Transcranial Magnetic Stimulation (TMS)

Reviewed by the HeyPsych Medical Review Board

Board-certified psychiatrists and mental health professionals

Published September 16, 2026•Updated September 16, 2026

Indications

Primary Indications

Major Depressive DisorderObsessive-Compulsive DisorderMigrainePtsdGeneralized Anxiety Disorder

Mechanism

TMS delivers rapidly changing magnetic fields via a coil placed on the scalp. These fields induce electric currents in cortical neurons, modulating excitability and network activity. Repetitive TMS (rTMS) can produce lasting changes in synaptic plasticity, resembling mechanisms of learning and memory.

Protocol

Preparation

Patient seated in a chair; no anesthesia required.

Procedure

Magnetic coil placed over the dorsolateral prefrontal cortex or other target.
Stimulation intensity determined by motor threshold.
Repetitive trains of pulses delivered.

Frequency: Daily sessions (5 days/week).

Duration: 20–40 minutes per session; 3–6 weeks total treatment course.

Expected Outcomes

Immediate

Mild scalp sensations
Occasional headache

Short Term

Mood improvement in depression
Reduced OCD symptoms

Long Term

Sustained remission in treatment-resistant depression
Functional improvements in mood and cognition

Side Effects

common

Headache
Scalp discomfort
Fatigue

uncommon

Dizziness
Transient hearing changes

rare

Seizure (extremely rare)

Patient Selection

ideal candidates

Patients with treatment-resistant depression
Individuals intolerant to antidepressants
OCD patients who have not responded to medication/therapy

screening required

Psychiatric evaluation
Seizure risk assessment
MRI/CT only if clinically indicated

Training Requirements

practitioner

Psychiatrists
Neurologists
Trained TMS technicians

facility

Specialized clinics or hospital-based TMS suites

Research Evidence

Key Studies

Large RCTs demonstrate efficacy of TMS for treatment-resistant depression.
Deep TMS approved for OCD with supportive clinical trial data.
Theta-burst TMS validated as non-inferior to standard protocols for depression.

Limitations

Response varies across individuals; durability of benefit may require maintenance sessions.

Cost Considerations

typical session cost: $300–$500

total treatment cost: $6,000–$12,000 for full course

insurance coverage: Often covered for treatment-resistant depression; coverage expanding for OCD.

cost effectiveness: High when successful, reducing long-term medication and hospitalization costs.

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Integration Support

Concurrent Therapies

Psychotherapy
Medication management
Lifestyle interventions (exercise, sleep hygiene)

Special Populations

👶Pregnancy

Appears safe, though more studies needed.

Clinical Notes

FDA-approved for depression, OCD, and migraine prevention.
Theta-burst TMS offers faster sessions with comparable efficacy.
Maintenance TMS may be needed to prevent relapse.

This treatment information is for educational purposes only. Treatment decisions should be made in consultation with qualified healthcare professionals based on individual circumstances, symptoms, and medical history. Do not attempt treatment without professional guidance.

Interested in this treatment?

This information is for educational purposes. Always consult with a qualified healthcare provider before starting any new treatment.

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