Services Offered
Modern treatments for mental health
Transcranial Magnetic Stimulation (TMS) - insurance based
TMS is an FDA-approved, non-invasive treatment for depression and other mental health conditions. Using magnetic pulses to stimulate specific areas of the brain, TMS helps regulate mood and improve symptoms when traditional treatments haven't been effective.
Transcranial Magnetic Stimulation (TMS) is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain. It is FDA-approved for treating major depressive disorder, particularly in patients who have not responded well to traditional antidepressant medications.
During TMS therapy, an electromagnetic coil is placed against your scalp near your forehead. The electromagnet delivers a magnetic pulse that stimulates nerve cells in the region of your brain involved in mood control and depression. This stimulation appears to affect how the brain is working, which in turn seems to ease depression symptoms and improve mood. It is typically 36 daily treatments over 9 weeks.
TMS is typically recommended for adults with major depressive disorder who have not responded adequately to at least one antidepressant medication. It may also be considered for other conditions such as anxiety disorders, OCD, and PTSD. A thorough evaluation is required to determine if TMS is right for you.
TMS offers several advantages: it is non-invasive with no systemic side effects, does not require anesthesia, and patients can return to normal activities immediately after treatment. Many patients experience significant improvement in their symptoms, with some achieving complete remission of depression. Treatment is typically covered by insurance.
Accelerated TMS
Accelerated TMS delivers multiple treatment sessions per day, significantly reducing the overall treatment timeline while maintaining effectiveness for depression and other mental health conditions.
Accelerated TMS is an intensive form of Transcranial Magnetic Stimulation that condenses the traditional treatment schedule. Instead of one session per day over several weeks, accelerated TMS delivers multiple sessions throughout the day, allowing patients to complete their full treatment course in just days rather than weeks.
Accelerated TMS uses the same FDA-approved magnetic stimulation technology as standard TMS but with a more intensive schedule. Patients typically receive multiple treatment sessions per day (usually from 3 to 10) with 30-60min breaks in between. This approach leverages the brain's neuroplasticity more effectively, potentially leading to faster symptom relief.
Accelerated TMS is primarily used to treat major depressive disorder, especially treatment-resistant depression. It may also be beneficial for anxiety disorders, OCD, PTSD, and other mood-related conditions. The accelerated protocol is particularly helpful for patients who need rapid symptom relief or cannot commit to weeks of daily treatments.
(mPNS) magnetic Peripheral Nerve Stimulation
mPNS is a non-invasive therapy that uses magnetic pulses to stimulate peripheral nerves, offering relief for various neurological and pain conditions without the need for surgery or medication.
Magnetic Peripheral Nerve Stimulation (mPNS) is an innovative, non-invasive treatment that uses focused magnetic pulses to stimulate peripheral nerves throughout the body. Unlike traditional nerve stimulation that requires implanted devices, mPNS delivers therapeutic benefits through the skin without any surgical intervention.
mPNS uses electromagnetic coils placed near the target nerve area to generate magnetic pulses that penetrate tissue and stimulate peripheral nerves. This stimulation can help modulate pain signals, improve nerve function, and promote healing. Treatment sessions are typically brief and painless, with patients able to resume normal activities immediately afterward.
mPNS is effective for treating chronic pain conditions, neuropathic pain, migraine headaches, and various neurological disorders. It may also help with muscle rehabilitation, nerve injury recovery, and conditions affecting peripheral nerve function. The treatment is particularly beneficial for patients seeking alternatives to medication or invasive procedures.
Spravato (esketamine)
Spravato is an FDA-approved nasal spray medication containing esketamine, offering rapid relief for treatment-resistant depression. Administered in a clinical setting under medical supervision, it provides a new option for patients who haven't responded to traditional antidepressants.
Spravato (esketamine) is an FDA-approved nasal spray medication for treatment-resistant depression. It works differently from traditional antidepressants by targeting the NMDA receptor in the brain, offering hope for patients who have not found relief with other treatments. Esketamine is derived from ketamine and has shown rapid antidepressant effects.
Spravato is self-administered as a nasal spray under direct medical supervision in a certified healthcare setting. The medication is typically given twice weekly for the first month, then weekly or every other week for maintenance. Patients must be monitored for at least two hours after each dose due to potential side effects. The treatment works by rapidly increasing glutamate activity in the brain, which can help restore neural connections.
Spravato is approved for adults with treatment-resistant depression who have tried at least two different antidepressant medications without adequate response. It must be used in conjunction with an oral antidepressant. A comprehensive psychiatric evaluation is required to determine eligibility, and patients must be enrolled in a Risk Evaluation and Mitigation Strategy (REMS) program.
Treatment sessions last approximately 2-3 hours, including administration and monitoring time. Some patients experience dissociation, dizziness, or sedation during treatment, which is why medical supervision is required. Many patients notice improvement in depressive symptoms within hours to days, though the full therapeutic effect may take several weeks. Insurance coverage varies, and our team can help verify your benefits.
Vagus Nerve Stimulation (VNS)
VNS is an FDA-approved therapy that uses a small implanted device to deliver mild electrical pulses to the vagus nerve, helping to treat treatment-resistant depression and epilepsy. Dr. Fox provides expert management and optimization of VNS therapy for patients who have already received the implant.
Vagus Nerve Stimulation (VNS) is an FDA-approved treatment for treatment-resistant depression and epilepsy. A small device, similar to a pacemaker, is surgically implanted under the skin in the chest. This device sends regular, mild electrical pulses through a wire attached to the vagus nerve in the neck. The vagus nerve then carries these signals to areas of the brain that regulate mood, helping to reduce depression symptoms over time.
Dr. Fox specializes in managing and optimizing VNS therapy for patients who have already received the implant. Management involves regular follow-up appointments to adjust stimulation settings, monitor treatment response, and optimize therapeutic benefits. Using specialized programming equipment, Dr. Fox can fine-tune the electrical pulse parameters to maximize effectiveness while minimizing any side effects. This ongoing management is crucial for achieving the best possible outcomes with VNS therapy.
VNS management is appropriate for patients who have already had a VNS device implanted for treatment-resistant depression or epilepsy. The initial implantation surgery is performed by a neurosurgeon, after which patients need ongoing psychiatric management to optimize the therapy. Ideal candidates are those with chronic, treatment-resistant depression who have not responded adequately to multiple medication trials and other treatments, or patients with epilepsy requiring device management.
VNS management appointments typically occur every few months, though frequency may vary based on individual needs. During visits, Dr. Fox reviews your symptoms, assesses treatment response, and may adjust device settings using a programming wand placed over the implant site. The adjustment process is painless and takes only a few minutes. Many patients begin to notice gradual improvement in depression symptoms over several months of optimized VNS therapy. Side effects are generally mild and may include voice changes, cough, or throat discomfort during stimulation cycles.
