Common, Usually Short-Lived Side Effects
- Scalp tenderness or headache early in the course.
- Brief facial or jaw twitching during stimulation.
- Driving and return to normal activities are allowed immediately.
Is Anger a Side Effect of TMS?
Not typically. In controlled trials, psychiatric side effects with active TMS are similar to sham. Patients can report many sensations during any medical treatment, but rates are comparable to placebo.
Does TMS Cause Forgetfulness?
That is not something I see with standard depression protocols. Memory complaints are not elevated above sham.
Medical Screening I Perform
- I review neurological history, including prior seizures, brain lesions, aneurysms, or masses.
- I screen for ferromagnetic or electronic implants within about 30 centimeters of the head.
- The seizure risk with TMS is very low. When seizures are reported, alcohol and other substances are the most common modifiable risk factors.
Who Tends to Benefit Most?
- Major depressive disorder that is recurrent, unipolar, and nonpsychotic is the best studied indication.
Who Isn’t A Good Match for TMS?
- High acuity, such as active suicidal intent, where a very rapid response is needed. ECT or higher levels of care are safer and more effective in that setting.
- Active substance use, which can counteract benefits and raise seizure risk.
Do You Need Bloodwork or Anything Invasive to TMS?
No. TMS requires no anesthesia, no sedation, and no bloodwork. You are awake and seated throughout.
What is The Age Limit for TMS?
Most high quality studies involve adults 18 and older. There is emerging adolescent data.
My clinic treats 18 and up, largely due to insurance and logistics.