TMS Side Effects and Safety: A Ohio Patient Guide

TMS side effects and safety in Ohio

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 when other treatments 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. It is usually delivered in an outpatient clinic, with the person awake and able to return home afterwards.

For many people, a standard course involves weekday appointments over roughly six to nine weeks, often around 36 sessions. The exact treatment plan, pulse pattern and length of each visit can vary. Before treatment begins, the clinician should explain the likely benefits, limitations, side effects and safety checks relevant to you.

TMS is generally well tolerated, but it is still a medical treatment. Understanding what is common, what is uncommon and what information to share with a clinician can help you make an informed decision.

Common TMS side effects

The most common side effects of TMS are temporary physical sensations around the treatment area. They often occur during the first sessions and may lessen as a person becomes accustomed to treatment.

Scalp discomfort

Some people feel tapping, tingling, pressure or discomfort on the scalp while the magnetic pulses are delivered. The sensation may be strongest at the start of treatment or when the treatment intensity is adjusted.

Scalp discomfort does not necessarily mean that anything is wrong, but you should not feel that you have to tolerate significant pain. Tell the treatment team if the sensation is uncomfortable. They may be able to adjust your position, check the placement of the treatment coil, pause briefly or discuss whether a gradual adjustment of intensity is appropriate.

Headache

Headache is another commonly reported side effect. It is often mild and may occur after a session, particularly early in a course of treatment. Some people find that rest, hydration or their usual clinician-approved pain relief is helpful.

Speak with the clinic if headaches are severe, persistent, different from your usual headaches, or accompanied by other concerning symptoms. It is sensible to ask before taking any new medicine or changing how you use existing medication.

Other treatment-day effects

People can sometimes feel tired after an appointment, although many continue with their usual daily activities. The clicking sound made by the TMS device can also be noticeable, which is why hearing protection is normally used during treatment.

Because TMS does not involve anaesthesia or sedation, people are generally awake throughout the session. The clinic should provide clear instructions about what to expect before and after each appointment.

Rare but important risks

The best-known serious risk associated with TMS is seizure. This is rare, but it is important enough that clinicians screen for factors that could increase the likelihood before treatment starts.

A seizure can involve changes in awareness, involuntary movements, collapse or confusion afterwards. TMS providers should have safety procedures in place for emergencies. Ask the clinic how it manages urgent medical situations and what its process is if you develop a concerning symptom between appointments.

The risk assessment is individual. It may take account of your medical history, medicines, sleep, alcohol or substance use, and whether you have had seizures or other neurological conditions. Do not stop prescribed medication on your own in preparation for TMS. Instead, discuss every medicine, supplement and recent medication change with the clinician overseeing your care.

TMS may also be unsuitable, or require specialist review, for people with certain metal or electronic devices in or close to the head. This is because the magnetic field may interact with some implanted materials or equipment. The clinic will need details of any implants, including devices used for hearing, pain management, neurological conditions or other medical needs.

Having dental fillings, braces or many routine dental restorations does not automatically rule out TMS, but it is still worth mentioning. The important point is not to make assumptions: give the clinic as much detail as you can, including implant cards, manufacturer information or records if these are available.

Who needs extra safety screening?

Every person considering TMS should have a clinical assessment. Some circumstances may mean that TMS is not appropriate, that further information is needed, or that the treatment plan needs to be adapted.

Tell the clinician if you have, or have previously had:

• Seizures, epilepsy, fainting episodes or unexplained loss of consciousness.
• A head injury, stroke, brain surgery or another neurological condition.
• Metal fragments, clips, plates, implanted electrodes or other devices in or near the head.
• A cochlear implant, implanted neurostimulator, pacemaker or other electronic medical device.
• Bipolar disorder, psychosis, or periods of unusually elevated mood, reduced need for sleep or impulsive behaviour.
• Severe headaches, migraines or a new pattern of neurological symptoms.
• Alcohol or drug use that could affect seizure risk, including recent changes in use.
• Pregnancy, plans for pregnancy, or breastfeeding.
• Hearing difficulties or sensitivity to loud sounds.

This list is not a diagnosis or a complete set of exclusions. It is a prompt for an open conversation. The clinic can decide what further review is needed and, where appropriate, coordinate with your GP, psychiatrist, neurologist or other treating clinician.

What to tell your TMS clinician

Accurate information helps the treatment team assess safety and avoid avoidable interruptions. Bring a current list of all medicines, including prescription medicines, over-the-counter products, vitamins, herbal products and supplements. Include the dose where you know it.

It is especially important to report medication changes during a TMS course. Do not assume that a medicine is irrelevant because it is prescribed for sleep, pain, allergies, attention, anxiety or another non-depression concern. The clinician can determine whether it affects your treatment plan.

You should also tell the clinic about changes in your wellbeing, including:

• New or worsening headache or scalp pain.
• Changes in sleep, including significant sleep loss.
• Changes in alcohol or recreational drug use.
• A new diagnosis, hospital visit or injury.
• Changes in mood, anxiety, agitation, suicidal thoughts or unusual changes in behaviour.
• Any seizure-like symptoms, blackouts or confusion.

Be honest about difficult symptoms, including suicidal thoughts. TMS appointments can provide regular contact with a clinical team, but they are not a substitute for urgent crisis care. If you are in immediate danger or feel unable to stay safe, seek emergency help straight away.

Questions worth asking before treatment

A consultation is a good opportunity to ask practical safety questions. You may want to ask:

• What side effects are most likely with the type of TMS you offer?
• What should I do if I develop a headache or scalp discomfort?
• How will you assess my seizure risk?
• Are any of my medicines or medical devices a concern?
• Who should I contact outside appointment hours if I have a problem?
• What happens if I miss sessions because I am unwell?
• How will you monitor my mood and progress during treatment?

You can also ask whether the clinician will communicate with the professional who currently manages your mental health care. Clear communication is particularly useful when medicines are being adjusted or when there are several health conditions to consider.

Finding TMS information in Ohio

TMS Therapy Ohio currently lists 91 published clinics across the state. Directory listings include options in Cincinnati, Mason, Beachwood, Cleveland, Hilliard, Columbus, Sandusky, Youngstown, Akron, Dublin, Centerville and Maumee, among other Ohio communities.

Availability, treatment approaches and insurance arrangements can differ between clinics. Insurance carriers commonly seen in Ohio include Anthem Blue Cross and Blue Shield, Medical Mutual of Ohio, UnitedHealthcare, Aetna, Cigna, Humana, Ohio Medicaid managed care plans and Medicare. Coverage depends on your individual plan, diagnosis, clinical history and provider arrangements, so it is important to confirm details directly with both the clinic and insurer.

Getting help in Ohio

Use the TMS Therapy Ohio clinic listings to find local providers, read the insurance guide before checking your cover, and visit the contact page if you need help using the directory.

This article is educational information, not medical advice.