Learning Center · TMS therapy
TMS benefits and side effects
What TMS can realistically do for you, what side effects to expect, and what to watch for. We'd rather you decide with all the information than agree to something we haven't fully explained.
30 Sessions of Deep TMS Response Rate
30 Sessions of Deep TMS Remission Rate
Years Treating Depression in OH
Five Star Google Reviews
The honest answer
What you get, what to watch for.
Here's the short version. We go deeper on each below.
- ✓ FDA-cleared for depression and OCD
- ✓ Non-systemic - no full-body side effects
- ✓ No daily medication required
- ✓ Awake-state - drive yourself home after each session
- ✓ Long-lasting effects after a completed course
- × Mild scalp discomfort during early sessions
- × Headaches in some patients, usually mild
- × Muscle twitching at the treatment site
- × Temporary symptom dip in a minority of patients
- × Seizure risk — extremely rare but real
Benefits
What patients get from TMS.
Beyond the response and remission numbers - the practical, day-to-day differences patients notice.
Sessions fit into your day
Up to 20 minutes per session. No sedation, no anesthesia, no recovery time. You can drive yourself to and from appointments and return to work, school, or normal activity immediately after.
A defined course, not a lifetime
Six weeks of treatment, then it ends. No tapering schedule. Most patients don't need ongoing TMS to maintain results - unlike daily medication, which often requires open-ended use.
You stay fully present
About 20 minutes per session. No sedation, no anesthesia, no recovery time.
Works alongside your current treatment
TMS is non-pharmacological. It doesn't interact with antidepressants, anti-anxiety medications, sleep aids, or anything else you may already be taking. You can continue therapy throughout.
How TMS compares
What to expect, from common to rare.
From very common (most patients) to very rare (less than a fraction of a percent). We name the rare ones because honesty matters more than reassurance.
What most patients feel during treatment
Scalp discomfort
Most patients · Weeks 1–2
A tapping or knocking sensation where the coil rests on your head. Most patients habituate within the first few sessions and report it as mildly uncomfortable rather than painful. Disappears between sessions.
Mild headache
Some patients · Usually early
Usually starts after the first few sessions and resolves within a week. Over-the-counter pain relievers (ibuprofen, acetaminophen) help. Most patients stop experiencing headaches once the body adjusts. Persistent headaches are uncommon.
Facial muscle twitching
During session only
The magnetic pulses can cause involuntary twitching of facial or scalp muscles near the treatment area during the session. It's not painful, stops immediately when the pulse stops, and has no lasting effect. We can adjust coil positioning if it becomes uncomfortable.
Less common variations
Lightheadedness or fatigue
Especially in the first week
Some patients report feeling briefly lightheaded after sessions, especially early in treatment. Fatigue can occur as the brain adapts to the stimulation. Both typically resolve within the first two weeks of treatment.
Hearing-related effects
From the device clicking
The TMS device makes a loud clicking sound during pulses. We provide earplugs for every session — wearing them prevents hearing-related effects. Without earplugs, temporary tinnitus or sensitivity is possible.
Rare but worth knowing about
'The TMS Dip'
~10–15% of patients · Weeks 2–3
A meaningful minority of patients experience a brief worsening of depressive symptoms around weeks 2–3 before improving. It is not the treatment failing — it reflects neural reorganization. Almost everyone who experiences the dip then improves substantially. We cover this in detail below.
Seizure
Less than one in many thousands of sessions
TMS carries a small but real seizure risk. Modern protocols and proper screening have made this extremely rare — the published estimate is fewer than one seizure per several tens of thousands of sessions, and almost all reported cases involved undisclosed risk factors. We screen every patient for personal and family seizure history, and will not proceed without neurologist clearance for patients with risk factors.
Mania or hypomania
In specific patient populations
In patients with undiagnosed bipolar disorder, TMS can occasionally trigger a manic or hypomanic episode. This is why we screen carefully for bipolar history during your consultation, and why our clinic does not treat patients with bipolar disorder, psychosis, or schizophrenia with TMS.
Side effects compared
TMS vs antidepressant side effects.
The most useful comparison for someone deciding between (or alongside) medication.
What treatment looks like
What we do beyond the device.
Side effect management isn't only the device. It's the protocol around it.
Initial mapping session
Your first session is dedicated to finding the optimal coil placement for your specific anatomy. Properly mapped placement reduces unintended muscle stimulation and minimizes discomfort.
Gradual intensity ramp-up
Daily 20-minute sessions. You'll feel a rhythmic tapping on one side of your head. Most patients notice no change yet. That's normal.
Daily check-ins from clinical staff
Every session begins with a brief check-in on how you're feeling. Side effects get flagged early and addressed before they accumulate.
Open access to Dr. Blair or your Psychiatric NP
If something feels off, you can speak with Dr. Blair or your Psychiatric Nurse Practitioner without waiting for your next appointment. Side effects you don't tell us about are side effects we can't help with.
Earplugs every session
Hearing protection is provided for every patient at every session. The TMS device's clicking sound can cause hearing-related effects without protection — we eliminate that risk by default.
Pre-session screening for seizure risk
Personal and family seizure history, current medications affecting seizure threshold, sleep deprivation, and other risk factors are reviewed before every treatment course. We don't proceed without proper clearance.
Frequently asked
The questions patients ask most.
Will TMS hurt?
Not usually. Most patients describe the sensation as tapping or knocking on the scalp — uncomfortable in the first few sessions, then easily habituated to. Mild headaches early in treatment are common and respond well to over-the-counter pain relievers. There's no lingering pain after sessions, and you can take a pain reliever beforehand if needed.
Can I take painkillers if I get a headache?
Yes. Over-the-counter ibuprofen or acetaminophen are fine before or after TMS sessions and do not interfere with treatment. We sometimes recommend taking one preventively before the first few sessions if you're prone to headaches.
Does TMS cause memory loss or cognitive issues?
No. TMS has no documented memory effects in the FDA-cleared protocols. This is a frequent point of confusion with electroconvulsive therapy (ECT), which can affect memory. TMS is a different treatment with a different safety profile — no anesthesia, no induced seizure, no memory effects.
Can TMS trigger a seizure in someone without epilepsy?
Extremely rarely, yes — but the documented cases almost always involved undisclosed risk factors (personal or family seizure history, medications lowering seizure threshold, severe sleep deprivation). Modern protocols and proper screening make this exceptionally rare. We screen carefully for risk factors before every treatment course.
Are there long-term effects from TMS?
None have been documented in the 15+ years of FDA-cleared use. There's no evidence of permanent brain changes, no cumulative damage, no addiction potential. The treatment works during the course, the response persists for months to a year or more, and the brain returns to its baseline state when treatment ends - except for the improvements in depression circuitry, which often persist.
Do side effects get worse over the course of treatment?
No - the opposite. Most side effects (scalp discomfort, mild headache, fatigue) are most noticeable in the first one to two weeks and reduce or disappear as your brain adjusts to the stimulation. The TMS dip is the exception: it appears around weeks 2–3 in some patients and then resolves into improvement.
Do I need someone to drive me home?
No. TMS doesn't sedate you, doesn't affect your thinking, and doesn't require recovery time. You can drive yourself to and from each appointment, return to work, and go about your day normally.
What if I experience a side effect I haven't heard about?
Tell us. Side effects we haven't named here are uncommon but not impossible — and we'd rather know early than late. Every session begins with a brief check-in. If something is happening between sessions, you can reach Dr. Blair or your Psychiatric Nurse Practitioner directly without waiting for your next appointment.
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