The guide outlines TMS for depression, its typical course, common mild scalp discomfort and headaches, and the need for screening to identify safety risks.
TMS Side Effects and Safety: A Louisiana 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 does not involve surgery, anaesthesia or electric current being passed through the body.
TMS was cleared by the US Food and Drug Administration (FDA) for major depressive disorder in 2008, and for depression with comorbid anxiety in 2021. It is often considered when depression has not improved sufficiently with medication, talking therapy, or both.
Like any medical treatment, TMS can have side effects and may not be suitable for everyone. A proper assessment, including a review of your medical history, medicines and any implanted devices, is an important part of treatment safety.
What TMS treatment feels like
During a session, a clinician places a magnetic coil against the scalp. The device produces tapping sensations and clicking sounds while it delivers brief magnetic pulses.
A standard treatment course commonly involves around 36 weekday sessions over six to nine weeks. Individual schedules can differ depending on the treatment protocol and a person’s clinical needs.
Most people are awake throughout treatment and can return to usual activities afterwards, including driving, unless their clinician has advised otherwise. TMS does not usually cause sedation or problems with memory associated with some other treatments for severe depression.
Common side effects
The most common side effects of TMS are local and usually mild to moderate. They often lessen as a person becomes accustomed to treatment.
Scalp discomfort
It is common to feel tapping, pressure, tingling or discomfort on the scalp during a session. Some people describe the sensation as irritating rather than painful, while others find it uncomfortable at first.
The treatment team may be able to improve comfort by adjusting the coil position, changing the intensity gradually where clinically appropriate, or allowing brief pauses. Tell the clinician if the sensation feels difficult to tolerate rather than trying to push through it.
Headache
Headache is another common side effect, particularly early in a course of treatment. It is often temporary and may settle after a session or over the first several treatments.
Tell the treatment team about headaches, especially if they are severe, persistent, different from your usual headaches, or accompanied by other symptoms. Ask before taking pain relief if you are unsure what is appropriate alongside your current medicines and health conditions.
Facial muscle twitching or jaw discomfort
The magnetic pulses can sometimes stimulate nerves or muscles near the treatment area. This may cause brief twitching around the forehead, eye or jaw while the machine is active. Some people also notice jaw tension, especially if they clench their teeth during treatment.
These effects should be discussed with the clinician. Small changes in positioning may help.
Tiredness, light-headedness or temporary discomfort
Some people feel tired after a session, or experience brief light-headedness. These effects are not usually long-lasting, but it is sensible to mention them. Your clinician can help decide whether anything in your treatment plan needs to change.
Hearing protection matters
TMS equipment makes repeated clicking sounds. Clinics should provide hearing protection, such as earplugs, during sessions.
Use the hearing protection as instructed. Let the team know if you have hearing loss, tinnitus, ear pain, an ear infection, or any difficulty wearing earplugs comfortably.
Rare but serious risks
The most significant rare risk associated with TMS is a seizure. A seizure is uncommon when treatment is delivered within established safety guidelines, but the possibility is one reason why thorough screening is needed.
Your risk assessment may include questions about:
- A personal history of seizures or epilepsy
- Previous serious head injury
- Stroke, brain surgery or a neurological condition
- Brain tumours or other structural brain changes
- Medicines that may affect seizure risk
- Heavy alcohol use, recent alcohol withdrawal, or substance withdrawal
- Severe sleep deprivation
- Major changes in medication, physical health or substance use during treatment
A history of seizures does not automatically mean that TMS is impossible, but it requires careful discussion with an appropriately qualified clinician. The same applies to other neurological conditions and factors that could lower the seizure threshold.
In rare cases, a person with bipolar disorder may experience mania or hypomania during treatment for depression. Tell the clinician if you have ever had periods of unusually elevated or irritable mood, needing very little sleep, racing thoughts, impulsive behaviour, or unusually high energy.
Seek urgent medical care for severe or concerning symptoms, including a seizure, sudden weakness, confusion, loss of consciousness, severe new neurological symptoms, or thoughts of harming yourself.
Who may not be suitable for TMS?
TMS is not appropriate for every person. In particular, certain implanted or embedded metal devices can be unsafe if they are close to the treatment area or could be affected by the magnetic field.
Examples that need careful assessment include:
- Cochlear implants
- Deep brain stimulators or other implanted neurostimulators
- Implanted electrodes
- Certain aneurysm clips, coils or stents
- Metal fragments in or near the head, particularly from an injury
- Other magnetic or electronically controlled implants near the head or neck
Dental fillings, braces and many routine dental implants do not automatically prevent TMS, but you should still tell the clinic about them. Do not assume that a device is safe or unsafe based only on its name. The clinician may need details about the manufacturer, model and location of an implant before deciding whether treatment can proceed.
Pacemakers and other implanted cardiac devices also require individual assessment. The treatment provider may need to consult the clinician who manages the device or review manufacturer information.
Pregnancy, breastfeeding, significant medical illness, and recent changes in mental health treatment should also be discussed. These circumstances do not necessarily rule out TMS, but they are relevant to treatment planning.
What to tell your TMS clinician
Be open and specific during the initial screening and throughout your course. The clinician needs current information, not only your records from a previous appointment.
Before starting, tell them about:
- All prescription medicines, over-the-counter medicines, supplements and recreational drugs
- Any recent medicine dose changes, including antidepressants, stimulants or sedatives
- Seizures, fainting episodes, head injuries, migraines, stroke or neurological diagnoses
- Metal in your head or neck, implanted devices, hearing devices, or prior brain surgery
- Alcohol use, substance use, or any plans to stop using alcohol or substances suddenly
- Sleep problems, particularly several nights of poor sleep
- Bipolar disorder, psychosis, self-harm, suicidal thoughts, or recent major changes in mood
- Pregnancy, possible pregnancy or breastfeeding
- Hearing difficulties, tinnitus, jaw pain or dental concerns
During treatment, report new symptoms and changes promptly. This includes a new medication, missed sleep, a change in alcohol or substance use, worsening anxiety, or a headache that feels unusual for you.
Questions to ask before treatment
A Louisiana clinic should be able to explain its screening and safety processes in clear terms. Useful questions include:
- Why is TMS being recommended in my situation?
- What treatment protocol is proposed, and how often will I attend?
- How will my seizure risk and medical history be assessed?
- Do any of my medicines or implants need further review?
- What should I do if I develop a headache or other side effect?
- Who do I contact outside appointment times if I feel unwell?
- How will my mood, symptoms and safety be monitored during the course?
It can also be helpful to ask about practical arrangements, such as travel, missed appointments and insurance authorisation. Insurance coverage varies by plan. In Louisiana, patients may encounter plans from Blue Cross and Blue Shield of Louisiana, UnitedHealthcare, Humana, Aetna, Cigna, Vantage Health Plan or Healthy Louisiana (Medicaid), but eligibility and prior authorisation requirements can differ.
Getting help in Louisiana
TMS Therapy Louisiana lists 20 published clinics across the state, including listings in Shreveport, New Orleans, Lake Charles, Slidell and other Louisiana communities. Use the directory’s clinic listings to find local providers, review the insurance guide before checking benefits, and visit the contact page if you need help using the directory.
This article is educational information, not medical advice.
This page is informational and is not medical advice.