If you’re considering Transcranial Magnetic Stimulation (TMS), you likely have questions about the procedure. Keep reading to learn everything you need to know about what TMS therapy feels like, what to expect during and after treatment, and potential side effects you may experience.

TMS is a non-invasive procedure that uses targeted magnetic pulses to stimulate specific areas of the brain that are associated with mood regulation. This helps activate neural pathways that may be underactive in people with certain mental health conditions.  

TMS has been FDA-approved to treat Major Depressive Disorder (MDD), Obsessive-Compulsive Disorder (OCD), migraine with aura, MDD in adolescents, and smoking cessation. However, some providers may use TMS off-label for conditions like anxiety, bipolar disorder, and Post-Traumatic Stress Disorder (PTSD). 

This innovative therapy is a promising alternative for those who prefer not to take prescription drugs or have experienced unwanted side effects from other medications. The procedure is also outpatient, which allows patients to return to their normal activities immediately after each session.

Walking into your first TMS appointment can feel intimidating, but understanding the process can help ease any anxiety. First, you’ll be seated in a comfortable, reclined chair that’s similar to what you might find in a dentist’s office. The treatment is performed while you’re fully awake and alert as no anesthesia or sedation is required. 

Before beginning, you’ll put in earplugs to protect your hearing from the clicking sound the TMS equipment makes. This clicking sound is the magnetic coil activating, similar to the sound an MRI machine makes. 

You’ll also need to remove any metal items near your head, including: 

• Hair clips
• Hearing aids
• Facial piercings
• Eyeglasses

Your first session will be a little different compared to subsequent treatments. During your initial visit, the provider will: 

1. Determine your threshold by sending small magnetic pulses to find the minimum intensity needed to cause a slight twitch in your hand. 
2. Map the area of your brain to target for treatment. 
3. Customize the settings specific to your needs. 

This process ensures you receive the most therapeutic benefit from TMS. After this initial mapping session, following treatments will follow a more standardized protocol based on your personalized settings. 

A typical TMS treatment session lasts between 20 and 30 minutes. During this time: 

• The TMS coil is positioned gently against your head, typically over the prefrontal cortex.
• You’ll feel a series of repetitive tapping sensations as the magnetic pulses are delivered. 
• You’ll remain awake and can talk with your provider throughout the procedure.

A common question people ask is whether or not TMS therapy hurts. The short answer is no. TMS is not considered painful; however, the sensations can vary from person to person:

• Some patients describe feeling a tapping or knocking sensation where the coil is placed on the head. 
• Others experience mild tingling or discomfort during the first few sessions, but this typically goes away as they become used to the treatment. 

It’s important to understand that TMS is very different from electroconvulsive therapy (ECT), which people sometimes confuse with it. ECT is administered under general anesthesia for pain management and deliberately triggers a seizure through electrical current. TMS is not as invasive and is generally considered safer, gentler, and has fewer side effects than ECT. 

If you experience any pain during treatment, always communicate this to your provider. They can make adjustments to the position or the intensity of the magnetic pulses for your comfort.

As mentioned previously, one of the advantages of TMS therapy is that patients can immediately resume daily activities after each session. There’s no downtime or recovery that’s needed due to its non-invasive nature. After completing your session: 

• You can drive yourself home
• Return to work or school
• Run errands
• Engage in social activities

Over the course of your treatment plan, you may gradually notice improvements in your mood, energy levels, and overall functioning in your day-to-day life. 

The timeline for experiencing benefits from TMS therapy can depend on the type of TMS protocol used and the person receiving treatment. For example, in a study on repetitive TMS (rTMS), patients reported improvement in their symptoms within just a week of starting treatment, even though the treatment still continued for several weeks after to get the full benefit. 

A newer protocol, called accelerated TMS, has been shown to have even faster results. A 2023 study found that “significant treatment effect was achieved by day three and maintained six weeks later.” This shows promise for individuals with severe depression or other mental health conditions who need relief quickly. 

It’s important to note that each person’s response to TMS will be different. While some patients experience rapid improvements, others may notice more gradual changes over the full course of treatment.

TMS therapy is known for its favorable side effect profile compared to many medications. The side effects are typically minimal, temporary, and mild. A study found the following TMS side effects: 

• Headaches are the most common side effect and affected 35.43% of patients
• 29.92% of patients experienced treatment site discomfort
• Muscle spasms occurred in about 5.91% of patients
• Jaw pain was reported by 5.71% of patients
• 4.53% of patients experienced neck pain

Less common side effects include sensations around the mouth (2.76%), dental pain (2.56%), and general discomfort (2.56%). 

These side effects usually go away quickly after each session and often tend to decrease in intensity as treatment continues. Over-the-counter pain relievers like acetaminophen or ibuprofen can help manage any discomfort. 

Serious side effects are extremely rare. A potential serious risk is seizures, but this happens in less than 1% of patients.

If you’re struggling with depression or another condition that hasn’t responded to other treatments, TMS therapy may be worth considering. At Pulse TMS, we’re ready to guide you through every step of the process, from your initial questions to your final treatment session. 

During your consultation, we’ll review your medical history, discuss your symptoms and previous treatments, and answer any questions you may have about the TMS experience. If you’re ready to see if TMS therapy can help you find relief from your symptoms, contact us today.