This guide explains TMS for depression, covering treatment sensations, common temporary effects such as scalp discomfort, rare risks and clinician safety reviews.
TMS Side Effects and Safety: An Oklahoma 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 is commonly considered for adults with major depressive disorder, particularly when antidepressant medicines, talking therapies or both have not provided enough relief.
TMS has been cleared by the US Food and Drug Administration for major depressive disorder since 2008, and for depression with comorbid anxiety since 2021. Like any medical treatment, it has possible side effects and may not be suitable for everyone. A proper assessment with a qualified clinician is an important part of deciding whether it is appropriate for you.
This guide explains the side effects, uncommon risks and safety information Oklahoma patients may wish to discuss before starting treatment.
What does a TMS session feel like?
During TMS, you sit in a treatment chair while a clinician places a magnetic coil against your scalp. The coil makes clicking sounds and delivers short magnetic pulses. You remain awake throughout the appointment and can generally return to normal activities afterwards, including driving if you feel well enough to do so.
Some people describe a tapping, knocking or tingling sensation on the scalp during treatment. This is not the same as electroconvulsive therapy (ECT): TMS does not involve an electric current passing through the body, anaesthesia or an induced seizure.
A standard course often involves weekday appointments over several weeks, commonly around 36 sessions across six to nine weeks. Your own schedule may differ according to the treatment protocol and the clinician’s recommendations.
Common TMS side effects
The most commonly reported side effects are usually mild and temporary. They often improve as a person becomes accustomed to treatment.
Scalp discomfort
Scalp discomfort during or soon after a session is one of the most frequent concerns. The sensation may feel like pressure, tenderness, tapping or mild pain where the coil is positioned.
This can be more noticeable at the start of a course. Tell the treatment team if it feels uncomfortable. They may be able to adjust the coil position, make changes to how treatment is introduced, or discuss practical ways to make sessions easier to tolerate.
You should not feel that you have to simply put up with significant discomfort. It is useful to speak up early, particularly if the sensation changes or becomes more painful.
Headache
Some people experience a headache after TMS, especially during the first days or weeks of treatment. Headaches are generally short-lived and may settle with rest or an ordinary pain-relief medicine, if that is safe for you to take.
Before using any medicine for a headache, check with your clinician or pharmacist if you have medical conditions, take other medicines or are unsure what is suitable. Let the TMS team know if headaches are persistent, severe, unusual for you or accompanied by other symptoms.
Facial muscle twitching or jaw discomfort
The magnetic pulses can stimulate muscles near the treatment area. You may notice brief twitching around the eye, forehead or jaw while the machine is active. This is usually temporary and stops when the pulses stop.
Some people also notice mild jaw tension, particularly if they clench their teeth during a session. Tell the clinician if this happens. A small adjustment may help.
Tiredness, light-headedness or temporary discomfort
A minority of people report feeling tired, light-headed or generally uncomfortable after treatment. It is sensible to allow yourself a little time after early sessions to see how you feel before returning to a demanding activity.
If you feel faint, confused, unusually unwell or unable to continue with your usual routine, contact the treating clinic for advice.
Rare but important risks
The most serious recognised risk associated with TMS is a seizure. This is rare, but it is important that patients understand it before agreeing to treatment.
A seizure is a sudden episode of abnormal electrical activity in the brain. The TMS team will use screening questions and treatment settings designed to reduce risk. They should also be prepared to respond if an emergency occurs.
Your individual risk may be affected by factors including a personal history of seizures, certain neurological conditions, sleep deprivation, alcohol or substance use, and medicines that can lower the seizure threshold. This is why an accurate medical history matters.
Other uncommon concerns can include changes in mood or behaviour. If you have bipolar disorder, a history of mania or hypomania, or notice unusually elevated mood, reduced need for sleep, racing thoughts, impulsive behaviour or agitation during treatment, tell your clinician promptly.
TMS is not generally associated with the memory difficulties sometimes linked with ECT. However, any new or worrying cognitive, emotional or physical symptom should be raised with your treatment team.
Who may not be suitable for TMS?
TMS is not right for every person. The clinician will consider both the likely benefits and potential risks in your circumstances.
In particular, TMS may not be suitable, or may need specialist consideration, if you have metal or electronic devices in or near your head. This can include certain implanted devices, clips, stimulators, cochlear implants or fragments of metal. Dental fillings, braces and ordinary jewellery are not automatically a problem, but you should still mention them.
Do not assume that an implant is safe or unsafe without checking. Bring information about the device if you have it, including the manufacturer or implant card.
A clinician may also need to consider TMS carefully if you have:
- A history of epilepsy, seizures or unexplained blackouts
- A brain injury, stroke, brain tumour or other neurological condition
- Bipolar disorder, mania or psychosis
- Severe anxiety, panic symptoms or trauma-related symptoms that may affect treatment tolerance
- Hearing difficulties or sensitivity to sound
- Pregnancy, plans for pregnancy or breastfeeding
- A substance use concern, including heavy alcohol use
- A medical condition that affects your ability to attend frequent appointments
TMS sessions make a repeated clicking noise. Hearing protection is normally used during treatment. Tell the team about hearing loss, tinnitus or other hearing concerns before beginning.
What to tell your TMS clinician
An open conversation helps the clinician assess safety and plan treatment appropriately. Before your first session, provide a full list of medicines, supplements and non-prescription products you use. Include medicines prescribed by other healthcare professionals.
It is particularly important to mention recent medication changes, because some medicines can affect seizure risk. Do not stop or alter prescribed medication solely because you are considering TMS unless the clinician managing that medicine advises you to do so.
You should also tell the clinician about:
- Previous mental health treatments, including medicines, therapy, hospital admissions and ECT
- Any past seizure, head injury, loss of consciousness or neurological diagnosis
- Metal in your head or face, implanted devices, and previous surgery
- Alcohol, recreational drug or other substance use
- Changes in sleep, especially significant sleep loss
- Pregnancy or breastfeeding
- Any history of mania, hypomania, psychosis or self-harm
- Allergies and significant medical conditions
It can help to ask what side effects the clinic expects you to report between sessions, who to contact outside appointment times, and what emergency support is available.
Practical safety during a course of treatment
Attend appointments having eaten, slept and hydrated as normally as possible. Avoid arriving after a night of very limited sleep, and be honest if you have been drinking alcohol, using recreational substances or have missed medicines. These details are relevant to safety, not a reason to be judged.
Let the clinic know if your health changes during the course. This includes new medicines, a new diagnosis, a head injury, pregnancy, major changes in alcohol or substance use, or a seizure-like episode.
TMS treatment is usually delivered alongside wider mental health care. Continue to follow the plan agreed with your GP, psychiatrist or other clinician. If you have thoughts of harming yourself or feel unable to stay safe, seek urgent help through local emergency services or a crisis service rather than waiting for the next TMS appointment.
Getting help in Oklahoma
TMS Therapy Oklahoma lists 20 published clinics, including directory listings in Edmond, Durant, Oklahoma City, Weatherford, Grove, Tulsa, Lawton, Broken Arrow and Moore. Use the directory’s clinic listings to compare local options, its insurance guide for information on carriers commonly seen in Oklahoma such as Blue Cross and Blue Shield of Oklahoma, CommunityCare, Aetna, Cigna, UnitedHealthcare and SoonerCare, and its contact page for further help finding information.
This article is educational information, not medical advice.
This page is informational and is not medical advice.