The guide explains TMS for depression, its typical course and sensations, common temporary effects such as scalp discomfort and headache, and the need for safety screening.
TMS Side Effects and Safety: An Arkansas 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 considered for people with major depressive disorder when other treatments, such as medication or talking therapies, have not provided enough relief or have caused difficult side effects.
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. A standard course commonly involves weekday appointments over several weeks, often around 36 sessions in total.
Like any medical treatment, TMS can cause side effects and is not suitable for everyone. Most side effects are mild and temporary, but it is important to understand the possible risks and to share a full health history with the clinician before treatment begins.
What treatment feels like
During a session, you sit in a chair while a clinician positions a treatment coil against your scalp. The coil produces brief magnetic pulses. Many people describe the sensation as tapping, knocking or a light pulling feeling on the scalp.
The treatment team will usually begin by finding the correct placement and intensity for you. This may include a measurement called a motor threshold, which helps the clinician set an appropriate treatment level. The intensity may be increased gradually if you find the early sessions uncomfortable.
TMS does not involve surgery, anaesthesia or electrical current being passed directly through the body. You remain awake throughout treatment and can usually return to ordinary activities afterwards, unless your clinician gives you different advice.
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 a course and may lessen as the person becomes accustomed to treatment.
Scalp discomfort
You may feel tenderness, pressure, tingling or discomfort where the coil rests against your head. Some people experience facial muscle twitching during the magnetic pulses, particularly around the forehead or jaw. This is usually temporary and stops when the pulses stop.
Tell the clinician if the sensation is painful, difficult to tolerate or changes during treatment. They may be able to adjust the coil position, alter the treatment intensity or make other practical changes to improve comfort.
Headache
A mild headache can occur during or after a session. This is often short-lived. Your clinician may discuss whether you can use an appropriate over-the-counter pain reliever, taking account of your medical history and other medicines.
Do not assume that a headache after TMS is always harmless. Contact the treatment team promptly if a headache is severe, persistent, unusual for you, or comes with symptoms such as confusion, weakness, vision changes or vomiting.
Other possible short-term effects
Some people may feel tired after an appointment, while others do not notice any change in energy. Temporary light-headedness can also occur. Because treatment schedules often involve weekday visits, it can help to plan for how appointments will fit around work, caring responsibilities, travel and rest.
TMS does not usually cause the memory problems associated with electroconvulsive therapy (ECT). If you notice concentration, memory, mood or sleep changes that concern you, discuss them with the clinician rather than trying to judge the cause alone.
Rare but serious risks
The most important rare risk associated with TMS is a seizure. Seizures during TMS are uncommon, but they are a recognised safety concern. Clinics screen for factors that may increase seizure risk and have procedures in place to respond if a seizure occurs.
Your likelihood of having a seizure may be affected by your medical history, certain medicines, recent changes in medication, alcohol or substance use, sleep deprivation and other factors. This is why the assessment before treatment matters, and why it remains important to update the clinic throughout the course.
Seek urgent medical help if you or someone with you experiences a seizure, loss of consciousness, severe confusion or another acute medical emergency.
Some people with depression may experience worsening mood, agitation or suicidal thoughts, whether or not they are receiving TMS. Tell your clinician immediately if you feel less safe, have thoughts of harming yourself, or notice a marked change in mood or behaviour. In an immediate emergency, call emergency services or go to the nearest emergency department.
When TMS may not be suitable
TMS is not appropriate for every person. A clinician will review whether it is safe in your individual circumstances.
Particular care is needed if you have metal or an implanted electronic device in or close to the head. This can include certain clips, stimulators, cochlear implants, shrapnel or other implanted items. Dental fillings and braces may not automatically rule out treatment, but they should still be disclosed so the clinic can assess them properly.
You should also tell the clinician if you have:
- A history of seizures or epilepsy
- A previous head injury, stroke, brain surgery or neurological condition
- A brain tumour or other known structural brain condition
- Fainting episodes or unexplained blackouts
- Bipolar disorder, mania or psychosis
- Hearing difficulties or sensitivity to sound
- Pregnancy, plans for pregnancy, or recent childbirth
- Alcohol or substance use that may affect seizure risk
- Major sleep disruption, including several nights of very little sleep
Having one of these factors does not necessarily mean that you cannot have TMS. It means the treatment team needs to consider the risks, possible alternatives and any extra precautions carefully.
What to tell your clinician before starting
A full and accurate medical history is one of the best ways to support safe treatment. Bring a list of all prescribed medicines, over-the-counter products, vitamins and supplements. Include the dose where possible, and note any recent changes.
Some medicines can affect seizure threshold or interact with other aspects of mental health care. Do not stop, start or change medication because you are beginning TMS unless the clinician managing your medicines advises you to do so.
It is also useful to tell the team about past mental health treatments, including antidepressants, therapy, hospital admissions, ECT, ketamine treatment or previous TMS. Share what helped, what did not help and what side effects you experienced.
During treatment, keep the clinic informed about:
- New medicines or dose changes
- Changes in alcohol, cannabis or other substance use
- Poor sleep or major sleep loss
- New headaches, neurological symptoms or fainting
- A possible pregnancy
- Changes in mood, anxiety, irritability or suicidal thoughts
- Any new implant, injury or medical diagnosis
Ask the clinic whom to contact outside appointment hours if you have a concern. It can also be helpful to ask what would happen if you need to miss a session because of illness, travel or a safety issue.
Practical safety during a course of TMS
Attend appointments rested where possible, and follow the clinic’s instructions about medicines, alcohol and other substances. Wear hearing protection if it is provided, as the treatment coil makes repeated clicking sounds.
Most people can drive themselves to and from treatment, but this may not be appropriate for everyone. If you feel unwell, light-headed or otherwise unable to drive safely after a session, arrange another way home and tell the clinic.
A TMS course is usually delivered regularly over six to nine weeks. The team should review your progress and tolerability during that time. Safety is not just the initial screening appointment; it is an ongoing conversation.
Finding TMS support in Arkansas
TMS Therapy Arkansas currently lists 32 published clinics across the state. Directory listings include clinics in Fort Smith, Little Rock, Conway, Fayetteville, Springdale, North Little Rock, Rogers, Benton and other Arkansas communities.
When comparing clinics, ask whether the provider offers an assessment before treatment, how they manage side effects, who monitors progress, and how they coordinate with your GP, psychiatrist or other mental health professionals.
Insurance cover can vary by plan, diagnosis and prior authorisation requirements. Arkansas plans commonly seen include Arkansas Blue Cross and Blue Shield, Ambetter of Arkansas, UnitedHealthcare, Aetna, Cigna, QualChoice, Arkansas Medicaid and Medicare. A clinic may help check benefits, but it is sensible to confirm cover directly with your insurer as well.
Getting help in Arkansas
Use the TMS Therapy Arkansas clinic listings to find local providers, read the insurance guide before contacting your plan, 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.