TMS Therapy Side Effects: What to Expect Before Your First Session

If you are considering TMS therapy for depression, treatment-resistant depression, or OCD, one of the first questions we hear at The Albany Clinic is a fair one: what does it actually feel like, and what side effects should I expect? That question matters even more if antidepressant medications already put you through nausea, weight changes, or other side effects that made treatment feel like its own burden. Transcranial Magnetic Stimulation (TMS) works differently than medication, and its side effect profile is different too. Here is what our Carbondale, IL patients typically experience during and after treatment, and how we help manage it.

What Is TMS Therapy, and Why Does It Feel Different Than Medication?

TMS uses magnetic pulses, similar in strength to an MRI machine, to stimulate underactive regions of the brain involved in mood regulation. The FDA cleared TMS for major depression in 2008 and later expanded clearance to obsessive-compulsive disorder in 2018, based on a clinical trial reviewed by the FDA. Because TMS does not involve swallowing or infusing any medication, it does not carry the systemic side effects that come from a drug traveling through your bloodstream, things like digestive upset, weight gain, or sexual side effects that are common complaints with antidepressants. You can learn more about how the treatment works on our TMS Therapy page.

The Side Effects Most Patients Notice

According to Mayo Clinic, the most common TMS side effects are generally mild to moderate and tend to ease as treatment continues. Patients most often report:

• Scalp discomfort or a tapping sensation during the session itself, where the coil rests against your head
• Headache: the most frequently reported side effect, usually mild and often easing within the first week as you adjust to treatment
• Tingling or twitching of facial muscles near the treatment site
• Lightheadedness that typically resolves shortly after the session ends

If any of these feel bothersome, your provider can adjust the intensity of stimulation or suggest an over-the-counter pain reliever before your session.

Less Common Side Effects Worth Knowing About

Serious side effects from TMS are rare. In the clinical trial that supported the FDA's 2018 clearance of TMS for OCD, headache was reported by about 38 percent of patients who received active treatment, compared with 35 percent who received a sham (inactive) treatment, and no serious adverse reactions were reported in either group. Uncommon risks that your provider will screen for include seizures, a manic episode in patients with a history of bipolar disorder, and hearing loss if the ears are not properly protected during treatment, which is why earplugs are standard for every session.

How We Help Minimize Side Effects at The Albany Clinic

A few things about our process in Carbondale are built around reducing side effects and surprises:

• A pre-treatment evaluation. Before your first session, we review your medical and mental health history, including any metal implants, seizure history, or bipolar disorder, to confirm TMS is an appropriate fit. You can find more on what this process involves on our FAQ page.
• Individualized mapping. Your first appointment identifies the right treatment location and the right dose of magnetic energy for your body, so later sessions are calibrated specifically to you.
• Hearing protection every session. Earplugs are provided as a standard part of treatment.
• No downtime. Because TMS does not require anesthesia, most patients drive themselves home and return to work the same day, unlike treatments such as ECT that require a driver and recovery time.

If you have been putting off treatment because you are worried about downtime or side effects, our team is happy to walk through exactly what a course of TMS would look like for you. Schedule your free initial consultation to get those questions answered.

A Different Kind of Trade-off Than Antidepressant Side Effects

Antidepressants work throughout the body, which is part of why side effects like weight changes, GI upset, or reduced sex drive are so common. TMS's side effects are localized to the treatment site because nothing is absorbed into your bloodstream. That does not make TMS a better fit for everyone; it is a different trade-off, and one worth discussing with your provider. For a fuller look at how the two approaches compare, see our guide to TMS vs. Antidepressants. TMS is also one of the options we discuss with patients exploring care for treatment-resistant depression here in Southern Illinois.

Who Should Talk to Their Doctor Before Starting TMS

TMS is well tolerated by most patients, but your provider will want to know if you have:

• Metallic or implanted devices near the head, including cochlear implants, aneurysm clips, stents, or implanted stimulators
• A personal or family history of seizures
• A diagnosis of bipolar disorder

None of these automatically rule out TMS, but they are exactly the kind of detail your consultation is designed to sort through before any treatment begins.

When to Contact Your Provider

Most side effects fade within the first week of treatment. Reach out to our team if you notice a headache that is getting worse instead of better, any signs of a seizure, or a sudden shift in mood. Our FAQ page covers more of the day-to-day logistics patients ask about, from payment to what to expect the day of your appointment.