Transcranial Magnetic Stimulation

Book TMS Initial Consult Appointment

rTMS at Shellharbour Psychological Medicine

Transcranial Magnetic Stimulantion

State-of-the-art rTMS with MRI-Brain scan guided treatment

for Treatment Resistant Depression



(no out of pocket expense for a course of up to 35 treatments)

Any GP or a Psychiatrist can refer you to us for rTMS

Or simply book your own appt, no referral necessary. Click the Green Book Appointment button underneath the video below. In addition to the rTMS treatment sessions, these TMS Initial Consultations are also bulk billed.

If there are no TMS Initial Consultations available through the HotDoc online self-booking system (via the green button below) or if the available appointments are too far away – call reception on 4295 3600 to enquire about other times that may be available.

Book TMS Initial Consult Appointment


What is Repetitive Transcranial Magnetic Stimulation (rTMS)?

rTMS is a non-invasive form of brain stimulation. Magnetic fields, generated by a magnetic coil placed on the head create pulses which stimulate a small area on the surface of the brain. Pulses are given repeatedly for therapeutic effect. A session of rTMS typically takes 20-30 minutes and is given on multiple days per week (2-5) on an outpatient basis. While receiving stimulation, the patient is fully awake. rTMS can is usually well tolerated with minimal side effects (compared to medication). There is no need for any anaesthetic or sedation and there are no adverse effects on memory and thinking ability.

When is rTMS used?

rTMS is used to treat depression and can be offered when patients have not responded to antidepressant medication, prefer to try an alternative to medication, or cannot tolerate antidepressant medications due to side effects. There is also growing evidence for the efficacy of rTMS in the treatment of OCD. Other conditions such as panic disorder, parkinson’s disease, migraine and social functioning in autism are showing promise with research ongoing in these areas.

Is rTMS an alternative to therapy or medication?

rTMS can be standalone or combined with both psychological therapy and medication treatments. Depending on your individual needs and prefences, you can benefit from all available treatments in combination, including rTMS.

Is there evidence that rTMS works?

A large body of research conducted worldwide indicates that rTMS has antidepressant effects when applied over the frontal areas of the brain. There are well over 30 studies in adults with depression, showing that rTMS is an effective treatment for depression. It is understood that rTMS works by modifying and rebalancing activity across brain networks, which have become altered in depression. rTMS is now an approved treatment for depression in countries including Australia, the United States, Canada, Israel and the United Kingdom. rTMS won’t work for everyone, however once one or two medications have failed to work, there is a much higher chance that rTMS will be effective compared to trying another antidepressant medication, approximately 4 times more likely to work.

What are the side effects?

Common side effects include headache. Scalp discomfort and facial muscle twitching are common during the treatment session. Most patients find that these side effects reduce in intensity as the course of rTMS progresses.

Like medication treatments for depression, there is a small risk that rTMS can precipitate a mood switch to mania and a very small risk that it could cause a seizure in those who are vulnerable to these conditions. The risk of these rare events will be considered before rTMS is prescribed.

Overall rTMS is significantly less likely to cause adverse side effects compared to antidepressant medication.

What happens during a session?

You will be awake through the whole session. A staff member will be with you to guide you through the treatment process. If you have any concerns during the treatment, the treatment can be stopped immediately. A session involves sitting in a chair. A small magnetic coil is then precisely placed on your forehead, touching your scalp. The placement of the magnetic coil can be MRI-scan guided with our advanced neuro-navigator equipment. When the treatment starts you will hear a clicking noise and feel a tapping sensation on your scalp. Ear protectors/plugs can be worn to reduce the impact of the clicking sound. The treatment will take 20-30 minutes and then you should be able to resume your normal activities including driving home after the session (waiting at least 1 hour following the first session and 20 minutes following subsequent sessions before driving is advised).

How long does rTMS take to work?

A course of 20 to 35 sessions given over 2-5 days per week is recommended for therapeutic results. Some patients may notice changes after a few sessions, for others it may take weeks to notice a response. The treatment effect is usually measured after 15 sessions and consideration given to the treatment optimisation depending on progress at this stage.


Shellharbour Psychological Medicine was the first provider in the Illawarra & Shoalhaven / South Coast NSW to offer rTMS in the Outpatients setting starting the rTMS clinic in 2018. We are excited to once again be a leader in the field offering the most advanced treatment options with state-of-the-art equipment.