Along with comprehensive psychiatric evaluation, appropriate medical work may involves following testing as needed:
- Genomind genetic testing– to assess the role specific genetic predispositions in patients with treatment resistant depression, accordingly taper of some medications and select the one most likely to work.
- Lab work to rule out hypothyroidism, deficiency of B12, vitamin D; CRP and ferritin levels (to r/o chronic inflammation); CBC, LFT & KFTs.
- CNS cognitive testing: it is computerized cognitive testing done to rule of impairment in cognition and memory.
- Sleep testing: use of home sleep testing ( to rule out sleep apnea, insomnia ) ; or PSG ( polysomnogram) for in-lab sleep testing when home sleep testing is not adequate.
- Brain EEG (QEEG) : is done in selective patients to study the brain EEG patterns to study the pre and post TMS changes ; to enhance the efficacy of TMS based on EEG patterns.