Understanding TMS

The magnetic pulses that reach the brain also touch muscles and nerves in the scalp. Most people say it feels like tapping, buzzing, or a light vibration while they are being treated. Once the session is over, the pulses stop and for most people, any discomfort also stops. The most common side effects are temporary and mild, such as a light tension headache or mild scalp tenderness during the first week. These can easily be managed with over-the-counter pain relievers.

A single session can be as short as 3 minutes or last 30 minutes or more. It depends on the plan your doctor uses. Most courses have around 30-36 sessions, spread over several weeks. There are also accelerated protocols such as SAINT (Stanford Accelerated Intelligent Neuromodulation Therapy) which delivers 50 treatments in one week.

Most insurances cover daily treatment on a Monday–Friday schedule, typically running for 9 weeks. However, there are also accelerated protocols which are completed in one day, one week, or a bit longer.

You stay awake and alert during and after each session. You can drive and go about your normal day. A good night's sleep before your sessions helps, because rest supports the brain changes that make TMS work. It is also important to tell your doctor about anything you use regularly, such as caffeine, nicotine, alcohol, or cannabis, other drugs, and any prescribed or over the counter medications, since these affect the brain and may change your results.

TMS carries a very small risk of seizure. Clinics follow careful steps to keep that risk low. If you have any concerns, talk them over with your doctor.

TMS is cleared by the FDA to treat major depressive disorder, depression with anxiety, OCD, PTSD, and migraine, and as an aid to quit smoking. Researchers are also studying it for other conditions, such as bipolar depression, autism, postpartum depression, Alzheimer's disease, and pain.1

TMS is not ECT (electroconvulsive therapy), which is sometimes called shock therapy. ECT passes an electric current through the brain to intentionally cause a brief seizure. It requires the patient to undergo brief general anesthesia, so a person cannot drive during a course of ECT, and some people have memory loss. TMS is different. It is non-invasive and uses gentle magnetic fields created by a small coil placed against the head. It requires no anesthesia, has no memory side effects, and you can return to your normal day right after a session.

Individual TMS treatment sessions can take anywhere from 3 minutes or to 30 minutes or more, depending on the plan your doctor uses. Most courses of TMS covered by insurance have around 30 sessions, spread over several weeks.3

Often, yes, though it can take some steps. Standard courses for treatment-resistant depression are the most widely covered. Your clinic gathers your records and sends them to your insurer for approval. Records about your diagnosis and past treatment can come from your mental health provider, such as a therapist, psychologist, psychiatrist, or psychiatric nurse practitioner. Work with your clinic so you know what they can and cannot get covered.4

Commercial Insurance & Medicare: Almost all major private insurance plans and Medicare cover TMS for depression when standard treatments haven't provided enough relief.

Medicaid: Coverage is expanding rapidly across the country, with major states like California and New York fully covering the treatment.

The most common side effects are mild. Many people feel some discomfort at the treatment spot during the session and a mild headache for a few hours after. Some people notice discomfort in the eye, teeth, or jaw, which usually eases with an over-the-counter pain reliever. Some also feel tired, especially after the first few sessions, which is good to keep in mind if you plan to return to work the same day.

Getting enough sleep before your sessions helps your brain respond best to treatment. It is also important tell your doctor about anything you use regularly, such as caffeine, nicotine, alcohol, or cannabis, since these affect brain activity and may impact your results.

While everyone's brain is unique, most people who respond to TMS begin to notice a lifting of their symptoms within the first few weeks of treatment with a conventional course, or within three to four days with SAINT. Some feel better sooner, and others take a bit longer.