, and many people find it pleasant. Once the treatment is complete, the effects of the medication will subside. You will usually be ready to go home after about an hour following your session.
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How do I prepare for my first Ketamine session?Following your appointment with your doctor and being prescribed Ketamine, you may have many questions. Your doctor and our team are well prepared to support you to get ready for, experience and integrate your Ketamine treatment.
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How do the staff from the Sitting Room assist in a Ketamine Session?Staff will ensure you have a safe and supported experience preparing for, taking, and integrating your Ketamine treatment into your life.
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Do I have to have someone to transport me home?Yes. You will be legally impaired for the rest of the day.
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Are the services that are provided in the Sitting Room covered by Insurance or Alberta Health?AHS does not cover but you can check with your private insurance as some may help. The cost is $650.00 per session.
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What if I have more questions about the Sitting Room services?If you have more questions about the Sitting Room and their services, please visit www.thesittingroom.ca
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What if I have questions or concerns following my session?If you have a medical emergency, contact 911. If you have a medical question, please follow up with your prescribing doctor.
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Can the staff from the Sitting Room prescribe, supply, or administer Ketamine?No.
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What do I need to do after a Ketamine Session?Be prepared to feel tired and the need to rest. You may want to write down your experience and explore any meanings that might have come up for you. You may also want to book a session with one of our professionals to help integrate the learnings of the session into your life.
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Are the sessions in the Sitting Room confidential?Yes, although with your permission, you may want us to share specific information with your prescribing doctor. A consent to share information form would be required.
APPLICATIONS
WHAT CAN TMS BE USED FOR?
TMS is primarily utilized for the treatment of depression and anxiety.
There is also benefit noted in the following conditions:
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Depression
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Burnout
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Obsessive Compulsive Disorder (OCD)
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Dementia
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Fibromyalgia
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Post-natal depression
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Post-traumatic stress disorder (PTSD)
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Anxiety
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Parkinsons
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Migraine
THE EFFECTIVENESS OF TMS ON BURNOUT
What is burnout?
A syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed. It is characterised by three dimensions:
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Feelings of energy depletion or exhaustion;
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Increased mental distance from one’s job, or feelings of negativism or cynicism
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Related to one's job; and
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Reduced professional efficacy.
It occurs in organizational cultures that demonstrate
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Unfair treatment of the employees
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Unmanageable work loads for employees
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Unclear communication from managers
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Lack of manager support
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Unreasonable time pressures on employees.
WHY IS BURNOUT IMPORTANT?
Burnout is an escalating problem and is strongly associated with depression, anxiety and significant physical ill health (heart disease and stomach issues). A recent Gallup survey of managers conducted between 2016-2019 (n=24,522) demonstrated that Burnout is a widespread problem. They concluded that:
76%
of employees experience burnout on the job at least sometimes
63%
of employees with burnout are more likely to take a sick day
23%
more likely to visit the emergency room for physical ill-health
28%
of employees experience burnout “very often”or “always”
50%
of employees with burnout are less likely to discuss how to approach
2.6%
times more likely to be actively seeking a different job