Transcranial Magnetic Stimulation (TMS) is a non-invasive therapy that can provide relief for numerous mental health conditions, including major depressive disorder, obsessive-compulsive disorder (OCD), and anxiety disorders. The treatment uses magnetic pulses to stimulate nerve cells in specific brain regions, helping alleviate symptoms without the systemic effects of medication.
Although TMS is non-invasive, non-systemic, and well-tolerated, it’s natural for people to wonder how it might affect their body and brain. In this guide, we’ll explore the potential side effects of TMS therapy, including both common and uncommon side effects.
What is TMS therapy?
Transcranial Magnetic Stimulation (TMS) is a non-invasive mental health treatment that uses magnetic fields to stimulate specific regions of the brain. This innovative treatment is mainly used to alleviate depression symptoms and other health conditions like anxiety and obsessive-compulsive disorder (OCD). First FDA-approved for treatment-resistant depression (TRD), TMS offers an alternative solution for those who haven’t found relief from antidepressant medications. More recently, TMS has also shown promise for treating conditions like insomnia, post-traumatic stress disorder (PTSD), and chronic pain.
TMS works by delivering magnetic pulses to targeted brain regions that are underactive in individuals with certain conditions. These localized pulses trigger the release of neurotransmitters and hormones like serotonin and dopamine, helping alleviate symptoms and restore brain function. Because TMS doesn’t rely on medications or surgical procedures, it can be an appealing option for those who prefer less invasive treatments.
TMS treatment sessions are simple, painless, and convenient. During a session, a specialized coil is placed on the scalp near the targeted brain area. This device sends MRI-strength magnetic pulses to stimulate the brain and relieve symptoms. Most sessions last around 20 to 40 minutes and require zero recovery time, meaning patients can return to normal daily activities right after treatment.
Different types of TMS include repetitive transcranial magnetic stimulation (rTMS) and deep TMS. Unlike vagus nerve stimulation, TMS is non-surgical and doesn’t require implanting electrodes.
See More: TMS for Anxiety: Benefits, Effects, and More
How TMS therapy works
TMS therapy is an outpatient procedure, meaning you don’t need to stay overnight in a hospital or clinic. At BestMind Behavioral Health, our TMS sessions are conducted in our cozy clinics and designed to be as comfortable and stress-free as possible.
Here’s what you can expect during TMS therapy:
- Preparation: Before your session begins, you’ll be asked to remove any metal items, like jewelry or accessories, that could be affected by the magnetic field. You’ll be seated in a comfortable reclining chair and given earplugs to minimize clicking sounds during the session.
- Personalization: Your first TMS session is known as ‘brain mapping’. This involves the TMS technician measuring your head to determine the best placement for the magnetic coil. They’ll also adjust the intensity of the magnetic pulses to personalize the treatment for your needs.
- Treatment: Once the targeted location has been found, the technician will place the magnetic coil on your scalp near the front of your brain. When treatment begins, you’ll hear a clicking sound as magnetic pulses are released. You might also feel a tapping or knocking sensation, which is painless.
- Post-treatment: A typical TMS session lasts between 20 to 40 minutes, depending on your treatment plan. After the session, you’re free to drive yourself home and continue your daily activities with no downtime.
- Follow-ups: Most TMS treatment plans involve undergoing treatment five days a week for 4 to 6 weeks, although the exact length of treatment depends on your condition and response to the therapy. Accelerated TMS offers a more condensed treatment schedule, delivering multiple treatments per day over a shorter period of time.
Keep Reading: What is Brain Mapping for Transcranial Magnetic Stimulation (TMS)?
Common side effects of TMS therapy
TMS is a safe and well-tolerated treatment for those who qualify, however there can still be some risk of side effects. These are generally mild, temporary, and manageable, often disappearing within two weeks of therapy.
Here are the most common side effects reported by TMS patients:
Temporary site discomfort
The most common side effect is mild discomfort at the location where magnetic pulses are delivered. This can include jaw pain or scalp discomfort, which typically subsides quickly after each session. As the body adjusts to therapy, this side effect tends to disappear altogether.
Facial twitching
Some patients notice brief muscle movements, like twitching in the jaw or eyelids. While this might feel a little funny, it’s not painful and tends to decrease or disappear as treatment progresses.
Headaches post-treatment
A small percentage of patients report mild headaches after treatment, often described as a tapping or knocking sensation on the scalp. These headaches are usually short-lived and can be alleviated with over-the-counter pain relievers like ibuprofen. Like other TMS side effects, the intensity of headaches decreases as the body adjusts to therapy.
Managing TMS side effects
The good news is that most of these side effects are mild and resolve within a few hours after a session. As you progress with the treatment, you’ll notice them less and less and they’ll eventually disappear altogether.
At BestMind Behavioral Health, your comfort is our priority. You’ll have an experienced TMS technician by your side throughout the entire treatment, ready to address any side effects or concerns immediately. If you find yourself struggling with discomfort during TMS therapy, we can adjust the stimulation levels to reduce side effects and better suit your needs.
Uncommon side effects of TMS therapy
Although TMS therapy is widely considered safe, there are a few rare but serious side effects that can occur. Fortunately, these risks are exceptionally low probability or can be prevented with proper precaution.
As with any depression treatment, predicting exact outcomes can be difficult, however our team takes every step to ensure your safety by carefully reviewing your medical history and monitoring your progress throughout treatment.
Here are some uncommon side effects that may occur during TMS therapy:
Hypomanic symptoms
In rare cases, TMS may trigger hypomanic or manic symptoms. These symptoms include early signs of mania, such as agitation or irritability, and are mostly experienced by people with bipolar disorder. Our team will closely monitor for behavioral changes throughout treatment, and if such symptoms occur, we’ll stop treatment immediately and provide follow-up care.
See: What’s Bipolar Disorder? How Do I Know If I Have It?
Light-headedness
Some patients may feel lightheaded during treatment. This side effect is temporary and usually a result of feeling anxious or nervous about the procedure. To help calm your nerves, our team will remain by your side during each session to keep you informed and relieve any anxiety. If you like, we can even provide you with a tablet to keep you distracted and entertained while the treatment is underway.
Seizures
Seizure is the most serious side effect of TMS therapy, however it’s extremely low probability – less than 1%. In one study of 586,656 TMS sessions, only 18 seizures occurred – a rate of 0.31% per 10,000 sessions.
Certain factors can increase the risk of seizure during TMS therapy, including a traumatic head injury, seizure condition, alcohol use, and certain medications. We carefully screen each TMS patient’s circumstances and medical history to reduce the chances of this occurring.
Hearing loss
Just like MRI machines, TMS machines emit a loud clicking sound during treatment. For some people, this sound can be harsh and irritating. If proper precautions aren’t taken, it can cause hearing loss with repeated sessions. At BestMind Behavioral Health, we provide every TMS patient with earplugs before each session to eliminate the possibility of hearing loss.
While these side effects may sound intimidating to some people, it’s important to remember that they are extremely rare and can be prevented with careful planning. Manic symptoms are mostly experienced by those with bipolar disorder, seizures are extremely low probability, and hearing loss can be prevented by protecting your ears during treatment.
Who shouldn’t get TMS therapy?
TMS therapy is a safe and effective treatment for those who qualify – but it is not suitable for everyone. Certain medical conditions, devices, or circumstances can increase the risk of complications during the procedure.
Below are some reasons why someone might not qualify for TMS therapy:
Metal implants or medical devices
TMS uses magnetic pulses, which can interfere with or be affected by metal objects or electronic devices placed in or near the head. You shouldn’t get TMS therapy if you have:
- Cochlear implants
- Deep brain stimulators
- Aneurysm clips or coils
- Shrapnel or metallic fragments
- Neck or brain stents
- Electrodes
- Face tattoos with metallic ink
- Metal plates
- Permanent piercings
- Any implanted electronic devices (like pacemakers).
It’s OK to receive TMS if you have braces or dental fillings, as these won’t affect the treatment.
Read More: Who Qualifies for TMS Therapy? (TMS Requirements)
History of seizures or epilepsy
TMS carries an extremely rare risk of seizures. If you have a history of epilepsy or frequent seizures, the risk of this side effect can be higher.
Pregnant or breastfeeding
There’s no strong evidence suggesting that TMS is unsafe during pregnancy or nursing, however it hasn’t been extensively studied. If you’re pregnant, planning to become pregnant, or breastfeeding, make sure to discuss this with us prior to treatment.
Children and adolescents
TMS therapy is FDA-approved for treating depression in people aged 15 and over. Its safety and effectiveness in younger populations hasn’t been explored enough yet, so it may not be suitable until more data is available.
Keep Reading: Is TMS Appropriate for Treating Adolescents With Depression?
FAQS: Side effects of TMS
Below, we answer some common questions people ask about TMS therapy.
Does TMS cause seizures?
Seizures are an extremely rare side effect of TMS therapy – less than 1%. If you have a history of seizures, are taking certain medications, or have other pre-existing conditions, it may increase your likelihood of experiencing seizures. Our experienced team carefully screens each TMS patient to minimize this risk and ensure TMS is safe and well-tolerated.
Does TMS cause brain tumors?
No, there is no evidence to suggest that TMS causes brain tumors. TMS works by delivering magnetic pulses to specific regions of the brain. This is a non-invasive process that has no harmful effects on the brain’s structure. TMS has been extensively studied for safety and has not shown any long-term adverse effects on a patient’s health.
Is TMS the same as electroconvulsive therapy (ECT)?
No, TMS is not the same as ECT. While both therapies are used to treat depression, they work in different ways. ECT uses electric currents to induce seizure in the brain while TMS uses magnetic pulses to stimulate specific parts of the brain without causing a seizure. TMS is also non-invasive and doesn’t require anesthesia, unlike ECT which is usually performed under general anesthetic. TMS also has fewer, and less severe, side effects than ECT.
Does TMS cause memory loss?
No, there has been no evidence of TMS causing memory loss or affecting cognitive ability.
How long does it take for TMS to work?
Most people start to notice improvements in their symptoms after 2 to 4 weeks of TMS treatment. For others, it may take longer to feel the full benefits, but long-term results can continue to improve even after a round of treatment is finished.
Does TMS hurt?
TMS is typically a painless procedure, but some people can experience mild discomfort during the treatment. This might feel like a tapping sensation on the scalp, a slight headache, or muscle twitching in the facial muscles. These sensations are usually temporary and resolve on their own after treatment.
Summary: TMS side effects
While TMS is a well-tolerated and safe treatment, it’s normal to feel intimidated or apprehensive about a therapy that targets the brain. At BestMind Behavioral Health, our team is by your side before, during, and after treatment to address and alleviate any concerns. We carefully evaluate each individual’s eligibility for TMS therapy and offer support in case of any side effects.
If you have any questions about the potential side effects of TMS – or how it can benefit you – don’t hesitate to contact our team. Our goal is to ensure the best possible outcome for each of our patients, and that starts with thorough and personalized care to ensure maximum safety and effectiveness.
