The Neuromodulation Clinic offers a variety of treatments that address mental health conditions by enhancing or suppressing the activity of the nervous system.
Neuromodulation treatments are intended for patients who have been unable to find success in relieving their symptoms with medication. Our team of experts will work with you to determine if neuromodulation might be right for you.
We offer a range of surgical and non-surgical treatments to help patients suffering from depression, bipolar disorder, catatonia, schizophrenia and obsessive-compulsive disorder (OCD), among other behavioral health conditions.
Transcranial Magnetic Stimulation (TMS)
Transcranial magnetic stimulation (TMS) is an outpatient procedure used to treat depression in adults who have not had success with medication. TMS involves five sessions per week — each lasting 3 to 20 minutes — for up to six weeks. A device that emits magnetic pulses to the brain’s left prefrontal cortex is placed on the patient’s head. The pulses stimulate nerve cells in the brain that control mood. During treatment, patients will hear a clicking sound and feel a tapping sensation on their head. A small percentage of patients complain of mild discomfort or headaches afterward.
Most insurance plans, including Medicare, cover TMS treatment, however Missouri Medicaid does not currently cover TMS treatment. For information about insurance, call us at 573-882-5688.
Electroconvulsive Therapy (ECT)
Electroconvulsive therapy (ECT) is an FDA-approved therapy in which small electric currents are passed through the brain to trigger a brief seizure and change brain chemistry. It is used to treat patients with severe symptoms of mental illness, including treatment-resistant depression, bipolar disorder, catatonia and schizophrenia.
ECT is an outpatient procedure that is done using general anesthesia. Patients typically have three treatments per week. The procedure itself takes just five to 10 minutes. Patients who have not had success treating depression with medication will sometimes get better responses to medication after being treated with ECT.
ECT is one of the fastest and most effective treatments for severe depression. Some patients see relief from their symptoms in as little as one week. Patients who see improvement from ECT may go into a maintenance program, in which they receive ongoing treatments weekly or monthly.
Most commercial insurances, as well as Medicare and Missouri Medicaid, cover ECT treatment.
Esketamine Nasal Spray
Esketamine is a prescription nasal spray used to help patients with treatment-resistant depression. Esketamine treatment is fast-acting and can offer relief to patients who haven't had success with other treatments. Side effects may include an increase in blood pressure, disassociation and sedation.
Because of the potential side effects, patients must complete the treatment at our clinic under the supervision of our medical staff, and they cannot drive themselves to or from the clinic. Total treatment observation time is two hours. Patients complete two treatments weekly for the first month, and then one treatment each week for the next three weeks. After that, our doctor will determine treatment schedule according to the patient's results.
Most commercial insurances, as well as Medicare and Missouri Medicaid, cover esketamine treatment.
Cranial Electrotherapy Stimulation (CES)
Cranial electrotherapy stimulation (CES) is an FDA-approved non-invasive, painless treatment that involves sending a very low alternating current to the brain through clips on the earlobes. It is used to treat anxiety, insomnia and depression. These outpatient treatments can last up to 45 minutes and are administered as needed.
This therapy uses a light box that offers illumination that mimics sunlight to reduce symptoms of seasonal affective disorder (SAD) in the fall or winter.
Deep Brain Stimulation (DBS)
Deep brain stimulation (DBS) is used to treat patients who suffer from severe, chronic obsessive-compulsive disorder (OCD) and have not found relief from cognitive behavioral therapy or medication. (DBS is also used to treat movement disorders. If you want information about DBS for movement disorders, click here.)
DBS is a surgical procedure that involves placing a small electrode in the brain. The electrode is controlled by a wireless device, and the electrical impulses are adjusted to provide relief of OCD symptoms. The device does not destroy brain tissue and can be removed if a patient doesn’t see improvement.
In order to qualify for DBS treatment, patients must have tried treating their OCD with cognitive behavioral therapy and three selective serotonin reuptake inhibitors (SSRIs). The treatment requires prior authorization from your insurance provider, and our staff can work with you and your insurance provider to see if you qualify.
Vagus Nerve Stimulation (VNS)
Vagus Nerve Stimulation (VNS) is used to help patients with treatment-resistant depression. It is an adjunct treatment, meaning it is used in addition to antidepressant medication. Patients who qualify for VNS have been unsuccessful with multiple antidepressant medications.
VNS involves a surgical procedure in which a small device is implanted under the skin in the patient’s chest area. A small wire from the device is connected to the left vagus nerve in the neck region. This device delivers a small electrical current through the wire directly to the nerve.
Stimulation from the device is controlled by a wireless handheld device that is kept with the neuromodulation providers. If adjustments are needed, patients will need to visit the clinic. Stimulation of the vagus nerve might reduce depression, however results might take months.
Side effects are tolerable for most patients and might lessen over time. Adjusting the impulses can help minimize effects. Talk to your doctor if the following symptoms continue:
- Voice changes
- Throat pain
- Shortness of breath
- Difficulty swallowing
- Tingling or prickling of the skin
- Worsening of sleep apnea