Reseda Medical Clinic for Mental Health

What Is Transcranial Magnetic Stimulation (TMS)?

Transcranial Magnetic Stimulation (TMS) is a cutting-edge, non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain. Unlike medications, which circulate through the body and affect the brain chemically, TMS treatment for mental health disorders works by directly influencing brain activity through electromagnetic pulses.

Using a specialized device, an electromagnetic coil is placed near the scalp, generating brief magnetic pulses that penetrate the skull and induce small electrical currents in targeted brain regions. This stimulation can alter the firing patterns of neurons, encouraging the brain to reorganize and form new connections, a process called neuromodulation.

TMS is typically administered as a series of sessions over several weeks and is delivered in an outpatient setting, meaning patients remain awake and alert during treatment and can resume daily activities immediately afterward.

What makes TMS particularly promising is its ability to target specific brain circuits linked to mood regulation, cognition, and behavior without the systemic side effects common to pharmacological treatments. This precision allows for a focused approach to mental health disorders that are otherwise difficult to treat.

How TMS Works for Specific Mental Health Issues?

1. Major Depressive Disorder (MDD)

• Target Area: Left dorsolateral prefrontal cortex (DLPFC)
• Mechanism: In depression, this brain region often shows reduced activity. TMS delivers magnetic pulses that stimulate neural firing here, increasing activity and improving mood regulation.
• Effect: Enhanced connectivity and neurotransmitter release (like serotonin and dopamine) help alleviate depressive symptoms such as sadness, lack of motivation, and cognitive fog.

2. Bipolar Disorder (Depressive Phase)

• Target Area: Left dorsolateral prefrontal cortex (similar to depression)
• Mechanism: TMS modulates dysfunctional mood circuits, particularly during depressive episodes, by increasing neural activity in underactive brain areas.
• Effect: Helps reduce depressive symptoms while minimizing the risk of triggering manic episodes when used carefully and under supervision.

3. Post-Traumatic Stress Disorder (PTSD)

• Target Area: Right dorsolateral prefrontal cortex (or bilateral in some protocols)
• Mechanism: PTSD is associated with hyperactivity in the amygdala (fear center) and hypoactivity in the prefrontal cortex (regulation center). TMS in Southern California aims to strengthen prefrontal control over the amygdala.
• Effect: This can reduce hypervigilance, intrusive memories, and anxiety by improving emotional regulation and dampening exaggerated fear responses.

4. Obsessive-Compulsive Disorder (OCD)

• Target Area: Supplementary motor area (SMA) or orbitofrontal cortex
• Mechanism: TMS modulates overactive circuits involved in compulsive behaviors and obsessive thoughts. Stimulation of these areas can reduce the repetitive behaviors and intrusive thoughts characteristic of OCD.
• Effect: Helps patients gain control over compulsions and reduces anxiety linked to obsessive patterns.

5. Anxiety Disorders

• Target Area: Right dorsolateral prefrontal cortex or medial prefrontal cortex
• Mechanism: TMS helps regulate the neural pathways involved in fear and worry by enhancing prefrontal cortex function, which normally suppresses excessive anxiety signals from deeper brain structures.
• Effect: Leads to reduced symptoms of generalized anxiety, panic attacks, and social anxiety by improving cognitive control over anxious thoughts.

6. Schizophrenia (Negative Symptoms and Auditory Hallucinations)

• Target Area: Temporoparietal junction or left temporoparietal cortex
• Mechanism: In schizophrenia, certain brain regions are abnormally active, leading to hallucinations. TMS can suppress this hyperactivity, reducing hallucinations and improving negative symptoms like social withdrawal.
• Effect: Helps reduce auditory hallucinations and may improve cognitive and emotional functioning.

Why TMS Treatment Can Feel Uncomfortable or Difficult?

1. Physical Sensations During Stimulation

• The magnetic pulses create rapid tapping or clicking sensations on the scalp, which can feel intense or startling—some describe it as a sharp tapping or a mild headache afterward.
• The sensation is usually localized to the head and sometimes neck muscles, leading to mild discomfort or muscle twitching.

2. Length and Frequency of Sessions

• Typical sessions last about 30-45 minutes and are repeated 5 days a week over 4-6 weeks. The commitment can be exhausting or stressful, especially if traveling to the clinic is involved.
• The repetitive nature of treatment can lead to “treatment fatigue,” where the ongoing routine feels overwhelming.

3. Anxiety or Sensory Sensitivity

• Patients with heightened anxiety or sensory processing sensitivities may find the noise (the clicking sound of the machine) or physical sensations harder to tolerate.
• Being still for the duration of the treatment can also cause restlessness or discomfort.

4. Expectation vs. Reality

• Some people start TMS with hopes of quick relief but may feel frustrated if benefits take several sessions to emerge, making the procedure feel discouraging.
• The psychological strain of committing to a new treatment can compound feelings of unease.

5. Side Effects

• While rare, some individuals experience mild headaches, scalp irritation, or jaw discomfort, which can add to the feeling of being “unbearable.”
• Very infrequently, seizures can occur, though clinics take careful precautions to minimize this risk.

How Moment of Clarity Helps Manage These Challenges

• Adjusting Stimulation Intensity: Our clinicians often start with a lower intensity and gradually increase it as patients acclimate.
• Comfort Measures: Using cushioned headrests, noise-canceling headphones, or breaks during sessions can improve tolerance.
• Open Communication: Encouraging patients to voice discomfort helps tailor the experience.
• Supportive Environment: A calming clinic atmosphere and empathetic staff make a big difference.
• TMS may feel uncomfortable for some due to physical sensations, session demands, and psychological factors—but many patients adapt over time and find the benefits outweigh the temporary discomfort. If it feels unbearable, discussing these issues with your provider can lead to adjustments that make treatment more manageable.

What Are Outpatient Mental Health Services?

Outpatient mental health services are therapeutic interventions provided in various settings, including:

• Community Mental Health Centers: Offer a range of services, including therapy and case management.
• Private Practices: Provide specialized care through individual or group therapy sessions.
• Hospital Outpatient Departments: Deliver services such as medication management and therapy.
• Telehealth Platforms: Facilitate remote therapy sessions for accessibility and convenience.
• These services are typically provided by licensed professionals such as psychiatrists, psychologists, social workers, and counselors.

Insurance Coverage for Outpatient Mental Health

In California, several insurance programs cover outpatient mental health services:

• Medi-Cal: Offers comprehensive coverage, including individual and group therapy, medication management, and crisis intervention. Beneficiaries can access services through county mental health plans or managed care plans. To find services, individuals can contact their Medi-Cal managed care plan or call the Medi-Cal Mental Health Care Ombudsman at (800) 896-4042.
• Medicare: Part B covers outpatient mental health services, including visits with psychiatrists, psychologists, and other mental health professionals. Services may include diagnostic tests, therapy sessions, and medication management.
• Private Insurance: Plans like Blue Shield of California and others often cover outpatient mental health services. Coverage details vary, so it’s essential to check with the specific insurer for information on benefits and provider networks.

Types of Outpatient Programs

Outpatient programs in California vary in intensity and structure:

• Intensive Outpatient Programs (IOP): Designed for individuals who need more support than traditional outpatient therapy but do not require inpatient care. These programs typically involve multiple sessions per week and focus on skill-building and symptom management.
• Partial Hospitalization Programs (PHP): Offer a higher level of care than IOPs, providing several hours of treatment per day, often five days a week. These programs are suitable for individuals with severe symptoms who need intensive support but can return home at night.
• Standard Outpatient Therapy: Involves regular sessions with a mental health professional, focusing on individual or group therapy to address issues such as depression, anxiety, trauma, and relationship challenges.

How to Access Outpatient Mental Health Services?

To access outpatient mental health services in California:

1. Contact Your Insurance Provider: Inquire about covered services, network providers, and any required referrals or authorizations.
2. Reach Out to Local Mental Health Clinics: Many counties have public mental health departments that offer outpatient services. For example, the Los Angeles County Department of Mental Health provides a range of outpatient services, including therapy and case management.
3. Utilize Online Directories: Websites like Psychology Today and Therapist Finder allow you to search for therapists by location, specialty, and insurance accepted.
4. Seek Referrals: Ask your primary care physician, community health center, or trusted individuals for recommendations on mental health providers.

California also offers specialized programs for individuals with specific needs:

• Assisted Outpatient Treatment (AOT): Under Laura’s Law, counties can provide court-ordered outpatient treatment for individuals with serious mental illness who have a history of repeated hospitalizations or incarceration. This program aims to offer structured support while allowing individuals to live in the community.
• Community Assistance, Recovery, and Empowerment (CARE) Court: A new initiative that allows family members, first responders, and others to petition the court for treatment for individuals with severe mental illness. The program seeks to provide treatment and services to those who may not seek help voluntarily.

Mental Health in Los Angeles County: Expanded Overview

1. Prevalence of Mental Health Disorders

Approximately 25% of Californians—which translates to around 10 million people statewide—experience some form of mental illness. This broad statistic highlights the pervasive nature of mental health challenges, ranging from mild anxiety and depression to severe conditions such as bipolar disorder and schizophrenia.

• Implications:
  With such a high prevalence, there is significant demand for mental health services across the state, including Los Angeles County. This underscores the importance of expanding accessible, affordable care options to meet the needs of a diverse population.
• Contributing Factors:
  Socioeconomic disparities, cultural stigma, and lack of mental health education can impact diagnosis and treatment rates. Urban stressors, including housing instability and unemployment, can also exacerbate mental health issues in densely populated areas like Los Angeles.

2. Youth Mental Health Needs

In Los Angeles County, 27.5% of teens report needing help with their mental and emotional health, signaling a growing concern about adolescent well-being. This figure encompasses issues such as anxiety, depression, trauma, and behavioral disorders.

• Implications:
  This high percentage indicates that nearly 1 in 4 teenagers feel they require mental health support, yet many face barriers to accessing appropriate care. Early intervention is critical because untreated mental health issues during adolescence can lead to chronic problems in adulthood.
• Challenges:
  Schools and community programs are often underfunded and overwhelmed, limiting their capacity to provide comprehensive mental health services. Stigma, lack of parental awareness, and insufficient insurance coverage can further hinder teens from seeking help.
• Initiatives:
  Organizations like Children’s Hospital Los Angeles and local school districts are increasing efforts to integrate mental health education and services within schools, including counseling and crisis intervention.

3. Access to Mental Health Services

Adults in Los Angeles County have the lowest rate of mental health visits within the Medi-Cal managed care system, indicating significant gaps in service utilization among low-income populations who rely on Medi-Cal (California’s Medicaid program).

• Implications:
  Despite having insurance coverage, many adults face obstacles such as provider shortages, long wait times, transportation issues, and a lack of culturally competent care. This gap results in unmet mental health needs and often leads to worsening symptoms or crises.
• Systemic Issues:
  Medi-Cal’s limited network of mental health providers and administrative hurdles can discourage patients from following through with treatment. There is also a shortage of bilingual or multilingual providers, which impacts access for Los Angeles’ diverse communities.
• Potential Solutions:
  Efforts to expand telehealth, increase provider reimbursement rates, and integrate behavioral health with primary care aim to improve access and engagement. The County Department of Mental Health is also expanding mobile crisis teams and community outreach programs to bridge gaps.

4. Wildfire-Induced Mental Health Strain

Southern California’s frequent wildfires have left lasting psychological scars. The 2024 fires in Los Angeles County, including areas near Reseda, led to increased rates of anxiety, depression, and PTSD among survivors. Displacement, property loss, and ongoing uncertainty have compounded these issues, with mental health crisis centers reporting a significant uptick in calls from the region. The Guardian+3Axios+3Press Advantage+3TIME

5. Economic Stress and Housing Instability

Economic pressures, including job insecurity and rising housing costs, contribute to mental health challenges in Reseda. These stressors can lead to increased rates of depression and anxiety, particularly among low-income residents. Organizations like Tarzana Treatment Centers offer integrated care to address both mental health and socioeconomic factors, but the need often outpaces the resources available. Tarzana Treatment Centers+1

6. Stigma and Underutilization of Services

Despite the availability of services, stigma surrounding mental health care continues to deter many individuals from seeking help. This is particularly evident among men, who may face societal pressures to avoid expressing vulnerability. Initiatives like Men’s Mental Health Month aim to raise awareness and encourage more men in Reseda to engage with available mental health resources. pr.southjordanjournal.com

Trauma and Adverse Childhood Experiences (ACEs)

A significant portion of California’s population, including those in Reseda, has been affected by Adverse Childhood Experiences (ACEs), such as abuse or household dysfunction. These experiences contribute to “toxic stress,” leading to long-term mental health issues. While initiatives like ACEs Aware aim to address these issues through screening and education, challenges remain in consistent implementation and resource availability. San Francisco Chronicle

Addressing these challenges requires a multifaceted approach, including expanding access to services, reducing stigma, and providing support for those affected by trauma and economic stress. Community organizations, healthcare providers, and local government agencies in Reseda continue to work towards improving mental health outcomes for all residents.

Family Support in California for TMS & Ketamine-Assisted Therapy

1. Research Local Providers Together

• In California, there are numerous accredited clinics—especially in areas like Los Angeles, Orange County, and the Bay Area—offering both TMS and Ketamine-Assisted Therapy.
• Families can help by researching insurance-covered providers, confirming board-certified clinicians, and checking success rates or patient reviews.
• Look for clinics that combine medication, therapy, and holistic approaches—this increases the chance of lasting improvement.

2. Offer Transportation & Scheduling Help

• TMS often requires daily sessions for 4–6 weeks, which can be hard for someone struggling with depression or PTSD to manage alone.
• Ketamine-Assisted Therapy may require weekly or biweekly sessions at first, and patients cannot always drive themselves afterward.
• Families can help by driving to appointments, helping manage schedules, and ensuring their loved one arrives consistently—critical for treatment success.

3. Encourage Full Program Participation

• Many California clinics offer integrated aftercare—like therapy groups, mindfulness programs, or lifestyle coaching—to reinforce treatment results.
• Families can encourage their loved ones to engage in these programs rather than stopping treatment early, which is a common reason for relapse.

4. Advocate for Insurance Coverage

• In California, many major insurers (Blue Shield, Anthem, Kaiser, Aetna, and Cigna) cover TMS for depression, and some are beginning to cover Ketamine-Assisted Therapy for treatment-resistant cases.
• Families can assist by handling insurance paperwork, appealing denied claims, and keeping track of authorizations so the patient can focus on healing.

5. Monitor and Support Progress

• After TMS or ketamine sessions, patients might feel tired, emotionally raw, or disoriented. Families can:
  • Prepare calming meals
  • Create a quiet home environment
  • Offer light conversation without pressure
• Keeping a progress journal together—tracking mood changes, energy levels, and symptom relief—can help the clinical team fine-tune treatment.

6. Combine Treatments for Maximum Benefit

• Both TMS and Ketamine-Assisted Therapy work best when combined with ongoing psychotherapy.
• Families can help by:
  • Scheduling therapy sessions right after treatments (while neuroplasticity and openness are higher)
  • Encouraging their loved one to discuss insights from treatments with their therapist
  • Helping maintain lifestyle habits that reinforce treatment gains

California’s fast-paced, high-cost lifestyle can worsen depression, anxiety, and PTSD symptoms. By helping a loved one navigate TMS or Ketamine-Assisted Therapy, families not only increase treatment success rates but also reduce relapse risk—ensuring that the investment of time, money, and emotional energy leads to long-term healing.

Ketamine-Assisted Therapy for Depression: A Full Guide

Ketamine-Assisted Therapy (KAT) is one of the most exciting advancements in mental health care for people living with depression — especially those who have tried traditional methods without lasting results. Unlike standard antidepressants, which often require weeks to months to take effect and may never deliver full relief, KAT works on a completely different brain pathway, offering the possibility of rapid, meaningful improvement. Why Ketamine is Different than Other Treatments?

A. Works in Hours, Not Weeks

• Traditional antidepressants like SSRIs and SNRIs must be taken daily for 4–6 weeks to build up in the body before patients feel any change.
• Ketamine, on the other hand, can often produce noticeable mood improvements within 4 to 72 hours after a session.
• This is particularly life-saving for people with severe depression or suicidal thoughts, where waiting weeks for relief can be dangerous.

B. Targets Brain Pathways, Not Just Neurochemicals

• Standard antidepressants mostly influence serotonin, dopamine, or norepinephrine, which are important mood-regulating neurotransmitters.
• Ketamine’s main action is on the glutamate system, which is the brain’s most abundant excitatory neurotransmitter and plays a major role in learning and memory.
• By activating NMDA (N-methyl-D-aspartate) receptors and enhancing glutamate signaling, ketamine helps the brain form new neural pathways — like rebuilding mental “roads” damaged by depression.

C. Boosts Neuroplasticity

• Neuroplasticity is the brain’s ability to change, adapt, and form new connections.
• Chronic depression often leads to a “shrinking” effect in parts of the brain related to emotion regulation, such as the hippocampus.
• Ketamine stimulates brain-derived neurotrophic factor (BDNF), which supports regrowth and strengthens connections between neurons, allowing patients to escape rigid cycles of hopeless thinking.

D. Pairs well with Mental Health Therapy

Chemical + Psychological Synergy

• Ketamine can open a “window of opportunity” where the brain is more open to change — therapy during this time can amplify and cement the positive effects.

Integration is Key

• Many patients report that during or after ketamine sessions, they gain profound new perspectives or emotional clarity.
• Without therapy, these breakthroughs may fade. With therapy, they can be translated into lasting behavioral and emotional changes.

Processing Deep-Seated Trauma

• For depression tied to trauma, ketamine can reduce emotional reactivity, making it easier to revisit painful memories without being overwhelmed.
• Therapists can then guide patients in reframing their experiences in a healthier, more self-compassionate way.

What is the Typical Process of Ketamine Assisted Therapy? 

Step 1: Assessment

• Comprehensive mental health screening to confirm a depression diagnosis
• Medical review to check for contraindications (e.g., heart issues, uncontrolled blood pressure)

Step 2: Session Setup

• Administered in a safe clinical setting via:
  • IV infusion (most common)
  • Intramuscular injection
  • Nasal spray (FDA-approved Esketamine / Spravato)
  • Oral lozenge (often for at-home protocols under supervision)

Step 3: Therapeutic Support

• A therapist is present or available to guide during the ketamine experience
• Focus on emotional exploration, calming techniques, and mindfulness.

Step 4: Follow-Up Care

• Integration sessions to discuss insights gained
• Adjust treatment schedule based on results — often 6–8 sessions over 3–4 weeks, followed by maintenance.

Who Benefits Most When Using Ketamine Assisted Therapy?

A. Major Depressive Disorder (MDD) – Especially effective for treatment-resistant cases where multiple medications have failed.

B. Bipolar Depression – Can help in depressive phases without triggering mania (must be medically supervised).

C. Suicidal Ideation – Several studies show that ketamine can reduce suicidal thoughts within hours, making it a potential emergency intervention.

D. Depression with PTSD – Addresses both mood symptoms and trauma-related triggers by reducing fear responses and increasing emotional processing capacity.

What is the California Advantage?

• High Concentration of Specialized Clinics – Areas like Los Angeles, San Diego, and the Bay Area have leading-edge ketamine therapy centers staffed by psychiatrists trained in psychedelic-assisted care.
• Integrative Care Models – Many California clinics pair KAT with mindfulness training, yoga, nutrition counseling, and Transcranial Magnetic Stimulation (TMS) for comprehensive recovery.
• Insurance Coverage Progress – While most ketamine infusions remain out-of-pocket, California has a growing acceptance of FDA-approved nasal spray (Spravato) by major insurers, making it more accessible.

Why Ketamine-Assisted Therapy is Popular for Veterans

1. High Rates of Treatment-Resistant Depression and PTSD in Veterans

• The reality of mental health in veteran populations is stark — years of service, combat exposure, and reintegration challenges lead to higher rates of chronic depression and PTSD than in the general public.
• Many veterans cycle through multiple classes of antidepressants (SSRIs, SNRIs, atypical antidepressants) with little or no improvement.
• This creates what clinicians call treatment-resistant depression (TRD) — a condition that affects an estimated 30–50% of veterans in active care.
• Ketamine offers a fundamentally different mechanism of action — instead of slowly altering serotonin levels over weeks, it targets glutamate transmission and NMDA receptors, leading to rapid, noticeable mood improvement.
• For a veteran who’s spent years waiting for medications to “kick in,” KAT’s faster turnaround can feel life-changing.

2. Rapid Relief from Suicidal Thoughts

• Suicide remains a public health crisis among veterans, with the VA estimating over 6,000 veteran suicides annually in the U.S.
• Many existing antidepressants can take 4–8 weeks to significantly reduce suicidal ideation, leaving high-risk individuals vulnerable during that period.
• Ketamine is unique in that measurable reductions in suicidal thinking can occur within hours of the first dose.
• This effect is not just temporary “numbing” — by disrupting negative thought loops and creating a neurochemical environment for hope, it helps veterans emotionally stabilize long enough to engage in therapy and safety planning.
• In crisis stabilization units and specialized veteran clinics, KAT is sometimes used as part of emergency intervention protocols for those in acute danger.

3. Helps with Both Emotional Numbing and Hyperarousal

• PTSD symptoms often swing between extremes:
  • Emotional numbing — feeling detached from loved ones, unable to feel joy, love, or empathy.
  • Hyperarousal — constant alertness, exaggerated startle response, insomnia, and irritability.
• These opposites make therapy challenging — a veteran may either feel too shut down to engage or too activated to focus.
• Ketamine appears to regulate brain networks involved in emotional processing, allowing for a more balanced state.
• Some veterans describe it as “being able to feel without falling apart” — a state that’s ideal for trauma processing therapies like EMDR, prolonged exposure, or cognitive processing therapy.

4. Supports Neuroplasticity for Trauma Recovery

• Chronic trauma can “lock in” certain brain circuits, making it hard to break free from fear-based responses and intrusive memories.
• Ketamine enhances brain-derived neurotrophic factor (BDNF) and increases the brain’s synaptic connections — this is neuroplasticity in action.
• Increased neuroplasticity means the brain is more adaptable and can form new, healthier associations with old traumatic triggers.
• When combined with psychotherapy, veterans often report that previously unbearable memories feel less threatening and more manageable, allowing them to integrate rather than avoid their experiences.

5. Fits with Holistic & Integrative Veteran Care Models

• Veteran-focused mental health care is increasingly multidisciplinary, blending medical, psychological, and community-based interventions.
• Ketamine is highly compatible with this approach because it can be:
  • Paired with talk therapy during or after sessions for deep trauma exploration.
  • Used alongside TMS for additional brain circuit regulation.
  • Integrated into peer support programs that reinforce healing outside the clinic.
  • Some veteran-specific clinics even offer group KAT sessions or guided integration therapy so that veterans can process experiences with others who understand military culture and combat realities.

6. Offers Hope When Other Treatments Have Failed

• Long-term mental illness can lead to treatment fatigue — a sense that “nothing will ever work.”
• Many veterans who try KAT have already been through years of therapy, dozens of medications, and inpatient stays without lasting relief.
• KAT’s noticeable and relatively quick symptom reduction can renew hope, sometimes after decades of suffering.
• This shift in perspective is often the most powerful part of recovery — not just the reduction in symptoms, but the belief that change is possible.

7. Strong Support & Advocacy in Veteran Communities

• Word-of-mouth is powerful in the veteran community — many learn about KAT from fellow service members who’ve had success with it.
• Nonprofits, veteran advocacy groups, and even some VA pilot programs have started to publicly endorse or trial ketamine for PTSD and depression.
• Because trust in the medical system can be fractured for some veterans, peer validation is often the tipping point in deciding to try it.
• Online forums, veteran podcasts, and grassroots veteran support groups are actively sharing stories about life after KAT — amplifying its visibility and acceptance.

Success Rates of Ketamine-Assisted Therapy for Depression

1. Rapid Response in Controlled Trials
   A meta-analysis of randomized, double-blind, placebo-controlled studies found that ketamine dramatically outperformed placebo within hours to days. Response rates and remission were significantly higher at 24 to 72 hours and continued through the day.
2. Treatment-Resistant Depression (TRD) Remediation
   Another meta-analysis of 35 publications revealed substantial benefits: approximately 45% of patients responded, and 30% achieved remission. Importantly, ketamine therapy near Reseda remained effective even in highly treatment-resistant cases
3. Short-Term Effects & Duration
   Sub-anaesthetic doses delivered via IV showed a strong effect within 4 hours, peaking at around 24 hours. Effects were still notable at 7 days but began to diminish, with repeated infusions helping maintain the response
4. Effect Size Compared to Traditional Therapy
   Ketamine demonstrates a very large effect size (~1.5)—outperforming traditional antidepressants (~0.3) and psychotherapy (~0.7), emphasizing its powerful impact on depressive symptoms.

Real-World Outcomes for Using Ketamine-Assisted Therapy

1. Clinic-Based Response and Remission
   In a private clinic analysis:
   • Overall: ~50% achieved at least a 50% reduction in symptoms;
   • Remission: ~25% saw symptoms resolved entirely.
   • Among those completing all six infusions, 70.6% responded, and 32.4% remitted.
     Many reported elimination of suicidal ideation following induction.
2. Broader Real-World Studies
   Across 2,665 patients in multiple studies:
   • 45 ± 10% responded,
   • 30 ± 5.9% remitted,
   • The antidepressant effect remained stable with repeat treatments,
3. Expanded Telehealth Insights
   Among over 11,000 patients using at-home, sublingual ketamine:
   • ~56% reported improvement,
   • ~28% reached remission after only four sessions.
     Less than 5% reported adverse effects, though these studies lacked a control group

Initial Assessment Duration – TMS vs. Ketamine-Assisted Therapy

1. Transcranial Magnetic Stimulation (TMS)

• Average Duration: 60–90 minutes for the first visit.
• Why does it take that long?
  • Intake & History Review (20–30 min): Mental health history, current symptoms, and prior treatment attempts.
  • Motor Threshold Mapping (20–30 min): This is unique to TMS—clinicians precisely locate and measure brain activity response to magnetic pulses to customize treatment intensity.
  • Treatment Simulation (~10 min): Patients experience a brief sample session to ensure comfort and proper settings.
• Extra Tip: This initial mapping only happens once—after that, daily sessions take about 20 minutes.

2. Ketamine-Assisted Therapy (KAT)

• Average Duration: 90–120 minutes for the first session (sometimes up to 2.5 hours if psychotherapy is included).
• Why does it take that long?
  • Medical Screening & Baseline Vitals (20–30 min): Medical history, medication review, and mental health baseline.
  • Therapeutic Goal Setting (15–20 min): Establishing intentions for the session with a psychotherapist (unique to KAT).
  • Ketamine Administration & Monitoring (40–60 min): IV infusion or nasal spray, with a provider monitoring vitals continuously.
  • Integration Discussion (20–30 min): After-effects and emotional processing are discussed immediately post-session to help “lock in” therapeutic insights.
• Extra Tip: This is longer than later sessions—follow-ups often drop to 60–90 minutes.

Key Difference The biggest time gap comes from integration therapy in KAT and motor mapping in TMS—both are essential to personalizing treatment, but only occur in the initial phase.

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