Robert Bota, M.D.  MSG DFPA

Dr. Bota is a board-certified psychiatrist and a distinguished fellow of the American Psychiatric Association. As a psychiatrist, he has a broad background in diagnosing and treating mental illness and major depressive disorder. His career has spanned both academic and private psychiatry practices. In his most recent position, he served as the director of the Medical Psychiatry Unit at the University of California, Irvine.

Dr. Bota has published over 60 articles and book chapters and has given over 100 presentations at national and international psychiatry conferences. In his pursuit of advanced, novel psychiatric treatments, Dr. Bota has studied transcranial magnetic stimulation (TMS) at Harvard University and at the University of South Carolina. He started and led the first TMS program at UC Irvine and is now proud to lead BrainHealth Solutions in Costa Mesa.

He is now joining Dao Medical Group to open a psychiatric clinic to help the Vietnamese community. His team will include Connery Lee, P.A-C, Haley Nguyen P.A and Tuan Le P.A.

PSYCHIATRIC SERVICES

Transcranial Magnetic Stimulation (TMS)

Transcranial magnetic stimulation (TMS) is a non-invasive treatment for major depressive disorder and OCD. It works by using magnetic fields to stimulate nerve cells in the brain.

How TMS Therapy Works:   TMS works by delivering electromagnetic energy painlessly via an electromagnetic coil placed against your scalp. The magnetic pulses stimulate nerve cells in the area of the brain involved in executive functioning, depression, and mood. TMS works by activating areas of the brain which display lower levels of activity in patients with depression, anxiety, and OCD

Who is eligible for TMS?  To be eligible for TMS, patients must have:  Moderate to Severe Major Depressive Disorder, Anxiety, or Obsessive-Compulsive Disorder.   At least one failed medication at or above the minimum dose.  A failed course of talk therapy.  ​There is no age limit to receive TMS.

What to Expect from TMS:  For most patients, response to TMS follows a predictable pathway of results. Within your first few sessions, thinking begins to grow clearer and the “brain fog” starts to subside.  Around session 5, sleep patterns become more regular and many patients report feeling more well-rested.  During the second week of treatment, you will start to have more energy and improvement will be visible to those around you.  Starting somewhere between the 10th and 15th sessions, you will start to notice that you are feeling better and the symptoms affecting your life are starting to subside, an improvement which will grow and consolidate over the remaining duration of treatment.

​In a real world retrospective study using CGI-S and a sample size of 615, patients with depression experienced 83% Response and 62% Remission. This data comes from the world’s largest depression outcomes registry from NeuroStar, with evaluable data on over 6621 patients since being initiated in 2016.

Logistics of TMS:  TMS is typically performed in a doctor’s office. You will be seated in a comfortable chair for the duration of the treatment.  Once you are relaxed, a magnet is used to locate your prefrontal cortex, which is where depression “lives” in the brain.  Your doctor will determine the amount of magnetic energy needed by placing the magnet on your scalp.  Once the right dose has been identified, the magnet then delivers pulses at this intensity for a total of 30 minutes. You will be awake and alert for the entire treatment.  Before starting the treatment, you will be encouraged to enter a relaxed state of mind by listening to alpha wave music and/or focusing on an object, such as a painting. This helps your brain become more receptive to treatment.  You can return to your normal daily activities after your treatment. Between treatments, most patients can typically work and drive.

Risks of TMS:  TMS is a non-invasive treatment. It does not require surgery or implantation of electrodes. Although it is considered safe, there are some potential side effects: headache, scalp discomfort at the site of stimulation, tingling, spasms or twitching of facial muscles, lightheadedness.  ​If any of these symptoms occur during your first session, you will be recommended an over-the-counter pain medication to take before the procedure for the next few sessions in order to prevent further occurrences.  Like antidepressant medications, TMS carries a slight risk of producing euphoria, which may result in hypomania or mania; as well, seizures may occur in roughly 1 in 30,000 patients during the procedure.

After TMS treatment:  If TMS works for you, symptoms of depression may improve or go away completely.  ​After a TMS treatment series, medication and psychotherapy may be recommended as ongoing treatment.  If your depression improves with TMS and later recurs, the treatment can be repeated.