Transcranial Magnetic Stimulation (TMS) therapy is generally well-tolerated, with most TMS therapy side effects being mild and temporary. The most common side effect is headache or scalp discomfort at the treatment site, which occurs in approximately 30-40% of patients but typically diminishes after the first few sessions as patients acclimate to the treatment.
Some individuals also experience a tapping or clicking sensation during the procedure, as the magnetic coils activate. Mild facial twitching or tingling may occur during treatment due to the stimulation of facial nerves, though this is generally not painful. These effects usually resolve shortly after each session ends and rarely cause patients to discontinue treatment.
Serious side effects from TMS are extremely rare, but the most significant potential risk is seizure, which occurs in fewer than 0.1% of patients. This risk is comparable to the spontaneous seizure rate in the general population. Other uncommon side effects include temporary hearing problems if adequate ear protection is not used during treatment, and in very rare cases, mania or hypomania in patients with bipolar disorder.
Unlike many psychiatric medications, TMS treatment for mental health disorders does not cause systemic side effects such as weight gain, sexual dysfunction, sedation, or cognitive impairment, making it an attractive option for patients who have not tolerated antidepressant medications well. Most patients can drive themselves to and from appointments and return to their normal activities immediately after treatment sessions.
Why Are TMS Therapy Side Effects Usually So Mild?
TMS therapy side effects are typically mild because the treatment is non-invasive and highly localized. Unlike medications that circulate throughout the entire body via the bloodstream and can affect multiple organ systems, TMS uses focused magnetic pulses that only penetrate about two to three centimeters into the brain, targeting specific neural regions without affecting the rest of the body.
The precision of the TMS therapy for mental health means there are no systemic effects on the digestive system, cardiovascular system, liver, kidneys, or other organs that often produce side effects with pharmaceutical treatments. The magnetic fields used are similar in strength to those in MRI machines, which have been safely used for decades. The stimulation only affects the small area of cortex directly beneath the treatment coil.
TMS doesn’t require any chemicals or substances to enter the body, eliminating the metabolic processing and biochemical interactions that cause many medication-related side effects. The treatment works by using electromagnetic induction to stimulate neurons naturally, essentially encouraging the brain’s own electrical activity rather than introducing foreign substances. As patients become accustomed to the sensation over several sessions, even these minor effects typically decrease or disappear entirely, making TMS one of the most well-tolerated treatments available for depression and other psychiatric conditions.
How Do the Side Effects of TMS Compare to Antidepressants?
TMS therapy offers a markedly different side effect profile compared to antidepressant medications, which is one of the primary reasons many patients and clinicians consider it an attractive treatment option. The effects vary in many aspects:
- Weight Changes: Antidepressants commonly cause weight gain that can range from several pounds to significant increases over time, which many patients find distressing and may lead to treatment discontinuation. TMS causes no weight changes, as it doesn’t affect metabolism, appetite regulation, or hormonal systems.
- Cognitive Effects: Many antidepressants cause brain fog, difficulty concentrating, memory problems, or a feeling of mental dullness that patients describe as feeling unlike themselves. TMS actually has the opposite effect, with many patients reporting improved mental clarity and cognitive function as their depression improves.
- Sedation and Fatigue: Many antidepressants cause drowsiness, fatigue, or excessive sleepiness, which can interfere with daily functioning and necessitate patients taking their medication at specific times. TMS sessions don’t cause drowsiness, and patients can drive themselves to and from appointments and return to normal activities, including work, immediately after.
- Withdrawal Symptoms: Discontinuing antidepressants often requires a careful tapering process to avoid withdrawal symptoms like dizziness and flu-like symptoms that can last weeks. TMS can be stopped at any time without any withdrawal effects or discontinuation syndrome, providing much greater flexibility in treatment.
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What Does It Feel Like to Get TMS Therapy?
The physical sensation of TMS therapy is often described as a tapping, clicking, or woodpecker-like feeling on the scalp where the magnetic coil is positioned. Each magnetic pulse creates a brief tapping sensation that corresponds with an audible clicking sound from the machine.
Most patients describe the feeling as unusual rather than painful, though the intensity can vary depending on individual sensitivity and the specific treatment parameters. Some people compare it to having someone lightly tap their head with a finger in rapid succession, while others describe it as feeling like small muscle twitches on the scalp. The sensation is strongest during the first few sessions when it’s completely new. Still, most patients report that they quickly become accustomed to the feeling and find subsequent sessions much more comfortable.
During a typical 20-40 minute session, patients sit in a comfortable reclining chair while awake and alert, able to talk, read, listen to music, or watch television between pulse sequences. The treatment consists of periods of stimulation alternating with rest periods, so it’s not continuous tapping throughout the entire session.
Are the Side-Effects of TMS Worth It?’
For the vast majority of patients who undergo TMS therapy, the mild and temporary side effects are absolutely worth it when weighed against the potential benefits and alternatives. Other benefits, including having insurance cover TMS therapy, are:
- The side effects are minor, short-lived, and don’t interfere with daily functioning.
- Many patients who pursue TMS have already tried multiple antidepressants without success.
- Studies show that about 50-60% of patients experience significant improvement in their depression symptoms with TMS, and roughly one-third achieve complete remission.
- Patients have the flexibility to stop treatment if they find it’s not working for them or if the side effects are more bothersome than expected.
Ultimately, deciding to undergo the treatment depends on individual circumstances, treatment history, and the severity of depression someone is experiencing.
Key Takeaways on TMS Therapy Side Effects
- TMS has remarkably mild and temporary side effects compared to most depression treatments.
- TMS avoids the systemic side effects that make antidepressants difficult to tolerate.
- The treatment experience itself is manageable and becomes easier over time.
- The mild side effects are generally considered worthwhile given the potential benefits.
- TMS offers flexibility and low risk for patients exploring treatment options.
TMS therapy is a non-invasive procedure often used to help alleviate symptoms of depression and other mood disorders. Common TMS therapy side effects may include mild headaches, scalp discomfort at the treatment site, or temporary fatigue, but these effects generally subside quickly. If you’re interested in more detailed information or have specific questions about the TMS process, contact Moment of Clarity in Southern California at 949-625-0564 today.
Resources
- Mayo Clinic – Transcranial magnetic stimulation
- Brain Stimulation Journal – Deep TMS: A comprehensive summary of adverse events from five multicenter trials
- National Library of Medicine – Adverse events of repetitive transcranial magnetic stimulation in older adults with depression, a systematic review of the literature
