TMS Therapy – Frequently Asked Questions
What is TMS?
Transcranial Magnetic Stimulation (TMS) is a non-invasive, FDA-cleared treatment that uses magnetic pulses to stimulate targeted areas of the brain involved in mood regulation. It does not require anesthesia and does not involve systemic (oral or IV) medication.
What conditions does TMS treat?
TMS is FDA-cleared for Major Depressive Disorder (MDD) and certain other indications, including anxious depression and obsessive-compulsive disorder (OCD).
It is typically considered when depression has not adequately responded to medication, when medications are poorly tolerated, or when patients prefer a non-systemic treatment option.
A structured psychiatric evaluation is required to determine whether TMS is clinically appropriate.
How does TMS work?
TMS delivers focused magnetic pulses to specific cortical regions involved in mood regulation. Over a series of treatments, stimulation may help modulate neural network activity associated with depression.
One helpful metaphor compares depression or anxiety to a congested intersection. TMS acts like a construction crew that redirects traffic, repairs malfunctioning “stoplights,” and strengthens alternate routes (synaptic connections) to reduce future bottlenecks.
Another analogy is a “brain workout,” in which targeted stimulation activates underactive areas, helping them strengthen over time.
Treatment protocols are individualized based on clinical presentation and motor threshold measurements performed by your provider.
What does treatment feel like?
Patients typically feel a tapping sensation on the scalp during stimulation. Mild scalp discomfort or headache may occur early in treatment but often improves as sessions continue.
Patients remain awake during treatment and may return to normal activities immediately afterward.
How long is a TMS course?
A standard course typically consists of 30–36 sessions, delivered five days per week over approximately 4–8 weeks.
Individual sessions last approximately 3–40 minutes, depending on the specific protocol used (e.g., intermittent theta burst vs. standard protocols).
What is the success rate?
Response rates vary depending on illness severity, duration, and prior treatment history.
Clinical trials demonstrate meaningful improvement for many individuals with treatment-resistant depression. Real-world effectiveness data from large patient registries have shown response rates (defined as ≥50% symptom improvement) ranging from approximately 58–83%, and remission rates ranging from 28–62%, depending on assessment method and patient population.
Individual results cannot be guaranteed, and outcomes are discussed in detail during consultation.
Is TMS covered by insurance?
Coverage depends on the specific insurance plan and clinical criteria. The office can review benefits and discuss coverage options during the evaluation process.
Currently, the practice is in-network with BCBS PPO and most Aetna plans. Self-pay options may also be discussed when appropriate.
Is TMS safe?
TMS is generally well tolerated. The most common side effects are scalp discomfort and mild headache. Less common side effects may include fatigue, dizziness, or tinnitus.
The risk of seizure is rare (approximately 0.007%) and is reviewed during the informed consent process. A thorough medical screening is completed prior to treatment initiation.
Who is not a candidate for TMS?
Individuals with certain implanted metallic or electronic devices near the head or neck may not be candidates.
Careful risk-benefit assessment is required for individuals with a history of epilepsy, significant traumatic brain injury, pregnancy, or certain neurological conditions.
A comprehensive screening evaluation is conducted to assess safety and eligibility.
How is TMS different from medication?
Unlike antidepressant medications, TMS does not circulate systemically and does not typically cause side effects such as weight gain, sexual dysfunction, or gastrointestinal symptoms.
However, TMS is not appropriate for everyone and is considered within the broader context of a patient’s psychiatric and medical history