Information for Patients About TMS (Transcranial Magnetic Stimulation) for Depression
TMS is an FDA-approved, safe, and effective non-invasive brain stimulation treatment for depression that has not responded to at least two different antidepressant medications. 1, 2, 3
What TMS Is and How It Works
TMS uses magnetic pulses (similar to MRI strength) to stimulate specific areas of the brain involved in mood regulation, specifically the left prefrontal cortex. 4, 3, 5
The treatment does not require anesthesia, does not cause seizures, involves no implanted devices, and has no drug-drug interactions or systemic side effects like medications. 5
The magnetic field induces small electrical currents in the brain that help restore normal activity in areas that are underactive in depression. 3, 5
What to Expect During Treatment
Treatment typically requires daily sessions (5 days per week) for 4-6 weeks, with each session lasting approximately 20-40 minutes. 2, 5
You remain awake and alert during the entire procedure—no sedation is needed. 3
You will feel a tapping sensation on your scalp where the magnetic coil is placed, and you may hear clicking sounds during stimulation. 3
You can return to normal activities immediately after each session, including driving. 3
Effectiveness for Depression
Response rates range from 29-48%, meaning approximately 1 in 3 to 1 in 2 patients experience significant improvement in depression symptoms. 2
Remission rates (complete resolution of symptoms) occur in approximately 20-63% of patients, with higher success rates typically seen with certain protocols. 2, 6
The number needed to treat is 3.4 to 9 patients for response and 5 to 7 patients for remission, indicating clinically meaningful benefits. 2
Benefits can be maintained for 3-6 months following the initial treatment course, though some patients may need maintenance sessions. 2
Safety Profile
TMS has an excellent safety profile with rare, mild, and transient side effects. 6
The most common side effect is mild scalp discomfort or headache at the stimulation site, which typically resolves quickly. 3, 6
TMS is particularly valuable for older adults or those with medical conditions that make antidepressant medications risky due to side effects or drug interactions. 6
Who Qualifies for TMS
You qualify if you have tried at least two different antidepressant medications at adequate doses for at least 4 weeks each without sufficient improvement. 1
The two medications should work through different mechanisms in the brain. 1
You are NOT disqualified if you have tried many medications, failed previous TMS treatment, or even failed electroconvulsive therapy (ECT)—you remain eligible for TMS. 1
Having other mental health conditions alongside depression does not automatically exclude you from treatment. 1
Important Considerations
Access can be challenging because treatment requires frequent in-person visits over several weeks. 2
TMS may be more effective when combined with psychotherapy such as cognitive behavioral therapy. 2
Some patients may benefit from maintenance TMS sessions (typically twice weekly for 3 months) after the initial treatment course to sustain improvement. 2
Only highly motivated patients should pursue this treatment given the daily commitment required. 2
What TMS Is NOT Recommended For
- TMS is not recommended for routine treatment of tinnitus (ringing in the ears), as evidence shows it lacks long-term benefit for this condition. 4