What Is TMS

What is TMS?

Bright Futures Psychiatry TMS suite

TMS is a noninvasive procedure that uses magnetic pulses to stimulate nerve cells in specific areas of the brain, also called the treatment area¹. The treatment areas are associated with the illness that is being treated; for instance, the treatment area for depression is the left dorsal lateral prefrontal cortex. By stimulating the treatment area with the magnetic pulses, areas with decreased activity (such as with depression) experience an increase. Conversely, areas with increased activity (such as with anxiety) experience a decrease. Either way, symptoms improve.

The treatment is completed outpatient, in your provider’s office. It is non-invasive, meaning it does not require any kind of anesthesia. The typical treatment consists of daily sessions (5 days per week) that last approximately 20 to 40 minutes. Typically, there are no restrictions on your activity, meaning you are able to drive and work (even on heavy machinery).

How does TMS work?

TMS coil in treatment position

A TMS session begins with the placement of an electromagnetic coil to the treatment area. If we are treating depression, the placement of the coil will be on the left side of the client’s head, near their forehead. The coil delivers electromagnetic pulses to the treatment area. Each pulse depolarizes the neurons, similar to turning a light switch on and off (just very rapidly); this resets the neurons and allows them to work more efficiently.

What can you treat with TMS?

In 2008, the FDA approved the use of TMS to treat depression, specifically treatment resistant depression. Since then, research has shown that it is effective in treating many other disorders, such as post-partum depression, bipolar depression, anxiety, PTSD, OCD, anorexia, and substance abuse. But, TMS is a treatment for more than mental illnesses. Research also indicates that TMS is effective in treating migraines, Alzheimer’s, epilepsy, pain, Parkinson’s disease, and tinnitus². It’s all about finding the correct dosage, frequency, and location of the brain.

What are the side effects of TMS?

TMS is considered to be a safe and well tolerated treatment¹. Common side effects are generally mild and may include headache and scalp discomfort at the treatment site. Serious side effects are rare, but may include seizures and mania (primarily in individuals with a history of bipolar disorder).

Be sure to tell your provider if:

Since TMS utilizes magnetic pulses, it is important to tell your provider if you have any metal objects, devices, or implants in your body. TMS may not be recommended for some people with the following:

  • Aneurysm clips or coils
  • Stents
  • Implanted devices:
    • Vagus nerve or deep brain stimulators
    • Electrical devices, for example: pacemakers or medication pumps
  • Electrodes for monitoring brain activity
  • Cochlear implants for hearing
  • Any magnetic implants
  • Bullet fragments
  • Tattoos that contain metal fragments
  • Any other metal device or object implanted in your body

Other information to tell your provider:

  • A complete list of all medications (prescription and over-the counter), supplements, and vitamins
  • Any history of seizures and family history of epilepsy
  • All mental health history, to include substance misuse, bipolar disorder, and psychosis
  • History of brain damage or injury
  • History frequent or severe headaches
  • Any other medical conditions


  1. Mayo Clinic Staff. (2017, December 29). Transcranial magnetic stimulation. Retrieved October 11, 2018, from https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625
  2. Burger, J., Frank, E., Kreuzer, P., Kleinjung, T., Vielsmeier, V., Landgrebe, M., . . . Langguth, B. (2011). Transcranial magnetic stimulation for the treatment of tinnitus: 4-year follow-up in treatment responders—a retrospective analysis. Brain Stimulation, 4(4), 222-227. doi:10.1016/j.brs.2010.11.003

Erin Recinos, MSN, APRN, PMHNP-BC

Erin Recinos, MSN, APRN, PMHNP-BC is a board-certified Psychiatric Mental Health Nurse Practitioner (PMHNP-BC). She has served the mental health community for over 10 years in various capacities. Erin is proud to have served as a Medic in the United States Air Force.

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