TMS Therapy: Can Caffeine Enhance Its Effects?

by Evan | Jun 14, 2025 | Blog

Reviewed by Dr. Olsen
M.D. Medical Director, Psychiatrist

TMS is a revolutionary treatment that offers hope for people living with depression and other mental health conditions, including anxiety, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). Even though TMS therapy has been FDA-approved for over a decade, it’s still a relatively new option compared to traditional mental health treatments, and many patients don’t know what to expect.

In this article, we’ll answer some of the most commonly asked questions about TMS therapy, including what to expect, how many sessions are typically needed, and what alternatives are available for those who need a faster or more flexible treatment schedule.

What is transcranial magnetic stimulation (TMS)?

Transcranial magnetic stimulation (TMS) is a safe, non-invasive treatment for major depressive disorder (MDD) and other mental health conditions. The innovative therapy uses gentle magnetic pulses to stimulate specific areas of the brain involved in mood regulation, helping treat depressive symptoms without the systemic side effects often associated with medication.

TMS was approved by the U.S. Food and Drug Administration (FDA) in 2008 for individuals who haven’t experienced sufficient relief from antidepressant medications or talk therapy (known as treatment-resistant depression). Since then, it has been also FDA-approved for obsessive-compulsive disorder, migraines, and smoking cessation, although it’s also used off-label for a range of conditions including bipolar disorder, Parkinson’s disease, fibromyalgia, tinnitus, and more.

TMS is a valuable treatment option for people who prefer non-medication-based treatments or those who have experienced significant side effects from medication. The benefits of TMS include:

Effectiveness: Studies show that TMS therapy can be twice as effective as antidepressants when treating depression.

Safety: TMS has minimal side effects. The few which do occur, like mild scalp discomfort or headache, are short-lived and resolve on their own after a few sessions.

Non-systemic: Unlike medications that affect the entire body, TMS stimulates specific regions of the brain without interacting with other parts of the body.

Personalized: TMS treatment plans are tailored to each individual’s needs based on their clinical history and response to treatment.

There are two main types of TMS: repetitive transcranial magnetic stimulation (rTMS) and deep TMS therapy (dTMS). The most widely used is rTMS. dTMS targets deeper brain regions and is often used in the treatment of OCD.

See: TMS Side Effects: All You Need to Know

What to expect from TMS

TMS therapy is conducted in outpatient environments, such as our comfortable TMS clinics in Colorado, Oregon, Washington. Each person’s experience is a little different, but here’s what you can expect from TMS treatment.

Before your first TMS treatment

Before starting TMS therapy, we’ll schedule a thorough physical and psychiatric evaluation. This will help us:

Rule out any underlying medical concerns that could affect treatment
Assess your mental health symptoms and screen for any co-occurring conditions to make sure TMS is a safe and appropriate option for you.

If you’re a good candidate for TMS, we’ll then schedule your first session.

Your first TMS session

Your initial treatment course, called the TMS induction session, involves brain mapping and motor threshold determination.

Brain mapping helps us identify the specific part of your brain linked to mood regulation (which is typically the left dorsolateral prefrontal cortex). Motor threshold testing allows us to determine the right strength of magnetic stimulation for you. Essentially, we’ll be looking to strike the perfect balance between maximum effectiveness and keeping you comfortable during treatment.

Once we’ve determined the appropriate settings for you, we’ll continue to use them for all your following treatments.

During each TMS session

Each TMS session lasts around 20 to 40 minutes and takes place while you sit comfortably in a reclining chair. Here’s how it usually goes:

You’ll be asked to remove any metal objects and given noise-canceling headphones or earplugs to reduce the sound of the device
Your TMS technician will explain the procedure and answer any questions you might have
An electromagnetic coil will be placed against your scalp to deliver targeted magnetic pulses to specific regions of your brain
You might hear clicking sounds during the session and feel a light tapping or tingling sensation at the treatment site
You’ll remain awake and alert throughout the procedure as no anesthesia, medication, or sedation is needed
The TMS technician will monitor your comfort closely and adjust the settings if needed.

After a TMS session

There is no downtime after a TMS session. Once the procedure is over, you can return to normal daily activities, like working, driving, or going to school, immediately afterwards. If you do experience any side effects, know that they are mild and temporary, often resolving within 24 hours.

How many TMS sessions do I need?

A typical course of TMS treatment involves about 30 to 36 sessions over four to six weeks. Sessions are usually scheduled five days per week, Monday to Friday, with each session lasting between 20 to 40 minutes.

Most patients begin to notice improvements in their symptoms around the third or fourth week of treatment, although some might feel changes earlier or later. It’s important that you stick with the program and complete a full series of sessions to achieve the best and most long-lasting results.

Some patients may continue with maintenance TMS treatments after the initial course to help sustain results. These schedules are personalized depending on each individual’s response to treatment.

Factors that affect TMS frequency

The exact number of sessions you need can vary depending on your individual circumstances and response to treatment. Some factors that can influence how many TMS treatments are needed include:

Severity and duration of symptoms: People with more severe or long-standing depression symptoms might require a longer course of treatment to achieve significant improvement
How quickly you respond to treatment: Some people notice positive changes within the first few weeks of TMS while others may take longer to feel results. We’ll monitor your progress closely and adjust your plan as needed.
Combination with other therapies: TMS is often used alongside antidepressant medications or psychotherapy, which can help relieve symptoms quicker
Presence of co-occurring conditions: Conditions like anxiety, OCD, or post-traumatic stress disorder (PTSD) can potentially affect the course and duration of TMS treatment
Past and current medical history: TMS is usually recommended after traditional treatments haven’t provided relief, and it can actually be more effective for those with treatment-resistant symptoms.

How successful is TMS therapy?

TMS therapy has shown promising success rates, with studies reporting that 50 to 60% of patients who complete a full course of treatment experience a significant improvement in their depression symptoms. Standard depression medications, on the other hand, have a success rate of about 27.5% with the success rate dropping for each new medication a person tries.

Other research focused specifically on rTMS found that up to 58% of patients saw a reduction in symptoms after about 30 sessions, with 36% achieving complete remission of symptoms. Data on dTMS suggests that it can reduce symptoms over a shorter timeframe, although outcomes will always vary depending on each individual.

Factors that can influence TMS success rates include:

Age: TMS can be more effective for individuals under the age of 60. Older patients can still experience meaningful benefits, but their response rates may be slightly lower.

Personality traits: Research shows that patients who score higher on the temperament and character inventory (TCI) personality scale for tenacity tend to respond to TMS faster.

Level of treatment-resistance: TMS tends to more effective for people with treatment-resistant symptoms, especially those who have tried multiple antidepressants without success

Use with medication: Continuing antidepressant medications while undergoing TMS therapy can help improve the overall effectiveness of treatment.

Learn More: How Successful is TMS Therapy?

What if I can’t commit to a full course of treatment?

If you’re unable to commit to a full course of TMS, alternative options are available: accelerated TMS and SAINT TMS. Both these treatments offer a faster, more condensed treatment schedule without sacrificing the benefits of traditional TMS.

Accelerated TMS (aTMS)

Accelerated TMS delivers the same magnetic pulses as traditional rTMS but condenses the treatment schedule into a much shorter timeframe.

aTMS treatments are completed in just over two weeks, with patients attending 3 to 5 sessions per day. Each session lasts about 9 minutes and is followed by a 45-minute break.

Because aTMS is delivered in a more intensive schedule, many patients report noticeable improvements earlier compared to traditional TMS timelines. You can read more about how accelerated TMS compares to standard TMS here: Accelerated TMS vs. Traditional TMS: Which One Makes Sense for You?

SAINT TMS

SAINT TMS stands for Stanford Accelerated Intelligent Neuromodulation Therapy. This treatment offers an even more condensed and targeted version of TMS therapy.

A full course of SAINT TMS treatment is completed in just five days. Patients undergo 10 sessions per day, each lasting 10 minutes with 50-minute breaks in between.

SAINT TMS is FDA-approved, just like regular TMS, and it uses advanced protocols to offer even more targeted treatment. Read more about SAINT TMS in our blog article: What Makes SAINT TMS Different From Regular TMS?

How to get the most out of TMS therapy

Now that you know what to expect from TMS, here are some ways to maximize your results during the treatment:

Stay consistent with your treatment schedule

TMS is most effective when you consistently attend every session. Each treatment builds on the last to help your brain form new pathways and patterns. Skipping or delaying sessions can interrupt this process and slow your progress.

Of course, life isn’t always so predictable so things might come up. If you can’t attend a session, let your team know as soon as possible so they can keep you on track.

Continue other treatments

TMS works best when it’s used alongside other treatments like medication or talk therapy. To get the most out of the sessions, continue any prescribed therapies unless you’ve been advised otherwise by your medication management provider.

Get good sleep

TMS is a gentle treatment, but your brain needs energy to adapt and build new neural pathways. It’s normal to feel a little more tired than usual during the first week or two of treatment. Prioritizing quality sleep can support your brain’s healing process while also improving your mood and emotional regulation.

Fuel your brain with nutrition

It’s never a bad idea to support your brain and body with a healthy diet, and if it makes your TMS treatment more effective, then all the more reason! Try to build your meals around nutrient-dense foods like healthy fats, lean proteins, whole grains, and lots of fruit and vegetables. It’s just as important to stay hydrated, so keep a water bottle near you and take sips throughout the day.

See More: How Diet and Exercise Affect Your Mental Health

Keep moving

Regular physical activity, even light movement like walking, can boost endorphins, improve sleep, and help regulate your mood naturally. You don’t need to follow a rigid fitness plan, but find ways to move that feel enjoyable and sustainable for you.

Stay awake during sessions

TMS works best when your brain is alert and active during sessions. You’re always awake, since there’s no sedation, but keeping mentally engaged can help optimize outcomes. Feel free to listen to music or a podcast, read a book, or chat with your technician if it helps you stay present.

Track your progress

Sometimes it’s hard to notice the small changes. Keeping a simple journal of your mood, energy, sleep quality, and daily functioning can be a helpful way to notice how your symptoms are improving over time. Stay patient and trust in the process!

Explore TMS therapy

If you’d like to explore TMS therapy as a treatment option for depression, OCD, or a range of other mental health conditions, our team at BestMind Behavioral Health is here to help. We offer this innovative therapy at our clinics in Colorado, Oregon, and Washington, and our compassionate team is here to support you every step of the way.