Quick answer
Yes, for most people. TMS is FDA-cleared for conditions including Major Depressive Disorder, Obsessive-Compulsive Disorder (OCD), anxious depression, and migraines.
The most common side effects are mild and temporary, like headache or scalp discomfort. The more serious risk, seizure, is shown to be rare (less than 1% overall) in large-scale data. Our EEG-informed screening rules out the small group of people for whom that risk is higher.
Introduction
Clarity about the potential risks is vital as you consider any treatment involving your brain, including antidepressants. TMS is a non-pharmaceutical alternative that has been used clinically for close to two decades, and that history comes with considerable safety data.
Here’s what that data actually shows, including the limitations, and who our EEG-based screening rules out before treatment starts.
Key takeaways
- Most side effects are mild: headache, scalp discomfort, and facial twitching top the list.
- Seizure risk is rare, estimated at roughly 3 in 100,000 sessions in a large multi-practice survey.
- TMS isn’t suitable for people with certain metal implants like pacemakers or deep brain stimulators, a history of seizures, or medications that lower seizure threshold.
- TMS involves no anesthesia, sedation, or reported memory effects.
- Our EEG and HALO™-guided screening helps ensure TMS is appropriate for everyone who starts treatment.
The safety profile in one paragraph
TMS has been FDA-cleared for depression since 2008 and has been delivered in millions of sessions since. Most people experience nothing beyond mild, short-lived side effects at the treatment site. The serious risk, seizure, exists but is rare, and our EEG-based scanning before treatment is designed to identify the people for whom that risk is elevated.
Common side effects and how often they occur
Most side effects are minor and concentrated around the treatment site.
Headache
Headache is the most commonly reported side effect. It’s usually mild to moderate and often resolves within a few hours, and over-the-counter pain relief can help.
Scalp discomfort at the stimulation site
Some discomfort or soreness at the treatment site is common, especially in the first sessions. It typically eases as your scalp gets used to the sensation.
Jaw or facial twitching
The magnetic pulse can activate nearby facial muscle fibers along with the targeted brain region, causing brief twitching. It stops as soon as the pulse ends.
Why these typically fade after the first sessions
Most people report these effects softening within the first week of daily treatment as the scalp and surrounding muscles adjust to the repeated stimulation.
Seizure risk, stated accurately
Seizure is the most serious risk associated with TMS, so we will now unpack it with precise details:
What the large-scale survey data shows
In 2021, a survey published in Brain Stimulation covering more than half a million TMS sessions across Clinical TMS Society member practices found an overall seizure rate of 0.31 per 10,000 sessions, or about 0.71 seizures per 1,000 people.
In plain terms: out of every 10,000 TMS sessions given, only about 3 led to a seizure, so for any one person going through treatment, the odds of a seizure happening are extremely low.
Why TMS does not intentionally induce a seizure, and why a rare risk still exists
TMS pulses are calibrated to modulate brain activity, not to trigger a seizure, and neuronavigated targeting (precision brain mapping) keeps stimulation within recommended parameters.
The rare cases of seizures that do occur have mostly involved an elevated risk factor, like an undisclosed seizure history or a seizure-threshold-lowering medication.
How that risk compares to some psychiatric medications
Some published research has placed the seizure risk associated with rTMS in a similar range to the spontaneous seizure risk sometimes reported with certain antidepressant medications, cited in one analysis at roughly 0.1 to 0.6 percent.
In other words, nothing is 100% risk-free, but both risks are small enough that doctors consider TMS safe as a routine treatment.
What screening and dosing protocols do to minimize it
International safety guidelines set defined limits on stimulation intensity and pulse patterns to keep seizure risk low. At Compassion Neurohealth, our EEG and HALO™ screening for personal seizure history and medications further reduces the risk.
Hearing protection and why it is required
Every pulse produces an audible click as the coil discharges, and that click repeats throughout the session. Earplugs are standard for everyone, every session, mainly to protect your hearing from the cumulative effect of that repeated sound across a full course of treatment.
Who should not have TMS?
A specific, identifiable group of people get screened out rather than starting TMS treatment.
Absolute contraindications
Because it uses a strong magnetic field, TMS is not suitable for people with implants containing ferromagnetic material in or near the head, or with implanted devices like pacemakers, defibrillators, deep brain stimulators, cochlear implants, and medication pumps.
Relative contraindications requiring clinical judgment
A personal history of seizures, certain structural brain lesions, and bipolar depression call for individual clinical judgment. We will weigh these specifics with you, guided by your EEG results.
Medications that affect seizure threshold
Certain medications, including high doses of some antidepressants, tramadol, and some antipsychotic or stimulant combinations, can raise seizure risk. Your full medication list gets reviewed before treatment starts, not just your psychiatric prescriptions.
What TMS does not do
TMS in the public imagination is often confused with other brain-related treatments like electroconvulsive (ECT) therapy. Here’s a clear breakdown of the specific characteristics of TMS and how they relate to its safety profile:
No anesthesia, no sedation, no memory effects, no recovery period
You stay awake and alert through every session. There’s no anesthesia, no sedation, no need to wait to resume regular activities after your session, and no reported effect on memory. Most people drive themselves home and return to their normal day immediately after.
How a clinic screens you for safety
Safety screening is a multi-stage process. At Compassion Neurohealth, EEG mapping and HALO™ analysis further establish whether TMS is safe for you ahead of starting treatment.
These deeper insights build the safety profile from your free pre-screening: an evaluation of your psychiatric and medical history, a specific check for implants and metal near the head, a review of your current medications, and any personal or family seizure history.
Get Screened Before You Decide
You don’t need to decide on TMS treatment to get screened. The screening itself helps you find out whether any of the risk factors above apply to you.
Frequently asked questions
Q: What Are the Most Common Side Effects of TMS?
A: Headache, scalp discomfort at the treatment site, and mild jaw or facial twitching are the most commonly reported side effects. Most side effects are mild and ease within the first week or so of daily treatment.
Q: Can TMS Cause a Seizure?
A: It’s possible but rare. A 2021 survey published in Brain Stimulation, covering more than half a million treatment sessions, found a seizure rate of less than 1%; about 0.31 per 10,000 sessions. Our EEG-informed screening helps identify elevated-risk people beforehand.
Q: Does TMS Affect Memory or Personality?
A: No memory effects have been reported with TMS, unlike some other brain-based treatments people sometimes compare it to. People remain awake and alert throughout every session with no reported change to memory or personality.
Q: Can I Have TMS if I Have Metal Implants or Dental Fillings?
A: It depends on the type. Dental fillings and braces don’t rule you out. Ferromagnetic implants, like aneurysm clips, and devices such as pacemakers or deep brain stimulators, typically do. Our screening, paired with an imaging scan for neuronavigation, confirms what is safe for you.
Q: Is TMS Safe to Have While Taking Antidepressants?
A: Yes, in most cases. TMS is typically added alongside your current antidepressant rather than used to replace it. Your full medication list is still reviewed beforehand, since a small number of medications affect seizure risk.
Q: Are There Long-Term Risks From TMS?
A: No long-term risks have been established in the research to date, though TMS is a relatively newer treatment compared with medication. Its long-term effects will continue to be studied as its popularity grows.
Q: Is TMS Safe for Older Adults?
A: TMS is used in older adults, though age-related factors like other medical conditions or medications are specifically reviewed during our EEG-guided screening. Your evaluation accounts for your full health picture, not just your age.
