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What Is TMS?
Transcranial Magnetic Stimulation (TMS) is a gentle, FDA-cleared treatment that uses magnetic pulses to stimulate brain regions associated with mood regulation. Unlike traditional methods of brain stimulation, it is non-invasive. For qualified candidates is safe and well-tolerated.
How TMS works
Transcranial magnetic stimulation (TMS) stimulates and rehabilitates brain cells by taking advantage of the brain's natural property of responding to pulses of magnetic fields.
These pulses are emitted by a device that is part of the TMS system, called a coil (pictured). The TMS coil emits these pulses in a pattern that mimics natural rhythms in the brain. Repeating this process increases activity in key areas and networks in the brain that restore function.
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Using precise measurements, the TMS coil is placed on the scalp where it can direct the magnetic pulses at key areas of the brain that are involved in the symptoms of conditions like clinical depression, PTSD, and OCD. Repeated stimulation of these areas by TMS modifies their activity.
These areas are connected to larger networks in the brain that play a critical role in the brain's capacity for emotional regulation, coping capacity, and resilience to life stresses.
TMS Side Effects and Safety
Although the vast majority of people who undergo treatment with TMS experience minimal side effects and no serious safety concerns, taking steps to minimize side effects and safety risk is important. An important purpose of a thorough evaluation prior to starting TMS is to identify any factors that may increase the risk of side effects and safety concerns. Below is a summary of the most common side effects and the most serious risks.
Common, Mild & Time-Limited Side Effects: generally well-tolerated and not a barrier to a successful and comfortable treatment.
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Tension-Type Headaches: occur in 28% to 65% of patients. It is caused by the magnetic field stimulating scalp muscles, leading to transient muscle tension that usually resolves within the first two weeks of treatment. Mayo Clinic Patient Reference
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Application Site Discomfort: reported by roughly 39% of patients. This mild scalp pain or tapping sensation typically diminishes rapidly as the patient acclimates across initial sessions. Consensus Review and Cnsiderations on TMS
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Facial Muscle Twitching: occurs in approximately 21% of active treatments due to localized peripheral nerve stimulation. Spasms or tingling around the jaw or eyes stop immediately when the pulse sequence ends. Rossi et al., Clinical Neurophysiology Safety Update
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Systemic Symptoms: minor, transient occurrences of nausea (7–11%), dizziness/lightheadedness (4–9%), or fatigue (7–8%) can occur during or immediately following initial sessions. Consensus Review and Cnsiderations on TMS
Serious & Rare Clinical Risks
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Seizures: The rarest clinical risk, occurring in fewer than 0.1% of cases (roughly 1 in 30,000 treatments) when established safety protocols are practiced. Risk rises with predisposing factors like severe sleep deprivation or a history of epilepsy. NIMH / Dr. Sarah H. Lisanby Safety Report
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Treatment-Emergent Mania: rare mood shifts can be precipitated by neuromodulation, primarily in individuals with underlying, untreated, or misdiagnosed bipolar disorder. Rossi et al., Clinical Neurophysiology Safety Update
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Hearing Changes: The mechanical click of the coil reaches 100 to 120 decibels. Temporary hearing shifts or tinnitus are completely preventable and mitigated by the mandatory use of standard foam earplugs. Mayo Clinic Patient Reference
Long-Term Safety & Cognitive Profile
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No Structural Damage: over two decades of rigorous clinical trial data demonstrate no association with structural brain damage, tissue lesions, or localized neurotoxicity. NIMH / Dr. Sarah H. Lisanby Safety Report
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Preserved Cognitive Function: unlike electroconvulsive therapy (ECT), TMS does not cause memory losses or permanent executive decline. Systematic reviews demonstrate completely preserved cognitive accuracy, with some groups showing minor improvements in processing speed following depression remission. Rossi et al., Clinical Neurophysiology Safety Update
What the Treatment Process is Like
1. Consultation
Consideration of TMS begins with a comprehensive consultation. We will learn about your symptoms, treatment history, medications, and health goals. Together, you’ll determine if TMS is the right option for you and develop a personalized care plan.
2. Motor Threshold Mapping
Before your first treatment session, we will map your treatment area and determine your specific stimulation level and location. This precise calibration ensures your TMS treatment is delivered both safely and effectively.
3. First Treatment
Once your settings are established, you will begin your first session. You’ll sit comfortably in a treatment chair while the TMS coil is gently positioned against your head. You will remain fully awake and alert during the session. As the magnetic pulses are delivered, you may hear a clicking sound and feel a light tapping sensation on your scalp.
4. Your Treatment Series
TMS builds momentum over time through a series of sessions. Depending on your personalized plan, your schedule will follow one of two pathways:
Standard TMS: sessions are typically scheduled once daily, Monday through Friday, for a total of about 36 treatments. Each appointment lasts around 20 minutes.
Accelerated TMS: sessions are scheduled multiple times per day and can be combined with brain imaging and medications that temporarily enhance neuroplasticity. An entire course of treatment may be completed in as little as 1 day or may last several days depending on your specific protocol.
5. Clinical Monitoring
We track your progress your every step of the way. We regularly check in on your symptoms, comfort, and any side effects, adjusting your treatment plan to fit your individual response. Following completion of TMS we continue to follow up with you to monitor your progress and provide support.
Scientific Evidence for TMS
Standard TMS
Proven daily treatment protocol with extensive clinical validation for long-term symptom relief.
Standard TMS has been studied in hundreds of experiments with consistent results. In most cases, standard TMS involves 30+ daily treatments that are scheduled Monday-Friday for several weeks.
Most people who receive standard TMS in published studies have treatment-resistant depression that is moderate to severe. This means that they have already tried typical treatments for depression without adequate improvement and their symptoms are usually very challenging to cope with.
In this group, about 2/3 achieve reduction of at least 50% in the symptoms of depression and about 1/3 achieve complete remission of depression symptoms. This is a remarkable benefit when compared to alternative treatment options.
Standard TMS is often used in conjunction with other treatments, like medication and talk therapy. Many people get the best results when their treatment plan is customized.
Accelerated One-day TMS
Rapid protocol designed for improved results in a condensed time frame.
The clinical data for one-day TMS was first published in the ONE-D study in December 2025. The protocol involves using a specialized TMS coil (AMPA L-coil) that is designed to optimize targeting and delivery of TMS pulses and administration of two medications that temporarily enhance neuroplasticity, d-cycloserine and lisdexamfetamine. A 3-minute treatment of TMS is administered every 30 minutes for 20 treatments.
The One-D study achieved results similar to the SAINT study in a single day. The figures in this section show the average patient response. On average, after one week depressions symptoms reduced by about 50% and by 4 weeks the average person achieved remission, which means they no longer met the clinical criteria for depression. This improvement was sustained until the study ended at 26 weeks. The One-D study showed similar results for anxiety symptoms.
While more studies are required to more fully elucidate the effects of One-day TMS, this is a significant step forward in advancing the efficiency and effectiveness of TMS.
