Frequently Asked Questions

Frequently Ask Questions

Discover answers from Dr. Lindsay Israel to the most popular TMS related questions below.

• What are the side effects of TMS?
  TMS therapy is a well-tolerated treatment for most patients, although it does not work for everyone. Side effects, while infrequent, can include headaches and neck pain. http://NIMH » Sarah H. Lisanby: Transcranial Magnetic Stimulation Safety and Risk (nih.gov)
• How long is an individual sessions and how many are required?
  At SuccessTMS, a typical TMS session lasts approximately 20 minutes. The sessions continue for five days a week over a duration of four to six weeks. Occasionally, a two-week tapering period may follow consisting of just a few sessions a week.
• Is TMS Safe?
  Yes. TMS is an FDA-approved treatment, which means it’s safe to administer to patients. It’s also non-invasive and virtually pain-free. http://Repetitive Transcranial Magnetic Stimulation (rTMS) Systems - Class II Special Controls Guidance for Industry and FDA Staff | FDA
• Is TMS effective? What are some results?
  Many TMS patients experience an increase in mood, energy, and appetite, while also experiencing a reduction in anxiety. 83% of people experience improvements, 62% achieve complete remission from their depression. https://neurostar.com/hcp/evidence/
• Can TMS cause brain damage?
  To date, there is no evidence that TMS causes any kind of long-term damage to the brain. TMS does carry a very minor risk of seizure during treatment, specifically less than 0.1%. This risk seems to be more associated with those who are already at risk of seizure, whether due to a medication, a chronic condition such as epilepsy, or secondary to drug and alcohol use. https://www.nimh.nih.gov/news/media/2020/sarah-h-lisanby-transcranial-magnetic-stimulation-safety-and-risk
• Can TMS be repeated?
  Yes, a person can have additional courses of TMS. In fact, patients who respond well to TMS initially, are more likely to continue to respond positively to TMS if used again in the future.
• Can TMS be used for bipolar?
  TMS is currently under investigation for its use in treating Bipolar disorder. It is currently not FDA-approved for Bipolar Depression, but the ongoing studies are showing some positive results.
• Can TMS make you tired?
  Yes, mild fatigue is possible after the first few treatments of TMS, as it is like a “work-out” for the brain. However, for many patients, this is a very welcomed effect and can be a benefit for many patients who experience insomnia due to their depression.  Also consider that fatigue is an associated symptom of depression itself, so any residual fatigue may not be directly caused by TMS. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3225130/
• Can TMS cause headaches?
  TMS can cause scalp tenderness during the treatment pulses but typically does not cause a lasting headache. For patients who are prone to headaches, they can premedicate with ibuprofen or acetaminophen prior to treatments to prevent a headache.
• Can TMS help with PTSD?
  Yes, TMS has been used off-label to help treat PTSD, but it should always be used in conjunction with trauma therapy to prevent exacerbation of memories that can trigger symptoms.
• Can TMS cause brain cancer?
  There is no evidence that shows TMS can cause cancer. It uses the same technology as an MRI.
• When does TMS start working
  The time to respond to TMS therapy varies. Patients can see improvement in their depression symptoms any time within the first third, middle third or end, and even as far out as 3-4 weeks. It is highly recommended that patients complete the TMS course to give them the best chance possible of achieving optimal results from the treatment.
• How does TMS feel?
  Our patients have described TMS to feel similar to a light tapping sensation on the top of your head. Watch our patients describe how TMS feels.

• Is training necessary to administer TMS?
  Training is provided by manufacturers of the device, as well as ongoing support. Many medical centers offer advanced courses on the treatment.
• Who are candidates for TMS?
  Patients who have failed to respond to traditional antidepressants and/or ECT are ideal candidates for TMS. People who are not a good fit for TMS are those with metallic implants in ears or eyes, stents in the neck or brain, and other metal devices implanted in or near the head should refrain from undergoing TMS therapy. https://pubmed.ncbi.nlm.nih.gov/19833552/
• Is TMS the same as ECT?
  No. While TMS is safe, painless, and has little-to-no side effects, ECT or electroconvulsive therapy requires general anesthesia which can carry some risk. Unlike TMS, whose patients can immediately resume activities like driving and physical exercise, electroconvulsive therapy (ECT) patients require an extended recovery period and heightened risk of seizure and memory loss. Get more info on TMS vs ETC here.
• How does TMS work?
  TMS has been shown to produce changes in the activity of neurons (brain cells) of the limbic system, which is linked to mood regulation. The procedure consists of magnetic pulses inducing brain activity in the cells of that region. These pulses activate the limbic system cells to form new and improved connections with each other, which leads to improvement of depression symptoms. TMS is most often prescribed when other treatments for depression have not been effective or tolerated. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6592198/
• Can TMS cause anxiety?
  There is a small possibility that as mood symptoms of depression start to improve with TMS treatments, any persistent anxiety symptoms may become more noticeable in a small subset of patients. https://www.cambridge.org/core/journals/cns-spectrums/article/abs/repetitive-tms-as-a-probe-in-anxiety-disorders-theoretical-considerations-and-case-reports/760FD3760FB210A2894ECC5808C45759  
• Can TMS help with anxiety?
  Yes, the FDA has cleared TMS to treat associated anxiety symptoms for patients who suffer from Major Depressive Disorder, also known as Anxious Depression. https://pubmed.ncbi.nlm.nih.gov/36630648/
• Can TMS worsen depression?
  It is unlikely for TMS to directly worsen symptoms, but there is a small possibility for some patients that symptoms can seem to get worse before they get better. To date, there are no trials that show an increase in depression symptoms with TMS, only a reduction of symptoms. https://pubmed.ncbi.nlm.nih.gov/32799106/
• Can TMS cause seizures?
  Yes, however, there is a less than 0.1% risk of seizure associated with TMS. If a patient has a history of seizures, or if they could be withdrawing from alcohol or a benzodiazepine, the risk could be higher and the TMS provider should be notified of any increased risk potential prior to starting TMS treatment. https://pubmed.ncbi.nlm.nih.gov/33324060/
• Can TMS cure or treat OCD?
  TMS has the FDA approval as a treatment for OCD, however, there currently is no 'cure' for OCD. TMS can help treat the symptoms of OCD and minimize this debilitating condition. https://www.globenewswire.com/news-release/2022/05/10/2439779/0/en/NeuroStar-Advanced-Therapy-for-Mental-Health-Receives-FDA-Clearance-for-Treatment-of-Obsessive-Compulsive-Disorder.html
• Can TMS cure depression?
  Depression is considered in terms of “remission” and “recurrence.”  TMS can put depression into remission for an extended period, but there is a possibility, depending on the nature of the patient’s depression, symptoms can recur down the road. If this does occur, then patients are even more likely to respond positively to repeated TMS treatments. https://pubmed.ncbi.nlm.nih.gov/31303854/
• What’s the success rate of TMS?
  83% of people experience improvements, 62% achieve complete remission from their depression. https://neurostar.com/hcp/evidence/
• Can I drive after my TMS treatments?
  Yes, unlike ECT, you can continue to drive your car after TMS treatments.