Helping patients with treatment-resistant MDD, GAD & OCD
My center offers state of the art neuromodulation treatments (TMS & Ketamine).
- Feedback from referring MD/therapist: Patient’s initial evaluation is preceded by phone conversation with referring MD or therapist to understand patients clinical history and recent treatments. This allow to understand patient’s specific factors relevant to TMS/ketamine treatment.
- Initial Neuropsychiatric Evaluation: I would like to share that my extensive neuropsychiatry training and background allows me to have a comprehensive multi-dimensional evaluation of patient’s illness including neuro-psychiatric, psychopharmacological, pharmacogenetic testing, sleep evaluation, cognitive evaluation etc. Initial evaluation will be forwarded to referring MD or therapist.
- Regular follow during TMS Rx: During the course of TMS Rx, each patient is seen weekly by me/team for promoting the ‘behavioral activation’ (setting up short term goals) and the ‘wellness factors’ (sleep, exercise, diet, social connectedness and stress reduction) to enable them to return to their ADLs, work and other activities.
- Two Unique TMS Systems: Our center acquired Mag & More’s Apollo System 5 years ago and an year ago added Magventure TMS system which has the first FDA approved coil for treatment of OCD in 2020. Both systems have the capability to offer FDA approved 19 min protocol for MDD and 3 min ‘Thetaburst stimulation protocol’. Our STW center has 2 TMS rooms with detailed attention to sound proofing, lighting, background music and television screens in front of TMS chairs.
- Precise TMS Target Localization: At STW center, we use ‘Alternative B3 method’ for determining the precise location of ‘Therapy Hot Spot’, which requires 3 different head measurements. Therapy hot spot is ‘left dorsolateral prefrontal cortex’ and this method is most widely practiced in clinical settings. ‘NCG -rTMS’: A new method called “Neuro-Cardiac Guided rTMS (NCG-rTMS)” helps to adequately target the frontal-vagal network. Iseger et al.1,2 show that the NCG-rTMS reliably locates the point of greatest heart rate deceleration at the DLPFC. Later this year we also plan to add the ‘MRI guided neuro-navigatio’ system to our center.
- Highly trained staff at STWcenter: TMS therapy is delivered by highly trained and compassionate TMS techs who make the TMS treatment experience very pleasant and comfortable. Patient’s progress is closely monitored even after the office hours with use of mobile app ‘ROSE’.
My STW center looks forward to be a credible and trustworthy referral center to psychiatrists, neurologists and psychotherapists located in Nassau, Queens and Suffolk area. We are constantly working to gain their trust by providing the excellent compassionate care to patients with neuropsychiatric disorders.
- Before the initial evaluation and starting TMS treatment, I would prefer to have a phone conversation with referring MD/therapist to understand more about the patient’s clinical history and treatment course. Often, I may suggest patient’s MD for possible medication adjustments if required prior to starting the TMS/Ketamine Rx (to have the optimal treatment response).
- During the course of TMS/ Ketamine Rx, the referring MD or therapist will be informed about the patient’s progress on a regular basis by email, text (or phone if preferred).
- Patients is clearly informed that my center in mainly focused on their TMS/Ketamine Rx and does not get involved in management of their medications during or after the treatment is finished.
- I closely monitor the patients and have regular follow ups during the course of their treatment to monitor any side effects, therapeutic gains, appropriate adjustments to TMS Rx as needed.
- We also enhance the therapeutic outcome by promoting the wellness factors (sleep, exercise, positive psychology, socialization & diet) and behavioral activation towards their return to normal activities.