<![CDATA[PsychoFarm: The TMS Podcast]]>https://psychofarm.substack.com/s/the-tms-podcasthttps://substackcdn.com/image/fetch/$s_!hJq4!,w_256,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F0c80a46f-b829-494f-a26d-ba93f825b9a6_1280x1280.pngPsychoFarm: The TMS Podcasthttps://psychofarm.substack.com/s/the-tms-podcastSubstackTue, 02 Jun 2026 18:49:28 GMT<![CDATA[Chestnut Lodge: The Psychiatry Case That Still Matters (for TMS)]]>https://psychofarm.substack.com/p/chestnut-lodge-the-psychiatry-casehttps://psychofarm.substack.com/p/chestnut-lodge-the-psychiatry-caseMon, 01 Jun 2026 20:46:58 GMTTMS 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.

]]><![CDATA[What Are the Safety Risks of TMS? (Seizures, Hearing Loss, and Metal)]]>https://psychofarm.substack.com/p/what-are-the-safety-risks-of-tmshttps://psychofarm.substack.com/p/what-are-the-safety-risks-of-tmsWed, 20 May 2026 12:03:18 GMTTMS 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.

]]><![CDATA[How TMS Works for Depression: Brain Networks, Neuroplasticity, and the Left DLPFC]]>https://psychofarm.substack.com/p/how-tms-works-for-depression-brainhttps://psychofarm.substack.com/p/how-tms-works-for-depression-brainFri, 15 May 2026 14:02:02 GMTHow 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.

]]><![CDATA[Serotonin Hypothesis of Depression: Why Low Serotonin Is Too Simple]]>https://psychofarm.substack.com/p/serotonin-hypothesis-of-depressionhttps://psychofarm.substack.com/p/serotonin-hypothesis-of-depressionWed, 06 May 2026 09:01:27 GMTSerotonin 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.

]]><![CDATA[How to Fail in a TMS Practice (Part 2): When Business Decisions Undermine Patient Care ]]>https://psychofarm.substack.com/p/how-to-fail-in-a-tms-practice-parthttps://psychofarm.substack.com/p/how-to-fail-in-a-tms-practice-partMon, 20 Apr 2026 09:01:12 GMTTMS 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.

]]><![CDATA[How to Fail in a TMS Practice: The Biggest Mistakes Clinics Make]]>https://psychofarm.substack.com/p/how-to-fail-in-a-tms-practice-thehttps://psychofarm.substack.com/p/how-to-fail-in-a-tms-practice-theMon, 13 Apr 2026 17:53:26 GMTTMS 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.

]]><![CDATA[TMS Greatest Hits: The 5 Most Important Studies That Changed the Field]]>https://psychofarm.substack.com/p/tms-greatest-hits-the-5-most-importanthttps://psychofarm.substack.com/p/tms-greatest-hits-the-5-most-importantWed, 01 Apr 2026 12:04:19 GMTTMS 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:

Study 4 — Single-Day TMS (ONE-D Protocol) Vaughn & Downar et al., Transcranial Magnetic Stimulation journal, 2025 → https://www.sciencedirect.com/science/article/pii/S3050529125001163

Study 5 — TMS + D-Cycloserine for OCD McGirr et al., American Journal of Psychiatry, 2025 → https://pubmed.ncbi.nlm.nih.gov/39967412/

]]><![CDATA[How TMS Was Invented And Why It Keeps Getting Better]]>https://psychofarm.substack.com/p/how-tms-was-invented-and-why-it-keepshttps://psychofarm.substack.com/p/how-tms-was-invented-and-why-it-keepsWed, 25 Mar 2026 13:38:01 GMTIn 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.

]]><![CDATA[TMS 101: What It Is and How It Works]]>https://psychofarm.substack.com/p/tms-101-what-it-is-and-how-it-workshttps://psychofarm.substack.com/p/tms-101-what-it-is-and-how-it-worksWed, 18 Mar 2026 01:54:09 GMTIn 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.

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