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Finding Out If TMS Is Right for You
To be considered for TMS Therapy you'll need a referral from your GP, psychologist, or another doctor. Once received, Dr Charles reviews the referral and, where appropriate, offers an appointment.
For TMS specifically, this generally happens in one of two ways:
Referred for TMS
If your doctor has referred you to Dr Charles specifically for TMS, he reviews the referral, and — once indications and any contraindications have been discussed and suitability agreed with your treating doctor — offers you a free 15-minute discovery session. This isn't a clinical assessment; it's a chance to see the machine, hear and feel what a session is like, ask questions, and have the costs and possible side effects explained, so you're comfortable before going ahead.
Referred for psychiatric care, already a patient
If you were referred to Dr Charles for psychiatric care more broadly and are already under his treatment, TMS may come up as part of your ongoing care. If it looks like it could be an option for you, he'll discuss it and take you through what's involved as part of your regular consultation.
No referral yet?
If you don't currently have a referral, please ask your GP or another doctor to refer you. This is required to see Dr Charles for any consultation, including TMS.
What Dr Charles considers during the assessment
. Suitability is determined by Dr Charles in a psychiatric assessment, after a referral has been received, and is agreed with your treating doctor.
These are the kinds of factors that assessment weighs. They are described here so you know what the conversation will cover.
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Your diagnosis and treatment history: including what has been tried, at what dose, for how long, and why anything was changed or stopped.
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Whether depression has not responded adequately to previous treatment: the strongest clinical evidence for TMS is in depression, particularly where there has been an inadequate response to two or more appropriate antidepressant trials.
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Your current medication and whether anything about it is affecting response: including side effects or tolerability.
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Other conditions and relevant medical history, and any factors that may affect suitability.
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Safety considerations: whether there are any contraindications that need to be reviewed (see below).
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Practical fit: whether you can commit to attending a full course of sessions, since TMS is delivered as a course rather than a single treatment.
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Shared care: TMS works best where your care is coordinated with the doctor who referred you.
When TMS may not be suitable
TMS is not suitable for everyone, and an assessment may conclude that another treatment is the more appropriate next step. Situations that require particular care include:
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Non-removable metallic objects near the head such as a cochlear implant, or certain stents or clips. TMS is contraindicated in these cases.
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A history of seizures or epilepsy: this requires careful clinical review before TMS could be considered.
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Being unable to commit to the course schedule. A course involves attending sessions on a fixed schedule over several weeks.
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Another treatment being more appropriate for your situation. An assessment does not assume TMS is the answer; it may point elsewhere.
Your full suitability, including any precautions specific to you, is discussed with you before any treatment begins.
TMS compared with medication
If you are weighing whether TMS is right for you against the medication you are already taking, the following general terms may be helpful:
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How they work. Antidepressant medication travels through the bloodstream and acts throughout the body. TMS acts on a targeted area of the brain using focused magnetic pulses delivered through a coil placed against the scalp. For depression that area is the left dorsolateral prefrontal cortex.
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Systemic side effects. TMS does not carry the systemic side effects commonly associated with oral antidepressants, such as weight gain or sedation. This is one consideration among many, and is not on its own a reason to choose TMS over another treatment.
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What is involved. Medication is taken daily at home. TMS is a course of sessions attended at the practice. A course can last 30 sessions in total, delivered either three times a day over ten working days, or once a day, five days a week, over about six weeks. See How a TMS course works.
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Whether they are alternatives. TMS is often considered where medication has not produced a sufficient response, rather than instead of it. Whether to start, continue, adjust, or stop any medication is a decision for you and your doctors.
Nothing on this page is a recommendation to change or stop any medication. Please do not alter prescribed medication without speaking to your doctor.
Your patient journey : From decision to treatment
Ask your GP, psychologist, or another doctor for a referral.
This is required for any consultation with Dr Charles.
Where you have been referred specifically for TMS,
Once indications and any contraindications have been discussed and suitability agreed with your treating doctor, you are offered a free 15-minute discovery session. This is a chance to see the machine, hear and feel what a session is like, ask questions, and have costs and possible side effects explained. It is not a clinical assessment.
Dr Charles reviews the referral
Where appropriate, an appointment will be offered.
If TMS looks like an option
Dr Charles discusses it with you as part of your consultation and takes you through what a course would involve.
If you are a patient or considering TMS: ask your GP, psychologist, or another doctor to refer you. A referral is required before any appointment can be offered.
Next Steps
If you are a patient or considering TMS: ask your GP, psychologist, or another doctor to refer you. A referral is required before any appointment can be offered.
If you are a doctor, psychologist, or mental health professional referring a patient: see TMS referrals for clinicians for what to include and where to send it.
If you are experiencing a psychiatric emergency, go to your nearest hospital emergency centre for assistance. This website is not an emergency service.
About Dr BN Charles
Dr BN Charles is a psychiatrist based in Cape Town, offering specialised TMS therapy at Mediclinic Crescent Mental Health Services in Claremont. His practice is dedicated to providing advanced, evidence-based neurobiological treatments that support functional recovery for patients managing treatment-resistant depression
Specialized Training
Dr. BN Charles has completed a Clinical Certification Course in Transcranial Magnetic Stimulation ( TMS ) through the Academy of Brain Stimulation, an internationally recognised organisation dedicated to advancing neuromodulation therapies
This certification ensures that TMS treatments are delivered according to international clinical standards and best practice guidelines
