TMS is a non-invasive depression treatment that may cause temporary scalp discomfort or headaches, while rare risks and individual suitability require clinical assessment.
TMS Side Effects and Safety: A Utah Patient Guide
Transcranial magnetic stimulation (TMS) is a non-invasive treatment that uses magnetic pulses to stimulate targeted areas of the brain. It is most often discussed for major depressive disorder, particularly when other treatments have not provided enough benefit or have caused difficult side effects.
TMS was cleared by the FDA for major depressive disorder in 2008, and for depression with comorbid anxiety in 2021. It does not involve surgery, anaesthesia or an electrical current passing through the body. During treatment, a clinician places a magnetic coil against the scalp while you remain awake and seated.
Like any medical treatment, TMS can cause side effects and is not suitable for everyone. A proper assessment before treatment is important. This guide explains the common effects people may notice, the rarer risks to discuss, and the information your Utah TMS clinician needs in order to assess safety.
What a TMS session feels like
A TMS session involves repeated magnetic pulses delivered to a specific part of the scalp. The coil may make a tapping sound, and you may feel tapping, pressure or a pulling sensation around the treatment area. Facial muscles near the coil can sometimes twitch during pulses.
A standard course is often around 36 weekday sessions, usually delivered over roughly six to nine weeks. Individual treatment plans can differ, so your clinic should explain the expected schedule, the type of TMS being offered and what you can expect during each appointment.
You should be able to return to normal daily activities after a session unless your clinician advises otherwise. TMS does not usually require recovery time in the way that a procedure involving sedation or anaesthesia would.
Common side effects
The most commonly reported side effects of TMS are scalp discomfort and headache. These effects are generally most noticeable at the beginning of treatment and may become easier to tolerate as a person becomes accustomed to the sensation.
Scalp discomfort
The magnetic coil rests against the head, and the pulses can feel uncomfortable for some people. You may experience tenderness, pressure, tingling or a tapping sensation in the scalp area being treated.
If the sensation is painful or difficult to tolerate, say so during the appointment. The clinician may be able to adjust the coil position, treatment settings or other aspects of the session while keeping the treatment plan appropriate.
Do not assume you simply have to put up with significant discomfort. It is useful for the treatment team to know how the sessions feel, particularly if discomfort is increasing rather than settling.
Headache
Some people develop a mild headache during or after treatment. This can be related to scalp and facial muscle tension, the repeated tapping sensation, or the effort of adjusting to a new treatment routine.
Tell your clinician if you get headaches, especially if they are severe, persistent, new for you or accompanied by other symptoms. They can help you decide what is appropriate and whether anything about treatment should be reviewed.
Other things you may notice
The sound of the machine and the feeling of repeated pulses can take time to get used to. Your clinic should provide hearing protection during treatment because of the clicking sound made by the coil.
Some people find the appointments tiring simply because they are attending frequently over several weeks. Others may feel anxious before early sessions if they are unsure what TMS will feel like. Letting the clinician know about anxiety, discomfort or practical difficulties with the schedule can help the team support you.
It is also important to distinguish between side effects and changes in your underlying condition. Depression, anxiety, sleep problems and changes in energy can all fluctuate. Keep your clinician informed about how you are feeling throughout the course, not only about the physical sensations during treatment.
The rare risk of seizure
Seizure is a rare but recognised risk of TMS. The treatment team screens for factors that may increase seizure risk before starting treatment and should continue to review relevant changes during the course.
A history of seizures does not automatically mean that TMS is impossible, but it is important information for a clinician to assess carefully. The same is true of epilepsy, significant head injury, certain neurological conditions and medicines or substances that may affect seizure threshold.
Be open about changes that occur while you are having TMS. For example, tell the clinic if you have started, stopped or changed a prescription medicine, have been drinking heavily, are withdrawing from alcohol or other substances, or have had a period of major sleep loss. Your clinician can then consider whether treatment should continue as planned or be adjusted.
A reputable service should have clear procedures for managing an unexpected medical event. Ask how the clinic handles urgent concerns and who you should contact outside appointment times.
Who may need extra safety screening
TMS is not appropriate for every person. Safety screening is particularly important if you have metal, electronic or implanted medical devices in or near the head.
For example, tell the clinician if you have:
- Metal fragments, clips, plates or other implanted metal in or near your head
- A cochlear implant or other implanted hearing device
- An implanted medical device or stimulator
- A history of neurosurgery or an implanted device following surgery
- Dental work, braces or other metal devices, so the clinician can confirm whether they are relevant
The precise considerations depend on the device, where it is located and the TMS system being used. Do not make a decision based on general internet advice or on whether an implant “seems far enough away”. Your treatment provider needs the details and may need information from another clinician or the device manufacturer.
Pregnancy, breastfeeding, a history of bipolar disorder, psychosis, neurological illness or serious medical conditions should also be discussed during assessment. These do not necessarily prevent treatment, but they can affect whether TMS is appropriate and how your care should be planned.
What to tell your Utah TMS clinician
Give the clinic a full and current health history before treatment begins. This helps the team identify possible risks and coordinate with your existing care where needed.
Bring, or be ready to provide, information about:
- Current prescription medicines, over-the-counter medicines and supplements
- Recent medication changes, including changes in dose
- Any past seizure, fainting episode, epilepsy diagnosis or family history of seizures
- Head injuries, concussion, stroke, brain surgery or neurological conditions
- Metal, implants, devices or previous surgery, especially involving the head, neck or ears
- Alcohol use, recreational drugs and any recent withdrawal from substances
- Major changes in sleep, including prolonged lack of sleep
- Pregnancy, plans for pregnancy or breastfeeding
- Your mental health history, including previous episodes of mania, psychosis or hospital admission
- Other treatments you are receiving, including counselling, medication management and physical health care
It is also helpful to tell the clinician about practical matters that could affect attendance. TMS is commonly delivered on weekdays over several weeks, so transport, work, family commitments and access to regular appointments matter. A clinic can explain its scheduling process, but it cannot safely make decisions without a clear picture of your circumstances.
Questions to ask before starting
A consultation is an opportunity to understand both the possible benefits and the limitations of TMS. Consider asking:
- Why do you think TMS is appropriate for my symptoms?
- What type of TMS treatment do you provide?
- How will you screen me for safety issues?
- What should I do if I have scalp discomfort or a headache?
- Which medication or health changes should I report during treatment?
- What is your plan if I miss appointments?
- Who should I contact if I have concerns between sessions?
- How will you communicate with my GP, psychiatrist or other clinician, if appropriate?
You should not feel pressured to begin treatment before you understand the plan and have had the opportunity to raise concerns.
Getting help in Utah
TMS Therapy Utah lists 96 published clinics across the state, including directory listings in Layton, Salt Lake City, St. George, Lehi, Provo, West Jordan, Orem and other Utah communities. Use the directory’s clinic listings, insurance guide and contact page to explore local options and ask practical questions about coverage through plans such as SelectHealth, Regence BlueCross BlueShield of Utah, University of Utah Health Plans, PEHP Health & Benefits, Cigna, Aetna, Utah Medicaid or Medicare.
This is educational information, not medical advice.
This page is informational and is not medical advice.