TMS for depression is an outpatient treatment with usually mild, temporary scalp discomfort and headaches, but screening and clinician discussion are important for safety.
TMS Side Effects and Safety: A Tennessee Patient Guide
Transcranial magnetic stimulation, usually called TMS, is a non-invasive treatment that uses magnetic pulses to stimulate selected areas of the brain. It is commonly considered for people with major depressive disorder, particularly when medication, talking therapy or both have not provided enough relief.
TMS was cleared by the FDA for major depressive disorder in 2008, and for depression with comorbid anxiety in 2021. It is delivered while you are awake, usually in an outpatient clinic. A standard course often involves weekday appointments over six to nine weeks, with around 36 sessions in total.
As with any medical treatment, TMS has possible side effects and safety considerations. A proper assessment should take place before treatment begins. This guide explains what Tennessee patients may wish to discuss with a clinician.
What TMS treatment feels like
During a session, a clinician places a magnetic coil against your scalp. The machine makes clicking sounds and you may feel tapping, knocking or a pulling sensation on the scalp.
The first treatment appointment is often used to find the appropriate placement and stimulation level. The clinician should ask about your comfort throughout the session and may adjust the settings gradually.
TMS does not require general anaesthesia or sedation, and patients are generally able to return to their usual daily activities after an appointment. However, individual circumstances vary. If you feel unwell, dizzy, unusually tired or concerned after treatment, let the clinic know.
Common side effects
The most common side effects of TMS are usually mild and temporary. They often occur during the early sessions and may reduce as you become used to treatment.
Scalp discomfort
Some people experience discomfort, pressure, tingling or tenderness on the scalp during stimulation. The feeling may be more noticeable at the start of a course or when the stimulation intensity is being adjusted.
Tell the clinician if the treatment feels painful or difficult to tolerate. They may be able to alter the coil position, make gradual adjustments to the intensity, or discuss other practical steps to improve comfort. It is important not to simply endure significant discomfort without mentioning it.
Headache
Headache is another commonly reported side effect. It may occur during or after a treatment session and is often short-lived. People who are prone to headaches or migraine should mention this before starting TMS, as it may affect the discussion about monitoring and comfort.
Ask your treating clinician which pain relief options are suitable for you. Do not assume that a medicine is appropriate just because it is available without prescription, especially if you take other medicines or have health conditions.
Other temporary effects
Some patients may notice tiredness, light-headedness, facial muscle twitching during treatment, or temporary discomfort around the jaw or forehead. The clicking sound from the machine can also be loud, so hearing protection is normally used during sessions.
Changes in mood, sleep, anxiety or energy should be reported to the treatment team. This includes improvement, worsening symptoms, agitation, or any thoughts of self-harm. TMS is part of mental health care, not a replacement for communicating openly about how you are feeling.
The rare risk of seizure
Seizure is a rare but important risk associated with TMS. The treatment team should screen for factors that could increase seizure risk and should explain how they manage safety during treatment.
A personal history of seizures does not automatically mean that TMS is impossible, but it does need careful clinical discussion. Similarly, conditions affecting the brain, recent changes in medicines, substance use, sleep deprivation and other health factors may be relevant.
Tell the clinician promptly if there have been changes between appointments. For example, mention a new medication, a missed dose of prescribed medicine, significant lack of sleep, heavy alcohol use, recreational drug use, illness with fever, or a recent head injury. These details may influence whether a session should go ahead as planned.
If you have a seizure during treatment, the clinic should have procedures for responding safely and arranging appropriate medical follow-up.
Metal, implants and other contraindications
TMS involves a strong magnetic field near the head. For that reason, certain metal objects or implanted devices may make treatment unsuitable or require specialist assessment.
In particular, tell the clinician about any metal in or near your head, including from previous surgery, injury or dental work. Also mention implanted medical devices, such as hearing devices, neurostimulators, pumps or other electronic equipment. The treating service needs to know the exact type, location and manufacturer information where possible.
Some items may be compatible with TMS, while others may not be. This is not something to decide from general online information alone. Safety depends on the device, where it is located, and the TMS system being used.
Dental fillings, crowns and braces are not necessarily treated in the same way as metal implants within the head, but they should still be declared during screening. Bring any implant identification card, operation notes or device details if you have them.
A clinician may also need to consider whether TMS is appropriate if you have:
- A history of epilepsy or unexplained seizures
- A significant brain injury, stroke or neurological condition
- A brain tumour or other condition affecting the brain
- An implanted device or retained metal fragment
- Severe alcohol or drug use, or withdrawal risk
- Major sleep disruption
- Pregnancy or plans to become pregnant
- A diagnosis of bipolar disorder, psychosis, or a history of mania
These factors do not all mean that you cannot have TMS. They mean that an experienced clinician should review your situation carefully and discuss the potential benefits, limitations and risks.
What to tell your TMS clinician
A full and accurate medical history helps the clinic make safer decisions. Before your first session, prepare a list of your diagnoses, treatments and concerns.
Be ready to discuss:
- All prescription medicines, over-the-counter products, vitamins and supplements
- Any recent changes to medicines, including antidepressants, stimulants or anticonvulsant medicines
- Previous seizures, fainting episodes, head injuries or neurological care
- Metal implants, dental hardware, hearing devices and implanted medical equipment
- Alcohol, cannabis or other substance use
- Sleep problems and major recent changes in sleep
- Pregnancy, breastfeeding or family planning
- Previous treatment for depression, anxiety, bipolar disorder, psychosis or other mental health conditions
- Current suicidal thoughts, self-harm urges or a recent mental health crisis
It can be helpful to bring a family member or trusted person to an assessment if you would like support remembering questions or sharing relevant history.
You should also ask practical questions. For example: who delivers the sessions, who reviews progress, what happens if side effects become difficult, and whom to contact outside appointment times if your mental health worsens.
Safety during a course of treatment
Safety screening is not only for the first appointment. Your circumstances can change during a course of TMS, which commonly lasts several weeks.
Let the clinic know before a session if you have started or stopped a medication, become unwell, had very little sleep, used alcohol or drugs differently than usual, or experienced a new neurological symptom. Do not make changes to prescribed medication solely because you are having TMS unless the prescriber advising you has agreed.
Keep attending any existing appointments with your GP, psychiatrist, therapist or other healthcare professionals unless they advise otherwise. If you are receiving TMS for depression, ongoing support and monitoring remain important.
Insurance and practical planning in Tennessee
Insurance arrangements vary by plan, diagnosis and provider. In Tennessee, patients may encounter plans from BlueCross BlueShield of Tennessee, UnitedHealthcare, Aetna, Cigna, Humana, TennCare Medicaid managed care organisations, Medicare through Palmetto GBA Jurisdiction M, or TRICARE East.
Before committing to treatment, ask the clinic and your insurer about referral requirements, prior authorisation, network status and possible out-of-pocket costs. Coverage rules may change, so confirmation from your own plan is important.
TMS Therapy Tennessee currently lists 97 published clinics across the state, including listings in Nashville, Brentwood, Franklin, Memphis, Knoxville, Clarksville, Chattanooga and other Tennessee communities. When comparing clinics, ask how they handle screening, side effects, emergency procedures and communication with your existing mental health team.
Getting help in Tennessee
Use the TMS Therapy Tennessee clinic listings to find local providers, read the insurance guide for practical coverage questions, or visit the contact page for help using the directory.
This article is educational information, not medical advice.
This page is informational and is not medical advice.