Transcranial Magnetic Stimulation (TMS) Therapy

A REAL PATIENT TMS THERAPY REVIEW & CASE STUDY

By Dr. Jack Castro of Brandywine Valley TMS in Wilmington Delaware

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TMS THERAPY SUPPORTS MENTAL WELLNESS

  • Depression
  • Lack of Joy
  • Sadness and Despair
  • Low Mood
  • Lethargy
  • Insomnia
  • Oversleeping
  • Social Isolation
  • Self-Harm
  • Substance Abuse
  • Suicidal Ideation
  • Alcoholism
  • Chronic Pain

LEARN HOW BRANDYWINE VALLEY TREATED ARMANDO WITH TMS

Background

In August 2023 I first met with Armando – a 43 y/o man who had experience trauma back in 2008 (armed robbery at his family business) and 2014 (another armed robbery during a date gone bad by the actual man he thought he was dating). Being undocumented, he felt isolated and unable to get help from the authorities. A third stressor weighing on him is the fact that he is gay and wouldn’t share this with his family who has a strong religious background. For years he felt like he was living a clandestine lifestyle and he became depressed, anxious, and developed PTSD (post-traumatic stress disorder) due to the traumas he endured.

Armando had never taken any medications for his psychiatric symptoms and while we agreed that it would be ideal to get things under control with TMS only, I didn’t want to risk waiting too long for TMS to kick in. So, to expedite the path towards remission I also prescribed sertraline (Zoloft) 25 Mg and aripiprazole (Abilify) 2 Mg at the outset of TMS.

Starting a TMS Therapy Treatment Program

On 8-29-23 we started TMS. Armando scored 27/27 on the PHQ9, indicating severe depression with suicidal ideation. He scored 19/21 on GAD7, indicating a panic attack-level kind of anxiety. We determined his motor threshold (MT) at 46% for TMS sessions and stimulated his left dorsolateral pre-frontal cortex at 10 Hz to improve depression AND inhibited his right dorsolateral pre-frontal cortex at 1 Hz to target his anxiety. It’s important to note here that higher frequencies (10 Hz) are stimulating while lower frequencies (1 Hz) are inhibiting. Also, depression affects the left side of the brain, while anxiety affects the right. Therefore, in Armando’s case, we wanted to increase activity of the left side and slow down the right

Armando's Progress With TMS Therapy

Initial treatment was set up at 3000 pulses per session on the left side and 600 pulses on the right. He quickly acclimated to TMS. Because he had no insurance and was paying of pocket, he was treated with a brief protocol of 10 daily sessions and once we noticed improvement, we lowered treatment frequency to once per week for one month and then again dropped frequency to every other week.

Tracking Using The PHQ-9

To track symptoms over the course of treatment, patients are asked to complete the PHQ-9 (Patient Health Questionnaire). Scores ranges from 0 to 27 (scores of 5–9 are classified as mild depression; 10–14 as moderate depression; 15–19 as moderately severe depression; ≥ 20 as severe depression)

Armando's PHQ9 Results Over 23 TMS Sessions

Session 01: 08-28-23 PHQ9 = 27

Session 09: 09-11-23 PHQ9 = 09
Session 11: 09-18-23 PHQ9 = 07

Session 13: 10-02-23 PHQ9 = 06

Session 17: 10-30-23 PHQ9 = 09
Session 19: 11-14-23 PHQ9 = 08

Session 21: 12-26-23 PHQ9 = 07
Session 23: 01-22-24 PHQ9 = 08

  • tms therapy treatment for depression - this is Armando and his TMS clinic case study by Dr. Jack Castro

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An image of Armando undergoing TMS therapy treatment by Dr. Jack Castro

Final Outcome & Continued Care

As of January 22nd 2024, Armando reported a significant improvement with approximately a 70% reduction of symptom severity as evidenced by his PHQ9 scores dropping from 27 at the outset of treatment down to 8. He is now functioning effectively at his business and goes to the gym several times per week. His PTSD symptoms from the robberies he experienced had subsided entirely. We’ve discussed that TMS and medication can provide relief but can’t fix his personal dilemma, but it’s understandable that opening up to his family may not be possible at this time.

For the foreseeable future, Armando will continue to visit Brandywine Valley TMS for maintenance sessions once to twice per month. He is currently taking Zoloft 50 Mg and we were able to stop Abilify 2 Mg after he completed the most critical stages of his depression treatment.

Conclusion

This honest TMS therapy review for depression treatment highlights the transformative impact of TMS, especially in cases where traditional medication approaches face limitations. Armando’s story is rooted in trauma and is a valuable TMS therapy review, showcasing real patient results under the expert guidance of Dr. Jack Castro of Brandywine Valley TMS located in Wilmington Delaware.

References

10.1046/j.1525-1497.2001.016009606.x

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TMS Therapy in Delaware: A Medication-Free Depression Treatment in New Castle & Kent Counties

By Jack Castro • February 20, 2025
Brandywine Valley TMS provides TMS therapy for depression in Delaware. Consult a specialist to see if TMS is right for you.
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"I came to see Dr Castro in the summer of 2023 l was feeling depressed. This had going on at least months. He explained what TMS is about and I decided to go for it. I was nervous about it but it was easier than expected and no pain at all. We did a bunch of sessions back to back for 2 weeks and then we lowered it to once every 2 weeks and then one Avery 3 weeks. So TMS has been extremely helpful, I was relieved in about a week and my issues disappeared in a month. I’m so thankful that I found TMS as a way to deal with my mental health problems without having to take lots of medication.l highly recommend Brandy Valley TMS  and Dr Jack Castro. Thanks you so much!!!"

Interested in more TMS case studies by Dr. Jack Castro?

Experience the Benefits of TMS Therapy Today

TMS Therapy, an FDA-approved treatment, is non-invasive and non-sedative, offering minimal to no side effects. Unlike mental health medications, which frequently bring about undesirable side effects, TMS therapy provides an immediate sense of optimal well-being following treatment sessions. Patients often experience noticeable positive changes as early as the third week, and sometimes even sooner. On this page, we've shared one real-world patient experience.

TMS has gained a strong reputation as an outstanding alternative for individuals who do not experience positive results from traditional mental health medications.

Local to Wilmington Delaware? Contact Brandywine Valley TMS today!

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Dr. Jack Castro with a Magventure TMS Therapy chair and device.
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