TMS Therapy: Pros, Cons, and What to Consider Before Treatment

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In 2020, an estimated 14.8 million American adults suffered from one major depressive episode. Over 60% of those adults received treatment during that year alone. 

Depression is one of the most common mental illnesses experienced in the U.S.,  occurring more often in women than men. It is a disorder that can negatively impact how you feel, think, and act. 

Fortunately, there are ways to treat or reduce the symptoms of depression. Transcranial Magnetic Stimulation (TMS) is a form of non-invasive brain stimulation that can help you find relief from depression and its symptoms.

What Is TMS Therapy?

For some people suffering from depression, medication doesn’t work. Antidepressants are often the first choice to treat depression, but they come with a wide range of side effects, including: 

  • Weight loss or gain
  • Sexual problems 
  • Insomnia
  • Drowsiness 
  • Fatigue 
  • Headaches 
  • Nausea 

These side effects can spur on more mental health problems, and long-term use can cause physical dependence. Before TMS, treatment for depression was mostly limited to antidepressants and
electroconvulsive therapy (ECT). 

Nowadays, people with depression can undergo TMS therapy as an alternative treatment option. TMS therapy is pain-free, easy, and fast.

TMS therapy is a non-invasive procedure that uses strong magnetic pulses to stimulate the brain to improve symptoms of depression. Unlike ECT, TMS is non-invasive, requires no anesthesia, and has limited side effects. 

Repetitive TMS increases the release of dopamine and serotonin production. Dopamine boosts happiness, while serotonin acts as a mood stabilizer. People with low serotonin and dopamine levels can display symptoms associated with depression.

Sessions typically last around 30 to 40 minutes. During a typical course of TMS, you will receive treatment five days a week for approximately four to six weeks. 

Because every patient is different, the reactions to treatment vary greatly. For example, some patients may notice changes after the second week, while others may not until the three or four-week mark.

What Are the Benefits of TMS Therapy?

For some, antidepressant prescription medicine is enough to treat symptoms of depression. For others, it’s not. People’s bodies respond differently to various types of depression treatment. If antidepressant medication isn’t working for you, you might consider TMS.

Doesn't Require Anesthesia

Unlike ECT, TMS therapy does not require the patient to undergo general anesthesia. Patients remain conscious throughout the session. They also do not experience any seizure or memory problems afterward.

TMS therapy allows you to resume your daily activities immediately after treatment. Unlike ECT, where you may have to wait for the anesthesia side effects to go away.

Shorter Treatment Times

TMS therapy sessions usually last between 30 to 40 minutes, much shorter than typical ECT treatment sessions. Because of the shorter treatment times, you can go to work before and after without having to take an entire day off. 

This is unlike ECT treatments which last longer and require you to go under anesthesia. You cannot drive for at least 24 hours after receiving an anesthetic. This makes scheduling appointments during work hours almost impossible.

Minimal Side Effects

TMS therapy has been found to have limited side effects, another advantage over ECT therapy. Some patients experience mild headaches and scalp discomfort. Those who do are advised to take over-the-counter pain medication to relieve any symptoms.

If you experience discomfort after your treatment, it is likely to disappear after the first few sessions. Keep in mind these side effects pale in comparison to those experienced with ECT and antidepressant medication.

Long-Term Results

TMS is effective in its ability to provide results long after the treatment is over. Unlike antidepressants which you must continue to take or risk uncomfortable withdrawal symptoms.

brain imaging

Most patients who complete the entire course of TMS treatment experience improvement from between six months up to a year or more. Better yet, some patients experienced complete remission after their TMS treatment.

Insurance Coverage

The good news is that TMS is an FDA-cleared therapy option for those struggling with treatment-resistant depression. Most insurance companies will cover TMS therapy as more and more companies recognize the benefits of TMS. These companies include: 

  • Tricare 
  • Anthem 
  • Aetna 
  • Blue Cross Blue Shield 
  • United Healthcare
  • Cigna

Can Manage a Wider Range of Conditions

Although TMS is only FDA-approved to treat major depressive disorder, it can also treat many psychiatric conditions. They include: 

  • Obsessive-compulsive disorder (OCD)
  • Anxiety 
  • Post-traumatic stress disorder (PTSD) 
  • Stroke rehabilitation 
  • Schizophrenia 
  • Parkinson’s disease 
  • Alzheimer’s 
  • Chronic pain
  • Multiple sclerosis (MS) 

TMS has also shown promising signs in reducing nicotine cravings by targeting the prefrontal cortex. Experts suggest the release of dopamine works to reduce the need for nicotine in heavy smokers.

What Are The Drawbacks of TMS Therapy?

TMS therapy is a godsend for many patients when alternative medications and treatments aren’t working.

But for some, TMS isn’t the best treatment choice. Price, insurance, and scheduling difficulties are the most cited reasons that prevent patients from experiencing the benefits of TMS.

Time Commitment

Since TMS therapy is administered every day over a four to six-week course, the patient requires a significant time commitment. This is the biggest drawback to TMS therapy, especially for working professionals. 

Most clinics open from 8 am onwards. Depending on your hours, you may be able to come in before work, during your lunch break, or after work.

Mild Discomfort

The treatment isn’t painful, but it may cause minor side effects. Headaches and scalp discomfort are the most common side effects of TMS therapy. You are more likely to experience these side effects during your TMS session. However, these side effects are likely to disappear within a few sessions.

Insurance Criteria

The good news is that TMS therapy is covered by most major insurance companies as long as you have tried and failed on at least two antidepressant medications.

However, the bad news is that most insurance companies will not authorize payment if TMS is your first depression treatment option. 

If your insurance does not cover your TMS therapy, you may be able to discuss alternative payment options with your TMS provider.

Not Recommended For Everyone

TMS therapy is not an advisable treatment method for people with metal implanted above their neckline. That’s because the magnetic field can’t pass through the metal. In some cases, it can also cause the metal to get hot. 

Other factors that might make you an unfit candidate include: 

  • History of seizures 
  • Brain tumors 
  • Implanted devices (incl. pacemakers) 

If you do have one or more of these issues, your doctor may still be able to accommodate you. Don’t discount TMS until you discuss your options with an experienced TMS provider.

What to Expect During a TMS Consultation

Before you receive your first TMS treatment, you will have an initial consultation with your doctor to ensure that TMS is right for you.

Your doctor will review your medical history during this session and discuss how TMS treatment works. 

To be considered as an ideal candidate for TMS therapy, you must: 

  • Be in good physical health 
  • Free from any implanted metal devices 
  • Previous medication has failed to provide any relief 
  • Experienced unpleasant side effects on medication
  • No history of seizures or seizure disorder 
  • Struggling from major depressive disorder 

If TMS is right for you, your doctor will create a treatment plan and answer any questions or concerns you may have.

How to Prepare for TMS Therapy

The best way to prepare for TMS therapy is to understand what it is and how it works. That way, it is easier to explain the process to friends and family who may have some reservations. 

Some people tend to confuse TMS with ECT, so it’s essential to explain the difference. Be sure to let them know that TMS is an effective treatment for many patients. 

You might like to ask a family member to take you to your first few sessions to ease any nerves. A support system during treatment can be incredibly valuable. 

In some cases, your support person may be allowed to enter the treatment room with you. But let them know they can also stay in the waiting room or run some errands. 

On the day of your treatment, it’s important to bring anything along that will help make you more comfortable. Some patients like to bring along: 

  • Headphones for listening to music or podcasts 
  • Bottled water 
  • Over-the-counter pain medication (in case you get a headache) 

Remember also to bring a list of current medications and dosages that you may need to tell your doctor about before treatment.

What to Expect During TMS Therapy for Depression

First, you will be asked to sit in a comfortable cushioned chair, similar to one a dentist would use. Before starting, you may be asked to remove any metallic jewelry, including earrings, necklaces, and bracelets. 

During your first TMS session, your doctor will measure your head and determine the proper placement for the magnetic coil. As it’s your first session, your doctor will measure your motor threshold through several brief pulses as they gauge your brain’s response. 

By measuring your brain’s motor threshold, it helps your doctor create personalized treatment settings and determine the amount of energy required to stimulate your brain cells.

Off Label TMS Uses

Once determined, the coil is brought forward to rest above the front region of your brain. As treatment begins, you will hear a series of clicking noises and feel a tapping sensation under the treatment coil. 

You can wear earplugs or play music through earphones to minimize this noise. 

Your treatment will last between 30 minutes to 40 minutes and be delivered five days a week over four to six weeks. Of course, this can vary depending on your response to the treatment.

What Happens After TMS Therapy

Following a session of TMS therapy, you are unlikely to experience any major side effects.

However, some patients report headaches, but these are often mild and can be treated with over-the-counter pain medication. The excellent news is that headaches tend to get better with each session. 

Following an entire course of treatment, you’ll likely notice the improvement of your symptoms. You may begin to experience the following benefits: 

  • Increased happiness 
  • Less hopelessness 
  • Less fatigue 
  • More interest in life
  • Less disrupted sleep 
  • More positive thoughts 

As with most treatments, it can take a few weeks to experience the complete relief of symptoms. But when you do, you’ll come to understand the dramatic healing effects TMS therapy can achieve.

Contact Inland Empire In Murrieta For a TMS Consultation

Dealing with severe depression is exhausting, but effective treatment options are available, including TMS. Now that you know about the TMS pros and cons, it’s time to consider taking the next steps for the sake of your mental wellbeing. 

At Inland Empire TMS, we care about your mental health. Our dedicated team of medical professionals is here to help you live a happy and fulfilling life. 

With the use of NeuroStar Advanced TMS Therapy, we can make long-term depression remission possible by activating regions of the brain that have decreased activity. 

TMS is non-invasive, requires no anesthesia, and doesn’t have the major side effects that you may experience with antidepressants. 

Contact us and start your healing journey today!


1. National Institute of Mental Health (2018, July 3). Major Depression.

2. HealthTalk (2021, August 18). Side Effects Of Electroconvulsive Therapy.

3. iMotions (2021, August 3) Dopamine and Serotonin.
4. National Center for Biotechnology Information (2020, February 29). Treatment-Resistant Depression: Therapeutic Trends, Challenges, and Future Directions.