The TMS Podcast

Epizode

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  Dr. Colleen Hanlon on Brainsway and the Next Frontier of Brain Stimulation and TMS for Addiction 15.07.2026 48min

  Neuroscientist Dr. Colleen Hanlon joins The TMS Podcast to discuss whether transcranial magnetic stimulation can meaningfully treat addiction…. and what the future of brain stimulation may look like. She explains the emerging evidence for deep TMS in alcohol and nicotine use disorders, how clinicians should think about seizure risk in patients who are actively drinking, and why abrupt alcohol withdrawal is more concerning than stable use. The conversation also explores accelerated TMS, BrainsWay’s ongoing alcohol-use-disorder trial, and rotational field TMS, a next-generation technology designed to stimulate neurons across multiple orientations. It is a practical look at how TMS may expand beyond depression into addiction, PTSD, pain, and other psychiatric conditions. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com
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  Which TMS Machine Should You Buy? 9 Questions Before Choosing a Device 01.07.2026 22min

  Which TMS machine should a psychiatry practice buy? In this episode, Dr. Steve Harvey and Dr. Greg Malzberg walk through the real-world factors clinicians should consider before choosing a TMS device. Rather than naming brands, they focus on the practical questions that matter: upfront cost, rental and per-use fees, coil replacement, service responsiveness, portability, cooling systems, exit options, and the hidden risks of working with a manufacturer. The episode is especially useful for clinicians thinking about starting or expanding a TMS practice who want a more thoughtful checklist than simply comparing the sticker price. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com
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  TMS for OCD: Effectiveness, Protocols, and Patient Selection 17.06.2026 24min

  TMS for OCD is more than just using the same treatment protocol as depression. In this episode, Dr. Harvey and Dr. Malzberg discuss how transcranial magnetic stimulation is used for obsessive-compulsive disorder, including FDA-cleared protocols, the H7 coil, symptom provocation, dorsomedial prefrontal cortex and anterior cingulate targets, and what patients can realistically expect. They also cover why TMS for OCD is less commonly used than TMS for depression, how insurance coverage affects access, and why clinicians need to be careful not to overdiagnose OCD when intrusive thoughts may fit a different formulation. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com
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  Chestnut Lodge: The Psychiatry Case That Still Matters (for TMS) 01.06.2026 27min

  TMS gets a historical frame in this episode, using the Chestnut Lodge case and Rafael Osheroff’s lawsuit to explore how psychiatry changes when old assumptions fail patients. Dr. Steve Harvey and Dr. Greg Malzberg discuss psychoanalysis, medication, neuromodulation, and the danger of treating any one approach as the only legitimate answer. The conversation connects a famous psychiatry history case to today’s patients who cycle through depression medications without hearing about TMS, while also warning against turning TMS or any newer treatment into hype. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com
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  What Are the Safety Risks of TMS? (Seizures, Hearing Loss, and Metal) 20.05.2026 42min

  TMS safety risks are the focus of this episode, with a balanced look at why transcranial magnetic stimulation is considered very safe while still requiring thoughtful precautions. Psychiatrists explain the rare but serious concerns patients should understand before treatment, including hearing damage without earplugs, seizure risk during stimulation, and metal-related issues near the magnetic field. The discussion also covers practical clinic safety steps, why medication changes can matter during a TMS course, and why “no side effects” is not the right way to describe any treatment. It is a clear, grounded overview for anyone considering TMS or educating patients about it. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com
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  How TMS Works for Depression: Brain Networks, Neuroplasticity, and the Left DLPFC 15.05.2026 23min

  How TMS works is the focus of this episode, which moves beyond the idea that depression is simply a chemical imbalance. Dr. Harvey and Dr. Malzberg explain why TMS targets the left dorsolateral prefrontal cortex, how that surface region may influence deeper connected brain networks. They also discuss neuroplasticity with appropriate caution, emphasizing that it is not magical brain fertilizer but one possible part of how treatments for depression create change. The result is a clear, honest psychiatry conversation about TMS, depression, brain networks, and what science still cannot fully explain. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com
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  Serotonin Hypothesis of Depression: Why Low Serotonin Is Too Simple 06.05.2026 21min

  Serotonin hypothesis of depression is the center of this episode, as two psychiatrists unpack why the low serotonin “chemical imbalance” story became so popular and why it falls short. They trace the monoamine hypothesis, discuss serotonin, norepinephrine, and dopamine, and review evidence that challenges a simple serotonin deficiency model. The conversation also explains why this does not mean SSRIs or antidepressants stop working, using clear analogies and clinical examples like delayed medication response, serotonin syndrome, tryptophan depletion, TMS, and depression research. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com
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  How to Fail in a TMS Practice (Part 2): When Business Decisions Undermine Patient Care 20.04.2026 20min

  TMS practice management is the focus of this episode on how clinics fail when business decisions start overriding clinical judgment. The conversation explores patient care vs profit, physician leadership, non-medical managers, clinician autonomy, Spravato pressure, and why treatment quality is also a business strategy. For psychiatrists, TMS providers, and private practice owners, this is a practical discussion of TMS clinic operations and healthcare management grounded in the realities of psychiatry. It is especially relevant for anyone trying to build a physician-led TMS clinic without letting quotas, sterile workflows, or non-clinical control erode patient care. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com
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  How to Fail in a TMS Practice: The Biggest Mistakes Clinics Make 13.04.2026 22min

  TMS practice mistakes are at the center of this episode on why TMS clinics fail and what those failures reveal about better care. The conversation covers timid rollout, underestimated demand, remote management, referral boundaries, physician leadership, and the damage that happens when business pressure starts to shape clinical decisions. For psychiatrists, practice owners, and clinicians interested in transcranial magnetic stimulation, this is a practical discussion of TMS clinic management rooted in real-world patterns rather than abstract theory. It is especially useful for anyone starting a TMS practice or trying to understand why a service is underperforming. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com
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  TMS Greatest Hits: The 5 Most Important Studies That Changed the Field 01.04.2026 29min

  TMS research has reached a tipping point, and in this episode Dr. Harvey walks through the five studies he believes have most dramatically reshaped the field. From a Dutch randomized trial showing TMS outperforms a third antidepressant by a factor of five, to the theta burst 3D trial that compressed treatment into three minutes, to Stanford’s headline-grabbing SAINT protocol and its 90% remission claim — each study adds a new layer to how clinicians can approach treatment-resistant depression. The episode also covers a promising single-day TMS trial and emerging data on TMS plus neuroplastogens for OCD, making this a must-listen for psychiatrists and patients alike.Study 1 — TMS vs. Antidepressants (Netherlands RCT) Dalhuisen et al., American Journal of Psychiatry, 2024 → https://pubmed.ncbi.nlm.nih.gov/39108161/Study 2 — The THREE-D Trial (Theta Burst vs. 10 Hz rTMS) Blumberger et al., The Lancet, 2018 → https://pubmed.ncbi.nlm.nih.gov/29726344/ (Full Lancet abstract also available at: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30295-2/abstract)Study 3 — The SAINT Trial There are two key papers here — the original open-label study and the follow-up double-blind RCT:* Original SAINT (Cole et al., Am J Psychiatry, 2020): https://pubmed.ncbi.nlm.nih.gov/32252538/* Double-blind SNT trial (Cole et al., Am J Psychiatry, 2022): https://pubmed.ncbi.nlm.nih.gov/34711062/Study 4 — Single-Day TMS (ONE-D Protocol) Vaughn & Downar et al., Transcranial Magnetic Stimulation journal, 2025 → https://www.sciencedirect.com/science/article/pii/S3050529125001163Study 5 — TMS + D-Cycloserine for OCD McGirr et al., American Journal of Psychiatry, 2025 → https://pubmed.ncbi.nlm.nih.gov/39967412/ This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com
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  How TMS Was Invented And Why It Keeps Getting Better 25.03.2026 18min

  In this episode, Dr. Harvey and Dr. Malzberg walk through the full history of transcranial magnetic stimulation, from Dr. Tony Barker’s 1985 discovery in a UK engineering lab to the 2008 FDA clearance of the Neurostar system for treatment-resistant depression. They explain how a magnetic field bypasses the skull to induce electrical current in the brain, why early TMS likely underdosed patients, and how new coil designs, expanded indications, and accelerated protocols have transformed the field into one of psychiatry’s fastest-moving areas. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com
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  TMS 101: What It Is and How It Works 18.03.2026 26min

  In this foundational episode on transcranial magnetic stimulation, Dr. Malzberg is joined by Dr. Steve Harvey… a TMS specialist and early adopter since 2013… for a clear, hype-free introduction to how TMS works and why it matters. They cover the basic physics of using magnetic pulses to create electrical stimulation in the brain, the evidence behind targeting the prefrontal cortex in depression, and how TMS differs fundamentally from ECT. They also take an honest look at where the field oversells itself, and why intellectual humility should guide how clinicians and patients think about brain stimulation therapy going forward. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com