At SilverLining℠ Psychiatry Medical Group, partnering with our San Diego TMS and Ketamine clinic, we are dedicated to delivering advanced, evidence-based mental health care with compassion and expertise. We specialize in Treatment-Resistant Depression (TRD) and Anxiety, Bipolar, OCD and PTSD —conditions that often resist traditional antidepressants or therapy. Studies show success rates drop significantly after two or more failed medication trials, which is why our innovative approaches offer renewed possibilities.
Expert TMS Leadership
Led by Dr. Dmitriy Sivtsov, an early California adopter of Transcranial Magnetic Stimulation (TMS), our board-certified team provides this FDA-cleared, non-invasive therapy. It gently stimulates underactive brain areas to restore balance and improve mood when other treatments haven't worked.
Cutting-Edge Technology
We utilize state-of-the-art MagVenture® systems—European-engineered with liquid cooling for superior comfort, precision, and efficiency. Enjoy shorter, quieter sessions comparable to those in Stanford's pivotal research.
Tailored, Supportive Care
Backed by over 20,000 hours of TMS experience, our welcoming staff personalizes every phase of your journey—from consultation to recovery—for depression, anxiety, PTSD, OCD, and more. Your dignity, comfort, and progress are our top priorities in a nurturing environment.
SilverLining℠ Psychiatry is about more than medicine—it's about hope and healing. Reach out today to explore if TMS is right for you and take your first step toward lasting wellness.
Frequently Asked Questions About TMS
Why does TMS work?
TMS has been shown to produce changes in neuronal activity in regions of the brain implicated in mood regulation, such as the prefrontal cortex. As each magnetic pulse passes through the skull and into the brain, this induces brief activity of brain cells underlying the treatment coil.
The frequency of pulse delivery also influences whether brain activity is increased or decreased by a session of TMS. Recent studies also suggest that stimulation over the left and right sides of the brain can have opposite effects on mood regulation.
When is TMS used?
Antidepressant medications and psychotherapy are the first line treatments for major depression. These treatments, however, do not work for all patients. In these instances, rTMS might be used as an alternative treatment, or to augment antidepressant medications or psychotherapy. Patients who have failed to achieve an adequate response from antidepressants, or who are unable to tolerate medications, might consider TMS therapy.
What happens during an TMS procedure?
For each TMS session, the patient sits in a specially designed treatment chair, much like the kind used in a dentist’s office. Because TMS uses magnetic pulses, before beginning a treatment, patients are asked to remove any magnetic-sensitive objects.
During the first TMS session, several measurements are made to ensure that the TMS coil will be properly positioned over the patient’s head. Once this is done, the TMS coil is suspended over the patient’s scalp. The TMS physician then measures the patient’s motor threshold, by administering several brief pulses. The motor threshold is the minimum amount of power necessary to make the patient’s thumb twitch, and varies from individual to individual. Measuring the motor threshold helps the physician personalize the treatment settings and determine the amount of energy required to stimulate brain cells.
Once the motor threshold is determined, the coil is then brought forward so that it rests above the front region of the patient’s brain. Treatment is then commenced. During the treatment, patients will hear a series of clicking sounds and will feel a tapping sensation under the treatment coil.
Succeeding treatment sessions do not require that the motor threshold be determined again, unless indicated otherwise, such as when changes in medications are made during the course of the treatment.
Who administers TMS?
TMS is always prescribed by a TMS physician. At SILVERLINING℠, all TMS providers are specifically TMS credentialed. Motor threshold is determined by a TMS physician. The treatment itself is administered by an experienced TMS technician under the direct supervision of the TMS physician or by the TMS physician.
The TMS technician or physician will always be present to monitor the patient during the treatment. The patient can stop a treatment at any time by asking the staff member present.
How long is an TMS procedure?
TMS therapy involves a series of treatment sessions. Treatment sessions can last between 3 and 18 minutes each, depending on the protocol used and administered 5 days a week. A typical course of TMS is 6 weeks. However, this can vary depending on an individual’s response to treatment.
What are the side-effects of TMS?
TMS is well-tolerated and associated with few side-effects and only a small percentage of patients discontinue treatment because of these. The most common side-effect, which is reported in about half of patients treated with TMS, is headaches. These are mild and generally diminish over the course of the treatment. Over-the-counter pain medication can be used to treat these headaches.
About one third of patients may experience painful scalp sensations or facial twitching with TMS pulses. These too tend to diminish over the course of treatment although adjustments can be made immediately in coil positioning and stimulation settings to reduce discomfort.
TMS has not been associated with many of the side-effects caused by antidepressant medications, such as gastrointestinal upset, dry mouth, sexual dysfunction, weight gain, or sedation.
The most potentially serious risk of TMS is seizures. However, the risk of a seizure is exceedingly low (<0.1%).