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Call: 021 761 1188
TMS: What to Expect
Suitability and Safety
To be considered for TMS Therapy you need a referral first, from your GP, psychologist, or another doctor. Once a referral is received, Dr Charles reviews it and, where appropriate, offers an appointment.
The suitability information below explains what an assessment covers. It is not a way to assess yourself. Suitability is determined by Dr Charles in consultation with you, after a referral has been received, and is agreed with your treating doctor.
TMS Treatment Programme
TMS treatment starts with a suitability assessment, followed by a structured course if it is considered appropriate for you. The protocol and course length depend on your diagnosis and your assessment. For depression, two protocols are currently offered:
Intermittent theta-burst stimulation (iTBS) : the standard starting protocol.
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30 sessions in total
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3 sessions a day, every working day, over 10 working days
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Each session takes about 3 minutes, with a 15-minute break in between
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Under an hour of your time per visit
Standard repetitive TMS (rTMS) : alternative protocol
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30 sessions in total
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1 session a day, five days a week, until the course is complete — typically around six weeks
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Each session takes under 20 minutes
Sessions are delivered by a suitably trained TMS technician. Currently this is provided personally by Dr Charles, so a course is scheduled around his available time in the clinic calendar.
What a session is like
A TMS session is straightforward:
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You remain awake and alert throughout. No anaesthesia is used.
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A treatment coil is placed gently against your scalp, over the target area of the brain (for depression, the left dorsolateral prefrontal cortex).
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The coil delivers brief, focused magnetic pulses. You may feel a light tapping sensation on the scalp and hear a clicking sound during stimulation.
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Sessions in the iTBS format last approximately three minutes each; standard rTMS sessions are under 20 minutes.
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After a session you can usually return to your normal routine immediately, there is no recovery period.
Where you have been referred specifically for TMS, the free 15-minute discovery session is your opportunity to see the machine and hear and feel what a session is like before deciding anything.
Safety and Precautions
Course Intake
During treatment, you will be asked to complete short online questionnaires about your mood and anxiety. These check-ins take place at the beginning, halfway through, at the end of the course, and again two weeks later.
They help you and Dr Charles discuss how you are doing during treatment. If your care is shared with another doctor, Dr Charles provides them with an update halfway through and at the end of treatment.
Reported Effects and Precautions
TMS is generally well tolerated. Some people experience temporary scalp discomfort or a light headache, particularly during the early sessions. These effects usually settle as treatment continues.
TMS is not suitable for everyone. Non-removable metal near the head, such as a cochlear implant or certain stents or clips, may mean that TMS is not appropriate. A history of seizures or epilepsy also needs to be reviewed carefully.
Suitability
Your full suitability, including any
precautions specific to you, is discussed during the assessment before treatment begins.
Where you have been referred specifically for TMS, indications and any contraindications are discussed and suitability is agreed with your treating doctor before treatment proceeds.
If you are 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
Practice enquiries: reception on 021 761 1188.
If you are experiencing a psychiatric emergency, go to your nearest hospital emergency centre for assistance. This website is not an emergency service and is not monitored as one.
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
