This guide outlines TMS for depression, including its non-invasive process, common temporary side effects and safety issues Indiana patients should discuss with clinicians.
TMS Side Effects and Safety: An Indiana Patient Guide
Transcranial magnetic stimulation (TMS) is a non-invasive treatment that uses magnetic pulses to stimulate areas of the brain involved in mood regulation. It is commonly considered for adults with major depressive disorder, particularly when other treatments have not provided enough benefit or have caused difficult side effects.
TMS was cleared by the US Food and Drug Administration for major depressive disorder in 2008, and for depression with comorbid anxiety in 2021. It does not involve surgery, anaesthesia or electrical current passing through the body. During treatment, a clinician places a magnetic coil against the scalp while you remain awake and seated.
Like any medical treatment, TMS has possible side effects and safety considerations. A proper assessment before treatment is important. This guide explains what Indiana patients may wish to know and what to discuss with a TMS clinician.
Common side effects
The most common TMS side effects are temporary and tend to be mild to moderate. They often improve as a person becomes accustomed to treatment.
Scalp discomfort
Some people notice tapping, pressure, tingling or discomfort on the scalp during a session. The magnetic coil makes a repeated clicking sound and produces pulses that can activate muscles around the forehead or face. This may feel unusual at first.
Scalp discomfort may be more noticeable during the first few appointments or when the treatment intensity is being adjusted. Tell the treatment team if it is painful or difficult to tolerate. They may be able to check the coil position, adjust settings where clinically appropriate, or suggest ways to make sessions more comfortable.
Headache
A mild headache is another commonly reported side effect. It may happen during treatment or later that day. For many people, it settles without lasting problems.
It is sensible to discuss your usual headache treatments with the clinician before beginning TMS. Do not assume that a medicine is suitable simply because it is available without a prescription, especially if you have other health conditions or take regular medication.
Facial muscle twitching or discomfort
Because the coil is placed close to muscles in the forehead and scalp, some people experience temporary twitching around the eye, jaw or face during pulses. This should be mentioned if it feels painful, persistent or concerning.
Tiredness, light-headedness or changes in concentration
Some patients feel tired after an appointment, particularly when they are also experiencing depression, anxiety or disrupted sleep. Less commonly, people may report light-headedness or temporary difficulty concentrating. These symptoms can have many causes, so it is worth reporting them rather than assuming they are part of TMS.
TMS appointments are usually scheduled on weekdays as part of a course of about 36 sessions over six to nine weeks. Repeated attendance gives the team an opportunity to check how you are feeling and whether side effects are changing.
The rare risk of seizure
Seizure is the most serious recognised risk associated with TMS, but it is rare. Clinics use screening procedures and treatment protocols designed to reduce this risk.
A seizure can involve changes in awareness, uncontrolled movements, altered sensations or other symptoms. The exact appearance varies between people. TMS staff should be trained to respond if a medical event occurs during treatment.
The chance of seizure may be affected by individual factors, including a personal history of seizures, certain neurological conditions, sleep deprivation, alcohol or substance use, and medicines that may lower the seizure threshold. This does not automatically mean TMS is unsuitable, but it means the prescriber needs a full and accurate picture before making a recommendation.
Do not make sudden changes to prescribed medicines, alcohol use or other substances during a TMS course without speaking to the clinician managing your care. A change that seems unrelated to treatment may matter for safety.
Who may need additional screening
TMS is not appropriate for everyone. The treatment provider should carry out a detailed safety assessment before the first session, and should review any changes during the course.
Particular care is needed if you have metal or electronic devices in or near your head. The magnetic field may interfere with certain implants or may affect metal objects. Examples that should always be raised include:
- Cochlear implants or other hearing implants
- Aneurysm clips, stents or other devices placed in the head
- Implanted neurostimulators or electrodes
- Shrapnel, metal fragments or retained foreign bodies near the face or head
- Any implanted medical device whose materials or location you are unsure about
Dental fillings, braces and many dental implants may not prevent TMS, but the clinic still needs to know about them. Do not try to decide eligibility based on a general online list. The type of device, its location and its manufacturer information can matter.
A clinician may also want to discuss TMS more carefully if you have a history of epilepsy or seizures, a significant head injury, stroke, brain surgery, fainting episodes, or another neurological condition. Tell them about any past diagnosis even if it was years ago or you believe it has resolved.
What to tell your TMS clinician
The safety consultation is a good time to be thorough. Bring a current medication list, including prescribed medicines, over-the-counter treatments, vitamins, supplements and any recent changes. If possible, include the dose and the name of the professional who prescribed each medicine.
Be ready to discuss:
- Any personal or family history of seizures
- Head injury, concussion, stroke, brain surgery or neurological illness
- Metal, implants, medical devices or previous surgery involving the head, neck or ears
- Current medicines and recent medication changes
- Alcohol, recreational drug or substance use
- Sleep problems, including severe insomnia or recent lack of sleep
- Headaches or migraines, particularly if they are frequent or severe
- Hearing problems or sensitivity to sound
- Pregnancy, plans for pregnancy or breastfeeding
- Any new symptoms since the initial assessment
It is also important to tell the team about changes during treatment. This includes a new medicine, missed sleep, worsening headaches, alcohol or substance use, a medical procedure, a fall or head injury, or a possible pregnancy.
Be open about mental health symptoms as well. TMS is used for depression, but depression can involve changes in sleep, energy, agitation, thoughts and behaviour that may require clinical attention alongside TMS. If you have thoughts of harming yourself or feel unable to stay safe, seek urgent support rather than waiting for your next session.
Practical safety during appointments
You will usually be awake throughout TMS and can generally return to ordinary activities afterwards if you feel well enough. Still, it can help to plan for your first few sessions cautiously. Notice how you feel following treatment before arranging a demanding work commitment, a long drive or other activity requiring sustained concentration.
Hearing protection is generally used during treatment because the coil produces repetitive clicking sounds. Follow the clinic’s instructions about what to wear, what objects to remove and whether any personal items should be kept away from the treatment area.
Ask the clinic what to do if you need to miss an appointment, develop an illness or start a new medication. Consistent communication helps the treatment team make safe decisions across the course.
Questions to ask before starting
You may wish to ask:
- What side effects do you see most often in your patients?
- How will discomfort or headaches be managed?
- How do you screen for seizure risk and implanted devices?
- Who will review my medicines during treatment?
- What should I do if I have a new symptom between sessions?
- What is the plan if TMS is not comfortable or is not helping?
- How will my existing mental health care fit alongside TMS?
Indiana patients may also want to confirm practical details such as travel arrangements, appointment frequency and insurance coverage before committing to a course. Insurance decisions vary by plan and clinical circumstances. Carriers commonly seen in Indiana include Anthem Blue Cross and Blue Shield, UnitedHealthcare, Aetna, Cigna, MHS Ambetter, CareSource Indiana, Healthy Indiana Plan (Medicaid) and Medicare.
Getting help in Indiana
TMS Therapy Indiana lists 68 published clinics across the state, including listings in Indianapolis, Richmond, Columbus, Danville, Bloomington and other Indiana communities. Use the directory’s clinic listings to compare local options, its insurance guide to prepare coverage questions, and its contact page if you need help navigating the information.
This article is educational information, not medical advice.
This page is informational and is not medical advice.