Frequently Asked Questions about TMS
What is TMS?
Transcranial Magnetic Stimulation (TMS) is a non-invasive brain stimulation therapy used to treat mental health conditions such as depression, OCD, and smoking addiction. It uses magnetic pulses to stimulate specific areas of the brain involved in mood regulation.
Who is a good candidate for TMS?
TMS is FDA-cleared for Major Depressive Disorder (MDD), Obsessive-Compulsive Disorder (OCD), and smoking cessation.
It is most effective for individuals who:
Have not responded to medication or therapy
Experience side effects from antidepressants
Are looking for a non-invasive, drug-free alternative
Is TMS safe?
Yes, Deep TMS is FDA-cleared and considered safe and well-tolerated. The most common side effects are mild headaches or scalp discomfort, which usually resolve with continued treatment. The risk of serious side effects, such as seizures, is extremely low (less than 0.1% in people without a seizure disorder).
How soon will I see results?
Some patients notice improvements within 1–2 weeks, but most experience significant benefits after 3–5 weeks of treatment. Effects continue to build over time.
How long do the effects of TMS last?
For many, improvements last six months to a year or longer. Many patients benefit from maintenance sessions (booster treatments) if symptoms return or to preserve the improvements.
Can I return to work or drive after treatment?
Yes! Deep TMS has no cognitive side effects, and patients can immediately return to daily activities, including work and driving.
Does TMS hurt or is it painful?
Most patients experience a tapping sensation on the scalp during treatment. Mild discomfort may occur initially but usually subsides over time.
What happens if TMS does not work for me?
If Deep TMS does not provide sufficient relief, other options include:
Additional TMS sessions (sometimes a second course enhances response)
TMS (esketamine) can provide further relief
Medication adjustments or psychotherapy
Alternative neuromodulation therapies, such as ECT or neurofeedback
What is the difference between traditional TMS (rTMS) and Deep TMS (dTMS)?
Deep TMS (dTMS)
Uses a H-coil (patented by BrainsWay) that generates a wider and deeper magnetic field.
Penetrates up to 4 cm into the brain, reaching deeper structures like the anterior cingulate cortex and insula, which play a role in mood and motivation.
Studies suggest higher efficacy in some cases of treatment-resistant depression and OCD.
Less precise coil positioning is needed due to the broader stimulation area.
FDA-approved for Major Depressive Disorder (MDD), OCD, and smoking cessation.
Traditional TMS (rTMS)
Uses a Figure-8 coil that generates a focused magnetic field.
Penetrates approximately 1.5–2 cm into the brain.
Primarily targets the dorsolateral prefrontal cortex (DLPFC), which is involved in mood regulation.
More localized stimulation, requiring precise coil positioning.
FDA-approved for Major Depressive Disorder (MDD), OCD, and smoking cessation.
How much does TMS cost? Is it covered by insurance?
TMS is covered by most insurance companies (BlueCross, Aetna, Cigna, United Healthcare, Medicare, etc). -though individual costs may vary depending on each patient's specific plan.
For those not using insurance—whether self-pay or seeking off-label treatments—we offer flexible payment options, including treatment packages designed to make this life-changing therapy more accessible.
Are there side effects associated to TMS therapy?
Transcranial Magnetic Stimulation (TMS or dTMS) is generally well-tolerated, but like any medical treatment, it can have some side effects. Fortunately, most are mild and temporary.
Common Side Effects of Deep TMS:
Mild headache (most common, usually subsides after a few sessions)
Scalp discomfort or tingling at the treatment site
Jaw or facial muscle twitching during treatment
Mild fatigue after sessions
Less Common Side Effects:
Lightheadedness
Temporary discomfort at the stimulation site
Mild cognitive fog (rare and temporary)
Rare but Serious Side Effects:
Seizures (very rare, risk estimated at less than 0.1% for individuals without a seizure disorder)
Hearing discomfort (earplugs are provided to protect against the clicking sound of the device)
Mood changes (in extremely rare cases, some patients report temporary irritability or emotional shifts)
What do patients usually feel during treatment sessions?
Tapping or Tingling Sensation on the Scalp
The magnetic pulses create a rhythmic tapping or knocking feeling at the treatment site.
This sensation usually fades as patients get accustomed to treatment.
Mild Discomfort or Pressure on the Scalp
Some patients describe a tightening or mild pressure during the session, but this typically improves after the first few treatments.
Adjustments in coil positioning or intensity can help reduce discomfort.
Muscle Twitching (Face or Jaw)
Due to magnetic stimulation, patients may feel involuntary twitches in their forehead, jaw, or other facial muscles.
This is normal and stops once the session ends.
Audible Clicking Sounds
The TMS device produces a repetitive clicking or tapping noise during treatment.
Earplugs are provided to protect hearing and reduce any discomfort from the sound.
What do patients usually feel after treatment sessions?
Most patients feel completely fine and resume their normal activities right away.
A mild headache or scalp tenderness may occur, especially after the first few sessions, but usually resolves quickly.
Some patients experience a subtle mood boost after several sessions, though full therapeutic effects may take a few weeks.
Overall, Deep TMS is well-tolerated, and any discomfort typically decreases over time as patients adjust to the treatment.
How long does Deep TMS treatment take?
Standard Protocol:
Each session lasts 20–30 minutes, typically 5 days per week for 4–6 weeks, followed by a tapering phase if needed.
Accelerated Protocol:
We offer multiple sessions per day over a shorter period (e.g., 5–10 days), reducing overall treatment duration while maintaining effectiveness.
Patients can resume normal activities immediately after each session, as no sedation or recovery time is required.
Do I need to stop medication or therapy for TMS?
No, you do not need to stop taking medication or participating in psychotherapy while undergoing Deep TMS treatment.
Medication: Most patients continue their prescribed antidepressants or other medications during treatment. In some cases, a provider may adjust medications based on treatment response.
Psychotherapy: TMS can be complementary to therapy or other treatments like TMS, and many patients continue talk therapy alongside treatment for the best results.
I don't want to take medication anymore, can I get off them with TMS?
The percentage of patients who successfully discontinue medication after TMS varies based on individual response, diagnosis, and treatment history. However, research suggests that:
About 30–50% of patients achieve full remission and may no longer need antidepressants.
About 65–85% experience significant symptom reduction, sometimes allowing for dose reduction or medication changes.
Some patients may still require maintenance medication, psychotherapy, or preservation / maintenance TMS sessions to sustain improvements.
Important disclaimer: Decisions about stopping medication should always be made in consultation with your healthcare provider to ensure continued stability and safety.