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Pros and Cons of TMS

October 3rd, 2023


Transcranial magnetic stimulation (TMS) is a non-invasive therapy used to improve the symptoms of psychiatric disorders. This blog will explore the pros and cons of TMS therapy.

What is TMS?

TMS uses magnetic fields to induce an electrical current at specific areas within the brain.1 When experiencing a mental health condition or a mood disorder, the brain’s ability to regulate emotions may not function at full capacity. This can result in signals along the neural pathways that normally regulate mood, emotions, and/or thoughts not working properly. TMS helps to alleviate symptoms of different psychiatric disorders by modulating activity in cortical regions and associated neural circuits.1 In simpler terms, this means TMS treatment works by sending short magnetic pulses to exactly the areas of the brain one wants to treat – stimulating and activating neural pathways and restoring the emotional control center.1

The magnetic fields utilized with TMS therapy are comparable to those used in magnetic resonance imaging (MRI).1 With an MRI, the magnetic fields cast a wide net as opposed to the small net that TMS casts. TMS focuses the magnetic fields on specific areas of the brain.

TMS therapy was FDA-approved for treatment-resistant depression in 2008.1 Since approval for treatment-resistant depression, TMS has also been approved for the treatment of OCD. To qualify for TMS therapy, one would need to have had an adequate trial of psychotherapy (talk therapy) and pharmacology (SSRIs, SNRIs, etc.). This therapy is reserved for patients who have failed one to two different antidepressant medications.

Pros and Cons of TMS Therapy 

Pros and Cons of TMS Therapy

Pros of TMS Therapy

TMS is a non-invasive, evidence-based treatment modality. There are many benefits to TMS therapy regarding efficacy and timelines.

  • Non-invasive

The most seen side effects in TMS are mild and transient. Along with this, TMS is considered non-invasive as there are typically no systemic side effects seen with treatment. During treatment, patients may experience some scalp discomfort which would subside once treatment is over.

A common side effect seen with treatment is headaches. This can be thought of as “muscle soreness” one may see as they first start at the gym. Over time, patients acclimate to treatment and this soreness will begin to subside. This side effect can be mitigated with the use of over-the-counter analgesics.

  • Efficacy

Many research studies demonstrate around 50-60% of patients with treatment-resistant depression will have a clinically significant response.1 Around half of the 50-60% of patients will find remission with the remaining half still seeing a clinically significant response.1 Multiple randomized trials have consistently demonstrated that repetitive surface cortical TMS is superior to placebo TMS for treatment-resistant depression.1 Placebo treatment involves treatment that mimics the therapy but has no therapeutic effect.

  • Timeliness

TMS therapy involves 36 treatments with one treatment a day for 6-9 weeks. While this may sound like a lot, patients spend 30 minutes a day in treatment. After treatment, patients can resume their daily routine. TMS therapy does not involve any anesthesia and allows patients to continue with their day-to-day activities even on treatment days.

Cons of TMS Therapy

While there are many advantages to TMS therapy, there are some disadvantages as well.

  • Insurance coverage

One of the disadvantages of TMS therapy is making sure one qualifies for the treatment via insurance coverage. TMS therapy can be costly out of pocket and is not attainable for most people. To qualify for treatment, patients must have failed to meet remission from psychotherapy and pharmacology.

Comparison to Other Treatment Options 

Comparison to Other Treatment Options

TMS therapy comes into play when patients are unable to find remission with psychotherapy and pharmacology. When a patient finds themselves here, they may feel overwhelmed with their symptoms and find themselves looking for other options. At this point, patients have options to consider for treatment. An option aside from TMS includes electroconvulsive therapy (ECT).

ECT is a therapy indicated for those with treatment-resistant depression. In addition to this, ECT is also a treatment modality for bipolar disorder, schizophrenia, schizoaffective disorder, catatonia, and neuroleptic malignant syndrome.2 ECT involves an electric current which is used to produce general cerebral seizures under general anesthesia. With ECT, patients must have anesthesia which makes the process more invasive than TMS. ECT treatments are typically given multiple times a week for 3 – 4 weeks.

TMS is a non-invasive, evidence-based therapy for treatment-resistant depression which is an excellent treatment option for patients who are experiencing depressive symptoms and are not finding full alleviation of these symptoms after trialing psychotherapy and pharmacology. Clarity Clinic is beyond thrilled to be able to offer TMS therapy at our Loop and Arlington Heights locations!

Written By: Summer Slininger, PA-C

Clarity Clinic

At Clarity Clinic, we have highly trained staff specializing in therapy and psychiatry services. Clarity Clinic currently offers Medication Management, Therapy, and TMS Services across Illinois. To learn more about how we can support your mental health, call Clarity Clinic at (312) 815-9660 or schedule an appointment today.

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  1. Holtzheimer PE. Unipolar depression in adults: Indications, efficacy, and safety of transcranial magnetic stimulation (TMS). In: Roy-Byrne PP, ed. UpToDate.
  2. Kellner K. Overview of electroconvulsive therapy (ECT) for adults. UpToDate.

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