*Now Offering: Intranasal Ketamine Treatment for Treatment Refractory Depression

Transcranial Magnetic Stimulation (TMS)

*** Dr. Saribalas was the FIRST doctor in central Ohio to use rTMS to treat major depressive disorder (actually the first to have multiple TMS devices running simultaneously) TMS has been researched since I was a medical extern at the Mayo Clinic back in 1990.

I recall seeing Elecroconvulsive Therapy (ECT) for the first time and thought to myself that this seemed rather archaic. However, ECT worked rather well for many patients, and in fact when I returned to the Mayo Clinic as a staff Senior Associate Consultant physician I was in charge of the ECT program at times.

Now, we have the option of TMS here in Central Ohio. I was the first and only physician in Central Ohio to offer this treatment three years ago. I have now given over 5200 treatments to patients who live anywhere from Pittsburg to Lima. It is a fascinating treatment that usually works. My success rate for improvement is approximately 90%. I do have patients who feel they do not improve, but this is rather rare.

Recently, the medical insurance industry has started to partially cover rTMS. Many Anthem plans now cover it and there has even been a few cases where Medicare covered it. With time, rTMS will become mainstream. In fact OSU and Riverside in Columbus are starting up programs.

The first rTMS session last around 1 hour as I must essentially map out on your head where to deliver the energy. This is called determining the motor threshold.

The routine rTMS sessions last 37 minutes and 30 seconds. This is usually done Monday through Friday between 9AM and 6PM. Unlike most TMS Centers in the USA, I personally place the TMS device on the target. A TMS Technician monitors you through the process. The treatment device delivers the focused energy for 4 seconds, then is off for 26 seconds, and this repeats. Most patients describe the 4 seconds as like a “woodpecker” on their head. There is no need to have a driver bring you. There is no anesthesia. Patients watch TV, read, surf the internet on their ipad.

Note: Leave your earrings and nose rings at home as no metal can be close to the TMS device. Dental fillings and implants are ok. c

Pharmacogenomics (Personalized Medicine)

*** Dr. Saribalas was the FIRST in central Ohio to use pharmacogenomic testing. Dr. Saribalas worked in the Mayo Clinic lab with Dr. John Black who discovered it.

Pharmacogenomic is the technology that analizes how genetic makeup affects an individuals response to drugs. It deals with the influence of genetic variation on drug response in patients by correlating gene expression or single nucleotide polymorphisms with a drugs efficacy or toxicity. The goal is to optimize drug therapy to ensure maximum efficacy with minimal adverse events. The testing is a relatively new technology where we can evaluate your personal DNA to help determine what antidepressants, antipsychotics, mood stabilizers, ADHD and Pain medications would be optimal for you.

This technology was researched and jointly developed by the Mayo Clinic Rochester and the University of Cincinnati Childrens Hospital. I have four companies that I use for testing depending on your insurance.

We take a sample of your DNA by swabbing the inside of your cheek on both sides with sterile swabs. The DNA from your cheeks is sent to this specialized laboratory where the analysis takes place. The results usually are available to us in 7-10 business days.

I will analyze the data then review it with you in person. The data basically shows what specific medications would be optimal for you, what medications could be used with caution with you, and what medications would likely be a bad idea for you. The data also shows some theoretical drug interactions of various types of medications given your profile.

My experience with this type of genetic testing, along with the Neurotransmitter plasma levels that we send to Mayo Medical Labs, help us get you better faster.

"I think it is awesome to have an internationally known Sleep Psychiatrist locally. " - Jean C.

" After TMS my depression improved significantly and i was able to decrease my meds by half" . . . "it makes ECT look archaic". - Roger C.

"The therapy is worth it. I did not think I would feel so refreshed ." - Evan G.

"I thought snoring was just something I had to deal with. Since therapy, I am now able to get a good nights sleep."
-Brett B.

"I cannot believe we did not have this evaluated a long time ago ." - Stacee M.

Dr. Michael Saribalas is currently a member in good standing with:
American Academy of Sleep Medicine
American Academy of Addiction Psychiatry
American Sleep Association
World Association of Sleep Medicine
National Sleep Foundation
"Doctors Without Borders"
Saribalas Clinic
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Tel: 614.532.5232
Affiliated with Mt. Carmel Health System and Ohio Health.
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