TMS Side Effects and Safety: A Kentucky Patient Guide

TMS Side Effects and Safety: A Kentucky Patient Guide

Transcranial magnetic stimulation (TMS) is a non-invasive treatment that uses magnetic pulses to stimulate targeted areas of the brain. It is commonly considered for people with major depressive disorder when other treatments, such as medication or talking therapy, have not provided enough relief.

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 implanted equipment. During treatment, a clinician places a magnetic coil against the scalp while you are awake and seated.

Like any medical treatment, TMS can cause side effects and may not be suitable for everyone. A proper assessment before treatment is important. Your Kentucky TMS provider should discuss your health history, current medicines and any implants or previous neurological concerns before recommending a course.

Common TMS side effects

The most common side effects of TMS are temporary and tend to be mild to moderate. They often occur during the first few appointments, while you are getting used to the sensation of the magnetic pulses.

Common effects include:

• Scalp discomfort or tenderness where the treatment coil is placed
• Headache during or after a session
• Tingling, tapping or tightening sensations in the scalp or face
• Temporary facial muscle twitching during pulses
• Tiredness or mild light-headedness in some people

The tapping sensation can feel unusual at first. TMS devices make a repeated clicking sound, and the scalp muscles near the coil may contract slightly. Clinics normally provide ear protection because of the sound produced during treatment.

Headache and scalp discomfort are the side effects most often discussed by patients. These symptoms may ease as treatment continues. Your clinician may be able to adjust the coil position, treatment intensity or other settings if the sessions are uncomfortable. Do not simply put up with pain or assume it is expected; tell the treatment team what you are feeling.

Some people use an over-the-counter pain medicine for a mild headache, but it is sensible to check with your clinician or usual prescriber first, particularly if you take other medicines or have medical conditions that affect which pain relief is appropriate.

Serious risks are uncommon

The most significant recognised risk of TMS is a seizure. This is rare, but it is important to discuss because seizure risk can be affected by personal medical history, sleep deprivation, alcohol or substance use, and certain medicines.

A clinic should screen for factors that may increase seizure risk before treatment begins. Staff should also explain what to do if you feel unwell between appointments or if something changes in your health or medication routine during the course.

You should contact the clinic promptly if you experience symptoms that concern you, such as a severe or unusual headache, fainting, confusion, a possible seizure, or a significant change in mood or behaviour.

TMS is generally delivered in an outpatient setting, so people usually return home after appointments. However, your own care team can advise on driving, work and daily activities if you have a medical condition or side effect that makes this a concern.

Who may need extra assessment?

TMS is not appropriate for every person. Having a medical device or metal in the body does not automatically mean you cannot have TMS, but its location and type matter greatly.

In particular, tell the clinician about any metal, electronic device or implanted equipment in or close to your head. This can include certain clips, coils, stimulators, shunts, hearing devices or other implanted hardware. A provider needs to determine whether the device is compatible with TMS and whether treatment can be carried out safely.

Dental fillings, braces and many forms of metal elsewhere in the body may not prevent treatment, but they should still be mentioned. Do not assume that an implant is irrelevant because it was placed years ago or because it has not caused problems before.

You may also need more detailed assessment if you have:

• A history of seizures or epilepsy
• A previous serious head injury, stroke or other neurological condition
• A brain tumour or another condition affecting the brain
• A family or personal history that could increase seizure risk
• A diagnosis of bipolar disorder, psychosis or significant mood instability
• Problems with alcohol, recreational drugs or withdrawal from either
• Severe sleep disruption or a recent period of very little sleep
• Pregnancy, or plans to become pregnant
• Hearing difficulties or use of hearing devices

These factors do not necessarily rule out TMS. They help the clinician decide whether TMS is suitable, whether additional precautions are needed, and whether another treatment may be more appropriate.

What to tell your TMS clinician

A safe TMS assessment depends on open, accurate information. Bring a list of your medicines, including prescribed tablets, injections, supplements, herbal products and medicines you buy without a prescription.

Tell the clinician if you start, stop or change a medicine during treatment. Some medicines can affect seizure threshold, and the TMS team may need to review changes before continuing. This includes medicines prescribed by another doctor, urgent care service or hospital.

It is also useful to discuss:

• Your depression symptoms and how they affect daily life
• Any anxiety, panic, agitation, racing thoughts or changes in sleep
• Previous mental health treatment, including medicines, therapy and hospital care
• Any history of mania, hypomania, psychosis or self-harm
• Alcohol intake and any use of recreational substances
• Recent illness, fever, dehydration or poor sleep
• Any new diagnosis, surgery or implant
• Hearing concerns and whether you use hearing aids or other devices

If you have ever had a seizure, lost consciousness without explanation, or had a serious head injury, raise this even if it happened a long time ago.

It can help to ask a family member, friend or other supporter to assist with gathering your medical history, especially if you take several medicines or have received care from different services.

Safety during a course of treatment

A standard TMS course is often about 36 weekday sessions delivered over roughly six to nine weeks. The exact plan can differ according to the protocol and your clinical circumstances. Safety checks are not limited to the first appointment; the team should continue to ask about side effects, medication changes and changes in your wellbeing.

Attend sessions well rested where possible, and let the clinic know if you have slept very poorly. Avoid arriving intoxicated or using substances in a way that could affect safety. Follow the clinic’s guidance on alcohol, medicines and missed appointments.

Treatment should feel manageable. You may feel tapping or discomfort, but you should be able to communicate with staff during the session. Ask whether you can pause if you are uncomfortable, and find out who to contact outside appointment times if you have concerns.

Finding TMS support in Kentucky

TMS Therapy Kentucky currently lists 38 published clinics across the state. Directory listings include clinics in Lexington, Louisville, Paducah, Hazard, Independence, Radcliff, Covington, Berea, Elizabethtown, Owensboro, Richmond and Mayfield.

When comparing providers, ask whether the clinic carries out a full medical and psychiatric assessment, how it monitors side effects, and how it coordinates with your GP, psychiatrist or other mental health professional. You may also wish to ask about insurance checks. Carriers commonly seen in Kentucky include Anthem Blue Cross and Blue Shield Kentucky, Humana, UnitedHealthcare, Aetna, Cigna, WellCare of Kentucky, Passport Health Plan by Molina and Medicare. Coverage and authorisation requirements can vary by plan.

Getting help in Kentucky

Use the TMS Therapy Kentucky clinic listings to find local providers, review the insurance guide before contacting a clinic, and visit the contact page if you need help using the directory.

This article is educational information, not medical advice.