TMS is a non-invasive depression treatment whose common side effects include temporary scalp discomfort and headache, with clinicians able to adjust sessions for comfort.
TMS Side Effects and Safety: A South Carolina 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 major depressive disorder when other treatments have not provided enough relief 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 electrical current being passed directly through the body. During treatment, a clinician places a magnetic coil against the scalp while you remain awake and seated.
For many people, TMS is well tolerated. However, all medical treatments have possible side effects and risks. Understanding these before beginning can help you ask informed questions and know when to contact your treatment team.
The most common side effects
The most commonly reported side effects of TMS are discomfort on the scalp during treatment and headache afterwards. These effects are usually mild or moderate, and they often improve as a person becomes used to the sessions.
Scalp discomfort
The magnetic coil makes a tapping or clicking sensation against the head. Some people describe this as uncomfortable, particularly during the first few sessions. You may feel pressure, tingling or brief facial muscle twitching near the treatment area.
Your clinician can often make adjustments to improve comfort. This may include changing the coil position slightly, altering treatment settings where clinically appropriate, or allowing short pauses during a session. Tell the team if the sensation is painful rather than merely uncomfortable. You do not need to “put up with” severe discomfort without discussing it.
Headache
A mild headache is another common side effect. It may occur after a session or during the early part of a treatment course. In many cases, it settles without further treatment.
It is sensible to ask your clinician what pain relief, if any, is suitable for you. Do not assume that an over-the-counter medicine is right for your circumstances, especially if you have other health conditions or take regular medication.
Some people also report temporary tiredness, light-headedness or discomfort in the neck or jaw area. These should be discussed with the clinic, particularly if they are persistent, severe or interfering with daily activities.
What a typical course involves
A standard TMS course often involves around 36 weekday sessions over roughly six to nine weeks, although your own treatment plan may differ. Sessions are generally carried out in an outpatient clinic, so people are commonly able to return home afterwards.
Because treatment is repeated over several weeks, it is useful to tell the team about side effects early. Small practical changes may make sessions easier to manage. For example, people may find it helpful to arrive well hydrated, avoid rushing to an appointment, and plan for a quieter period afterwards if they tend to get headaches.
TMS does not usually require sedation. This means you are awake during treatment and can tell the clinician how you are feeling.
The rare risk of seizure
A seizure is a recognised but rare risk of TMS. Clinics use screening procedures and carefully selected treatment settings to reduce this risk. Your clinician should explain how they assess safety in your individual case and what procedures are in place if a medical concern arises during treatment.
The risk may be affected by factors such as a personal history of seizures, certain neurological conditions, sleep deprivation, alcohol or drug use, and medicines that can lower the seizure threshold. This does not automatically mean TMS is unsuitable, but it does mean the clinician needs full and accurate information before treatment starts.
Seek urgent medical help if you or someone nearby experiences seizure-like activity, loss of consciousness, serious injury or other severe symptoms. Your clinic should also tell you whom to contact outside normal appointment times if you have concerns during a course of treatment.
Who may not be suitable for TMS?
TMS is not appropriate for everyone. A proper assessment is important because safety depends on your medical history, current health and the location of any implanted metal or electronic device.
In particular, tell the clinician if you have metal in or near your head. This can include certain clips, coils, implants, fragments from an injury, or other devices. Dental fillings and braces are often assessed differently from metal implanted in or close to the skull, so do not make assumptions either way: list all known implants and ask the clinic to review them.
You should also report any implanted electronic device, such as a stimulator or pump. The treatment team will need to establish whether TMS can be performed safely with that device.
Other matters that may need careful review include:
- A history of seizures or epilepsy
- Previous head injury, stroke or other neurological illness
- Brain surgery or known structural brain changes
- Fainting episodes or unexplained blackouts
- Current or past bipolar disorder, mania or psychosis
- Pregnancy, plans for pregnancy or breastfeeding
- Alcohol or substance use, including recent changes in use
- Severe sleep loss or major changes to your sleep pattern
Having one of these factors does not necessarily rule out TMS. It means a clinician needs to assess your situation individually and discuss the possible benefits, limitations and risks.
What to tell your TMS clinician
The safest approach is to be thorough, even if you are unsure that something matters. Bring an up-to-date list of medicines, including prescriptions, over-the-counter products, supplements and any recent medication changes.
It is especially important to mention medicines that have been started, stopped or had a dose changed. Do not stop antidepressants, anti-anxiety medicines, sleeping tablets, seizure medicines or other prescribed treatment without speaking to the clinician who manages them.
Before your first session, tell the team about:
- Any past seizure, concussion, head injury or neurological diagnosis
- Metal implants, retained metal fragments, cochlear implants or implanted medical devices
- All medicines and supplements you use
- Changes in alcohol intake, recreational drug use or sleep
- Previous treatment for depression, anxiety, bipolar disorder or other mental health conditions
- Pregnancy or the possibility of pregnancy
- New symptoms since your assessment, including worsening mood or thoughts of self-harm
During treatment, update the clinic if you develop new headaches, unusual pain, a change in medication, illness with fever, significant sleep disruption, or any symptom that concerns you.
Mental health safety during treatment
TMS is used as part of a wider care plan, not as a replacement for urgent support. Depression can change quickly, and it is important to tell your clinician if your mood worsens or if you have thoughts of harming yourself.
If you are in immediate danger or think you may act on suicidal thoughts, call emergency services or go to the nearest emergency department. You can also call or text 988 for the Suicide & Crisis Lifeline in the United States.
Continue to attend relevant appointments with your GP, psychiatrist, therapist or other healthcare professionals unless they advise otherwise. Clear communication between the people involved in your care can be particularly helpful when medicines are being reviewed alongside TMS.
Questions to ask before starting
A South Carolina clinic should give you an opportunity to discuss safety before treatment begins. Useful questions include:
- Why do you believe TMS is suitable for me?
- What side effects should I expect, and how do you manage them?
- Do any of my medicines or health conditions need further review?
- Do I have any metal or device-related reasons not to have TMS?
- What should I do if I miss a session or become unwell?
- Who do I contact if I have symptoms between appointments?
- How will progress and side effects be monitored?
There are 35 published clinic listings on TMS Therapy South Carolina, including listings in Columbia, Charleston, Mount Pleasant, Myrtle Beach, North Charleston, Anderson and other communities. Availability, assessment processes and insurance arrangements can vary, so it is reasonable to ask each provider directly about its clinical screening and follow-up procedures.
Getting help in South Carolina
Visit the TMS Therapy South Carolina clinic listings to find published providers, read the insurance guide for information on plans commonly seen in the state, including BlueCross BlueShield of South Carolina, State Health Plan (PEBA), Medicare and TRICARE East, and use the contact page for further directory help.
This is educational information, not medical advice.
This page is informational and is not medical advice.