What to Know Before Starting TMS for Depression

You have tried medication, attended appointments, and made changes to your daily routine, but depression continues to interfere with your life. If traditional treatments have not provided enough relief, you may be wondering whether there are other options.

Transcranial magnetic stimulation, commonly called TMS, is a noninvasive treatment that may be an option for certain people experiencing depression.

Understanding how TMS works, what treatment involves, and who may benefit can help you make an informed decision.

What Is TMS?

TMS uses magnetic pulses to stimulate targeted areas of the brain involved in mood regulation.

During treatment, a device is positioned near your head. The magnetic pulses are delivered through a coil without surgery or implanted electrodes.

TMS does not require general anesthesia, and patients generally remain awake throughout treatment.

TMS has established evidence supporting its use for major depressive disorder, particularly for individuals who have not experienced adequate improvement with other treatments (Miron et al., 2025).

Who May Be a Candidate for TMS?

TMS may be considered for people with major depressive disorder who have experienced an insufficient response to appropriate medication treatment or who meet other clinical eligibility criteria.

A psychiatric evaluation is necessary to determine whether TMS is appropriate.

Your provider will review your diagnosis, prior treatment history, medication trials, medical conditions, and potential safety considerations.

TMS is not appropriate for every individual, and an initial consultation does not guarantee treatment eligibility.

What Does a TMS Session Feel Like?

During a typical TMS session, you sit in a treatment chair while a specialized device delivers magnetic stimulation.

You may hear clicking sounds or experience tapping sensations on your scalp.

Some people experience scalp discomfort or headache, particularly during early sessions. These effects are often temporary.

Ear protection is generally provided because the device produces repetitive sounds.

Unlike treatments that require anesthesia, standard outpatient TMS generally allows patients to resume routine activities afterward.

How Many Treatments Are Needed?

TMS is usually provided as a series of treatments rather than a single appointment.

Traditional treatment courses often involve sessions on multiple weekdays over several weeks.

The exact schedule depends on the device, treatment protocol, clinical indication, and individual circumstances.

Some newer protocols involve shorter stimulation periods. Your treatment team should explain the proposed schedule before therapy begins.

Does TMS Work for Everyone?

No treatment works for every person.

Research supports TMS as an effective option for appropriately selected patients with depression, but individual responses vary.

Some patients experience meaningful improvement in depressive symptoms. Others have partial improvement or may not respond adequately.

Your provider should discuss reasonable expectations, potential benefits, alternative treatments, and how your symptoms will be monitored throughout care.

A 2025 clinical consensus review supports the safety and effectiveness of repetitive TMS for depression while emphasizing individualized treatment selection and appropriate monitoring (Miron et al., 2025).

Is TMS Safe?

TMS is generally well tolerated when administered according to established safety procedures.

Common adverse effects include headache and scalp discomfort.

Rare but important risks include seizures. Hearing protection is also necessary because of treatment associated noise.

Certain implanted devices or metallic objects near the head may create safety concerns. Patients should disclose all implants, medical devices, relevant medical conditions, medications, and seizure history during screening.

Your treatment team should explain potential risks and answer questions before treatment starts.

Can TMS Be Used for OCD or PTSD?

Specific TMS devices and protocols have received authorization for certain conditions beyond major depressive disorder, including obsessive compulsive disorder.

However, regulatory authorization depends on the specific device and protocol.

TMS for posttraumatic stress disorder remains an area of clinical research, and evidence does not support presenting it as an established, universally authorized PTSD treatment.

A psychiatric provider can explain which treatment protocols may be appropriate for a patient's diagnosis.

Will Insurance Cover TMS?

Insurance coverage depends on the patient's plan, diagnosis, treatment history, medical necessity criteria, and the specific services being requested.

Some plans require documentation of previous medication trials or other treatments.

Before beginning TMS, ask your treatment provider to review eligibility requirements and any necessary authorization.

TMS Consultations in Las Vegas

At Stepping Points Psychiatry, we understand how discouraging it can feel when depression continues despite treatment efforts.

A TMS consultation provides an opportunity to review your history, explore potential treatment options, and determine whether further evaluation for TMS is appropriate.

If depression has continued to affect your daily life despite treatment, you may have additional options worth discussing.

Schedule a TMS Consultation at Stepping Points Psychiatry.

Visit www.steppingpointspsychiatry.com for more information about psychiatric services in Las Vegas.

Reference

Miron, J. P., et al. (2025). Consensus review and considerations on TMS to treat depression: A comprehensive update endorsed by the National Network of Depression Centers, the Clinical TMS Society, and the International Federation of Clinical Neurophysiology. Clinical Neurophysiology, 170, 206–233. https://doi.org/10.1016/j.clinph.2024.12.015