Depression (TMS, MeRT, and Spravato) Anxiety (TMS and MeRT) Insomnia (MeRT) Traumatic Brain Injury/Post-Concussive Syndrome (MeRT) PTSD (MeRT) Substance Abuse (MeRT) Brain Fog/Cognitive Issues (MeRT) Autism (MeRT* this treatment is available for children 5 years old and older) Parkinson’s Disease (MeRT) After-Effects of Stroke (MeRT) ADHD/Learning Disorders (MeRT)

Nasal Esketamine (Spravato) is covered by many insurance policies. Our clinic specialist will handle all the paperwork.

TMS may be covered for Major Depressive Disorder (MDD).

MeRT is not covered by insurance. However, MeRT treatments are administered with an FDA approved device.

Nasal Esketamine begins working in just hours.

Our treatment protocol is in phases. Phase 1 consists of two treatments a week for four weeks. Phase 2 consists of one treatment a week for four weeks. Phase 3 consists of one treatment every 1-2 weeks.

Transcranial Magnetic Stimulation (TMS) has received FDA approval for addressing depression, bipolar depression, obsessive-compulsive disorder (OCD), and aiding in smoking cessation. Nevertheless, it is often applied "off-label" to manage various symptoms and psychiatric or neurological conditions. Our approach utilizes evidence-based research and established protocols to treat conditions that have demonstrated notable improvements through TMS therapy. These conditions encompass generalized anxiety disorder, panic disorder, post-traumatic stress disorder (PTSD), peri- and post-partum depression, addiction, autism spectrum disorder, insomnia and other sleep disorders, eating disorders, chronic pain, fibromyalgia, headaches, tinnitus, tremors, and cognitive disorders such as Alzheimer’s disease.

Transcranial Magnetic Stimulation (TMS) is a long-lasting treatment for depression, with 65% of individuals maintaining positive results up to one year following a successful initial course. Like all known antidepressant treatments, TMS requires ongoing maintenance to sustain its benefits. After completing your initial TMS series, you will need to closely monitor your symptoms with your primary psychiatrist and therapist to assess any potential worsening of mood. If you and your healthcare providers decide that maintenance TMS is necessary, we will collaborate with you to develop a personalized maintenance schedule. However, not everyone who undergoes TMS will require maintenance sessions. Insurance may cover an additional full course of TMS therapy if there is at least a 50% improvement in depression symptoms after the initial treatment, followed by a regression of symptoms six months later. Additionally, Transcranial Electrical Stimulation (TES) therapy, which can be performed at home, may be considered to help maintain the improvements achieved with TMS therapy.

Clinicians will thoroughly evaluate your treatment plan and collaborate with you to enhance its effectiveness while minimizing any risks linked to psychiatric medications. Generally, you can maintain your regular medications throughout your TMS treatment. However, certain medications may need to be discontinued or reduced before starting TMS to mitigate the risk of seizures. This will be addressed during your initial consultation visit.

No, TMS and ECT are distinct treatments. Electroconvulsive therapy (ECT), often referred to as "shock therapy," deliberately induces a seizure. Patients undergoing ECT must be sedated with general anesthesia and given muscle relaxants to prevent movement. Recovery from an ECT session is gradual, and patients typically require close monitoring for several minutes to a few hours afterward. In contrast, Transcranial Magnetic Stimulation (TMS) does not trigger a seizure and therefore does not necessitate sedation, anesthesia, or muscle relaxants. Patients can return to their daily activities immediately after a TMS session.

The primary objective of MeRT brain treatment is to achieve functional recovery, with outcomes varying according to individual symptoms. Functional recovery benefits include improved sleep quality, better mood, clearer thinking and language skills, positive behavioral changes, increased eye contact, improved attention span, enhanced sociability, boosted motivation, heightened concentration and focus, greater self-confidence and self-esteem, improved emotional stability, reduced anxiety, increased energy levels, better adaptability to change, and reduced cravings for substances such as food, drugs, and alcohol.

Cortical MeRT treatment involves delivering magnetic pulses to specific areas of the brain. A typical MeRT session consists of 36 trains of electromagnetic stimulation, each lasting 5 seconds, with a 45-second rest period between trains, targeting a specific location on the head. The entire session lasts about thirty minutes.

We recommend a minimum of one month of treatment, which includes 20 MeRT sessions, following the assessment period. However, the overall duration of treatment depends on the individual's response rate. The length of treatment will be determined collaboratively by the clinician and patient after evaluating clinical and EEG changes.

According to our current data, side effects of MeRT treatment are rare and generally mild. The most commonly reported side effect is a mild tension headache at the site of stimulation, which usually lasts 1-2 hours and responds well to over-the-counter pain relievers. Other possible side effects include hyperactivity, increased agitation, or euphoria. Although there is a minimal risk of seizures associated with brain stimulation, this risk is exceptionally low with MeRT. At Advanced Neuro Solutions Iowa, we further minimize this risk by limiting the intensity of stimulation.

Spravato® has been FDA-approved since 2019 and has undergone extensive evaluation in both short- and long-term trials for safety and efficacy. Administered in our office, patients will be closely monitored for any adverse side effects. Before beginning esketamine therapy, we will discuss all potential side effects and interactions to ensure Spravato® is the right choice for you.

In our office, patients will self-administer the Spravato® nasal spray under the supervision of one of our healthcare providers. Afterward, patients will remain under observation for two hours to monitor for side effects. Unlike daily antidepressants, Spravato® is administered only a few times each week: twice per week during the first month, once per week during the second month, and once every two weeks in subsequent months. Patients undergoing Spravato® therapy often report some sedation and dissociation effects during or shortly after the drug's administration. Other possible side effects include nausea, dizziness, vertigo, and headaches.

SPRAVATO® (esketamine) CIII nasal spray is a derivative of ketamine. It is an FDA-approved nasal spray for treatment-resistant depression and is also approved to treat depressive symptoms in adults with major depressive disorder who have suicidal thoughts or actions. Unlike SPRAVATO®, ketamine has not been approved by the FDA for the treatment of depression. Both SPRAVATO® and ketamine are classified as Schedule III controlled substances under the US Controlled Substances Act.

If you have high blood pressure, whether treated or untreated, you should discuss this with your healthcare provider to determine if SPRAVATO® is suitable for you. Do not use SPRAVATO® if you have a blood vessel disease (such as an aneurysm), an abnormal connection between blood vessels (arteriovenous malformation), or a history of bleeding in the brain. SPRAVATO® can temporarily increase your blood pressure for about four hours, so your blood pressure will be measured at various intervals, including before and after taking SPRAVATO®. If your blood pressure is high before using SPRAVATO®, your healthcare provider will decide whether to start the medication or wait until your blood pressure is lower. Notify your healthcare provider immediately if you experience chest pain, shortness of breath, sudden severe headache, changes in vision, or seizures after taking SPRAVATO®.

You should discuss your plans for the remainder of the day with your healthcare provider. Due to potential side effects that can affect mental alertness and motor coordination, you won't be able to drive, operate machinery, or engage in activities requiring full alertness until the day after a treatment session, following a restful sleep, even if you feel capable. Because of this driving restriction, you will need to arrange for transportation on treatment days.

SPRAVATO® may cause sleepiness (sedation or loss of consciousness), fainting, dizziness, a spinning sensation, anxiety, or a feeling of disconnection from yourself, your thoughts, feelings, and surroundings (dissociation). Therefore, do not drive, operate machinery, or engage in activities requiring full alertness until the day after a treatment session, following a restful sleep, even if you believe you feel well enough to do so.