By Dr. David Woo - November 1, 2022

Transcranial magnetic stimulation (TMS) is a medication-free, FDA-approved treatment that has been shown to be highly effective at treating symptoms of depression, even for patients who are considered treatment-resistant–meaning they haven’t found relief (or enough relief) from their symptoms with antidepressants.(1)

If you’re considering TMS, you’re probably curious about what the experience is like. You may be wondering, “What does it feel like?” and “What do patients say about it?” Most importantly, you’re likely wanting to know, “Is it safe?” Below, we discuss the answer to these questions.

TMS Is a Safe and Effective Treatment for Depression

Years of research and clinical trials support that TMS is safe and well-tolerated.(2) In the United States, TMS is FDA-approved to treat depression, depression with co-occurring anxiety, and OCD (obsessive-compulsive disorder). However, many studies show that TMS is also safe and effective for a number of other conditions, including:

• Addiction and/or substance abuse disorder, including alcohol and tobacco 
• PTSD
• Parkinson’s disease
• ADHD 

What Do Patients Say TMS Feels Like?

TMS feels different for everyone, but most often my patients describe TMS as:

• A tapping sensation on the head
• Mild tension in the scalp and face muscles at or near the treatment area
• Sometimes, a feeling of pressure

There are many sensations that can occur during your first TMS session, but by the second and third day, many of those sensations will either go away or feel minimal. My patients report rapid acclimation to TMS, meaning that the negative sensations tend to go away very quickly.

While the sensation may feel strange, TMS is not painful and should be easy to tolerate.

TMS should not hurt, and the way in which we administer TMS, gradually, means that patients should not experience any sensation that is not easy to tolerate. You should not have to tolerate anything uncomfortable in order to get the benefits of TMS. 

How TMS Is Administered

TMS is administered in 20-minute sessions over the course of nine weeks, for 36 sessions total. During the first 6 weeks of treatment, patients receive one treatment session a day five days a week. The final six sessions are administered over a three–week taper period. 

During your first session, we take extra time to find just the right settings and learn how to best treat you. This means that your first session will be a little longer (45 minutes total) than other treatment sessions. 

At the start of every session, the TMS technician calibrates the magnetic coil to suit your specific sensitivity level. Our technicians start at a very low energy level, where we are sure you will feel nothing but the lightest tap. We then slowly increase the energy while checking in with you regularly to make sure you are comfortable, avoiding discomfort as much as possible.

Resources:

1. Carpenter LL, Janicak PG, Aaronson ST, et al. Transcranial magnetic stimulation (TMS) for major depression: a multisite, naturalistic, observational study of acute treatment outcomes in clinical practice. Depress Anxiety. 2012;29(7):587-596. Link. Accessed October 10, 2022.

2. Cohen SL, Bikson M, Badran BW, and George MS. A visual and narrative timeline of US FDA milestones for Transcranial Magnetic Stimulation (TMS) devices. Brain Stimul. 2022;15(1):73-75. Link. Accessed October 10, 2022.

Dr. David Woo

Dr. David Woo is the owner and head clinical psychiatrist at Madison Avenue TMS and Therapy in New York City. Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.

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