Transcranial Magnetic Stimulation

UT Southwestern Medical Center has one of the largest departments of psychiatry in the United States. Our psychiatric providers possess the expertise and skill to treat the most severe forms of mental illness using an array of innovative and evidence-based therapies, including transcranial magnetic stimulation (TMS).

Offered by our interventional psychiatry specialists, TMS is a noninvasive treatment for people with severe depression who have not had success with psychotherapy and oral medications.

Noninvasive and Targeted Treatment for Severe Depression

Transcranial magnetic stimulation (TMS), which was approved by the FDA for routine clinical use in 2013, is a painless and virtually side-effect free treatment for people with severe depression.

TMS works by sending magnetic pulses into a targeted area of the brain involved with mood regulation. After a series of treatments, the magnetic pulses begin to alter the functioning of the nerve cells in such a way that the symptoms of depression improve and, in many cases, resolve completely.

TMS is a noninvasive, office-based procedure, meaning there are no incisions and it does not require anesthesia or sedation.

Traditional treatment for mental health disorders begins with psychotherapy (counseling) and medications. If these treatments do not provide full relief, TMS may be a safe and effective alternative.

Our interventional psychiatry team employs the most up-to-date clinical practices to determine who is most likely to benefit from TMS therapy and the optimal TMS treatment protocol for an individual patient. We believe strongly that a personalized approach to care yields the best results.

What to Expect

The first step in the treatment planning process involves a comprehensive evaluation with one of UT Southwestern’s interventional psychiatry specialists to determine if a patient is likely to benefit from TMS therapy or if another treatment should be considered.

If TMS is recommended, the next step is to identify the optimal treatment location and protocol for the patient.

TMS therapy is an outpatient procedure administered in a doctor’s office or clinic, with treatments occurring five days per week for up to six weeks. Treatment sessions usually last 15 to 30 minutes.

Each TMS procedure typically involves the placement of a magnetic coil over the front left region of the scalp. Once in place, the coil pulses rapidly, providing a gentle electrical stimulus to cells in the outer layer of the brain beneath the coil.

As the magnetic pulses are delivered, it is normal to feel tapping on the head. Some patients may also experience a nonpainful pressure sensation. The strength of the magnetic pulses produced by the TMS coil is similar to that of an MRI machine, and the magnetic pulses do not extend beyond a depth of 2 inches.

Side effects, which are rare, can include brief headaches, scalp discomfort at the stimulation site, lightheadedness, and tingling or twitching of facial muscles. The only known serious medical risk is a very small chance for seizure activity during the TMS procedure. Less than 5% of patients discontinue TMS therapy due to side effects or medical concerns.

While TMS does not work for everyone, those who benefit often experience initial signs of improvement within the first two weeks. The goal of every TMS series is complete symptomatic remission of the patient’s depression, and if remission is achieved, there is a strong likelihood the response will be sustained after completing treatments. For patients who have responded well to TMS therapy but experience a relapse of their depression despite ongoing psychiatric care, additional courses of TMS can be considered.

People with a history of seizures or any metal foreign objects in or around their head, including surgical hardware, should not have TMS due to an increased medical safety risk. (Dental fillings and braces will not affect treatment.)

Before starting TMS therapy, insurance coverage will be verified.