What is transcranial magnetic stimulation (TMS)?

Transcranial magnetic stimulation, or TMS, is a way to treat major depression. It uses energy from magnets to stimulate nerve cells in the brain and improve depression.

During TMS, an electromagnetic coil is placed against your scalp near the forehead. The electromagnet painlessly delivers magnetic pulses to the region of your brain involved in mood control and depression. The pulses stimulate nerve cells, easing depression symptoms and improving your mood.

Why should I consider TMS?

Depression is usually a treatable condition. Your doctor may recommend TMS if standard treatments are not working for you or when the side effects of depression medication are intolerable.

About half of people with depression who do not find relief with medications experience a positive response to TMS. About one third of those people experience a full remission. That means their symptoms go away completely for a period of time. Most TMS patients report feeling better for several months after treatment stops — the average being a little more than 1 year.

It is important to note that these results are not permanent. Like most other treatments for mood disorders, the problem usually comes back. Some patients choose to come back for more treatments.

If your depression does not get better with TMS, you may want to consider trying electroconvulsive therapy (ECT), another safe and effective treatment.

What are the risks and side effects?

Generally, TMS is considered safe, and any side effects are mild. Side effects usually get better shortly after the first session and become less frequent over time. Common side effects include:

  • Headache
  • Discomfort on the scalp at the site of stimulation
  • Tingling, spasms, or twitching of facial muscles
  • Lightheadedness

Serious side effects are rare and may include:

  • Seizures
  • Mania
  • Hearing loss (if you don’t have good ear protection during treatment)

How do I prepare for TMS?

  • Talk with your doctor about whether TMS is right for you.
  • Fill out the required forms.
  • Schedule a psychiatric evaluation with a TMS specialist.
  • If TMS appears to be the right treatment for you, you will need to schedule a physical exam and appropriate lab tests.
  • You can expect to have TMS treatments every day for 4 to 6 weeks, for a total of 30 treatments.

What can I expect during my TMS treatments?

The procedure will last about 30 minutes. TMS is not invasive and does not require anesthesia. It is performed in the clinic. You may drive yourself to your appointments or have someone with you.

Here’s what you can expect:

  • You will sit in a comfortable chair and wear earplugs. The magnetic coil is placed against your head.
  • When the machine is turned on, you will hear clicking sounds and feel tapping on your head.
  • At your first appointment, your doctor will slowly increase the magnetic dose, stopping when your fingers or hands twitch. This is called the motor threshold and helps determine the right dose for you.
  • You will be awake and alert during treatment. Usually, a technician will provide the follow-up treatments. Your doctor will meet with you about every 1 to 2 weeks during your course of treatment.
  • The amount of stimulation can be changed at any time based on your symptoms and side effects.

What happens after my TMS treatments?

After each treatment, you will be able to go back to your normal daily activities. Most people will be able to work and drive after the procedure.

What do I need to tell my doctor before starting treatment?

Tell your doctor or mental health provider if you:

  • Are pregnant or thinking of becoming pregnant.
  • Have any metal in your body or implanted medical devices.
  • Change or start any new medications.
  • Have a history of seizures or a family history of epilepsy.
  • Have other mental health disorders such as substance use disorder, bipolar illness, or psychosis.
  • Have frequent or severe headaches.
  • Had prior treatments with TMS and whether it was helpful in treating your depression.

What do I need to do next?

  1. Talk with your doctor about your situation and the benefits and risks of TMS.
  2. Call the Avenues Psychiatry and Counseling clinic at 801-408-8500. Ask to speak to the TMS Coordinator. Once you fill out all of the forms, a TMS Evaluation will be scheduled.
  3. If TMS is recommended, follow your doctor’s orders about what to do before and after each treatment.