Anyone considering transcranial magnetic stimulation (TMS) will likely have questions about what to expect during their treatment series. Mindpath Health’s National TMS Medical Director Christina Ni, MD, gives a quick overview of the process, as well as what occurs during daily appointments.

TMS Patient being consulted by TMS technician

What is Transcranial magnetic stimulation (TMS)?

Transcranial magnetic stimulation (TMS) is a safe, effective, non-invasive treatment for treatment-resistant depression. TMS uses short, magnetic pulses to stimulate underactive nerve cells in brain regions that regulate mood.

How long does TMS treatment take?

An average TMS treatment series includes 36 treatments over six to nine weeks. Each outpatient treatment lasts about 20 minutes. Patients can drive themselves to and from their appointments and continue with daily activities, such as work or school.

The first appointment is usually the longest, lasting about one hour. This allows the TMS psychiatrist time to perform the brain (cortical) mapping, determining the treatment location and the power or “dose” the device will be set to. The first TMS treatment is administered after the brain mapping. A Mindpath Health TMS psychiatrist will be present with the technician to ensure comfort and answer any questions.

Preparing for your first TMS session

After check-in, patients are admitted to a treatment room, and their temperatures are taken. A TMS technician will ask 12 questions to identify changes in sleep, mood, medications, or diet.

Significant changes in sleep, medication, alcohol consumption, or caffeine intake may result in changes in the amount of power used during treatment. If these changes occur, the TMS clinician may recheck the ideal location and dosage, and occasionally, appointments may be rescheduled for safety reasons.

The TMS technician will ask patients to complete rating scales to measure progress every week. At regular intervals during the TMS treatment, the TMS psychiatrist will re-determine the brain mapping to ensure the integrity of the treatment location and the power and make any necessary changes.

The TMS procedure: What to expect

Patients will sit in the TMS chair, and the technician will adjust to optimize comfort. The technician will place the treatment coil on the location determined by the TMS clinician during the brain mapping process.

A TMS treatment session lasts about 20 minutes and consists of 75 trains, or groups, that will deliver 3,000 pulses. Each train lasts for a few seconds and is followed by an 11-second rest period before the cycle begins again.

The TMS machine emits a repeated tapping sound when active. Patients will feel a tapping or pulsing sensation at the treatment site.

TMS should never be painful, but it can cause discomfort. Patients become used to treatment during the first five to ten sessions. Some patients read books or watch TV during treatment, while others listen to music or talk with the TMS technician. Patients are monitored throughout treatment sessions to ensure comfort and safety.

After TMS treatment and possible side effects

After the daily TMS treatment, patients can resume their regular daily activities.

While side effects are significantly less than those of medications, occasionally, patients report side effects such as a minor headache, feeling tired immediately following treatment or discomfort at the site of treatment. Typically, these side effects resolve within a week of treatment as patients adjust.

The TMS psychiatrist will complete weekly check-ins to monitor progress. While every patient may experience improvements at different time points during treatment, many patients start to notice improvements in their depressive symptoms around four weeks into treatment, which they are encouraged to share with their TMS technician or psychiatrist.

Learn more about TMS and other mental health topics

Want to learn more about your mental health? Visit our Patient Resources for articles, tips, and education from Mindpath Health’s clinicians. Visit our TMS page to learn more about how TMS can help with treatment-resistant depression.

Christina Ni, MD

Calabasas, CA

Dr. Christina Ni is a board-certified psychiatrist. She promotes a multifaceted approach toward achieving optimal health through improving mental and physical health, including diet, exercise, and self-care. Dr. Ni is a strong advocate for transcranial magnetic stimulation (TMS) as a modality for treatment-resistant psychiatric illnesses and has seen the beneficial transformation of TMS treatment in people’s lives. Dr. Ni graduated from the University ... Read Full Bio »

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