TMS Therapy FAQ

TMS (transcranial magnetic stimulation) is a non-invasive, FDA-cleared treatment that uses magnetic pulses to stimulate nerve cells in brain regions involved in mood regulation. You remain fully awake during each session. There is no anesthesia, sedation, or recovery time, and most patients return to their normal routine immediately after treatment. Visit our TMS therapy page for a detailed overview of the treatment.

Standard TMS uses a figure-8 coil that stimulates the brain's surface at roughly 0.7 cm depth. Deep TMS uses an H-Coil design that reaches approximately 1.8 cm, activating broader and deeper neural networks. Research published by the National Institutes of Health shows this broader field reduces targeting sensitivity and allows more effective stimulation of structures involved in mood regulation. At CARMAhealth, we utilize advanced localization technology to ensure maximum response with either deep or conventional figure-8 coils.

TMS is FDA-cleared for major depressive disorder and depression with comorbid anxiety. Your psychiatric practitioner will determine whether TMS is appropriate for your specific condition during a psychiatric evaluation.

TMS is typically recommended for adults with major depressive disorder who have not responded adequately to antidepressant medication. Most insurance plans require documentation that you have tried at least two medications before approving TMS. TMS may also be appropriate if you experience intolerable medication side effects or prefer a non-medication approach. Your psychiatric practitioner will review your full treatment history and determine candidacy.

TMS is not recommended for patients with non-removable metal implants in or near the head, such as cochlear implants, aneurysm clips, or deep brain stimulators. Patients with active seizure disorders or implanted cardiac pacemakers should also avoid TMS. A history of head injury, epilepsy, or certain medications that lower the seizure threshold may require additional clinical review. Your psychiatric practitioner will screen for all of these factors before recommending treatment.

The most common side effects are mild scalp discomfort and headache, reported by roughly one-third of patients during the first week. These typically resolve on their own as treatment continues. Less common effects include muscle twitching near the treatment site and lightheadedness. According to the National Institute of Mental Health, seizure is the most serious potential risk but is extremely rare, occurring in fewer than 1 in 1,000 sessions. Unlike antidepressant medications, TMS does not cause weight gain, sexual dysfunction, nausea, or fatigue.

You sit in a comfortable chair while a cushioned helmet or figure-8 coil is positioned over your head. The device delivers rapid magnetic pulses to targeted brain regions. You will hear clicking sounds and feel a tapping sensation on your scalp. Each session lasts about 20 to 30 minutes. You remain fully awake and can listen to music, watch a show, or simply relax. There is no sedation and no recovery period with standard protocols. You can drive yourself to and from appointments and return to work or daily activities immediately after.

A standard course includes sessions five days per week for four to six weeks, totaling 20 to 30 treatments. According to Yale Medicine, about 60% of patients with treatment-resistant depression experience a meaningful response. Some patients notice improvement within the first two weeks; most experience significant benefit by weeks three to five. Your psychiatrist may also discuss accelerated protocols or combination approaches depending on your progress.