TMS Side Effects and Safety: A Kansas Patient Guide

TMS Side Effects and Safety: A Kansas Patient Guide

Transcranial magnetic stimulation (TMS) is a non-invasive treatment that uses magnetic pulses to stimulate areas of the brain involved in mood. It is commonly considered for people with depression when medication, talking therapy, or both have not provided enough relief.

TMS was cleared by the FDA for major depressive disorder in 2008, with clearance later expanded to depression with comorbid anxiety in 2021. It does not involve surgery, anaesthesia or electrical current passing through the body. You remain awake and can usually return to normal activities after a session.

Like any medical treatment, TMS has possible side effects and safety considerations. A proper assessment should take place before treatment begins. This guide explains what Kansas patients may wish to know before discussing TMS with a clinician.

Common side effects of TMS

Most people tolerate TMS well. The most common effects are temporary and tend to be mild, particularly after the first few sessions.

Scalp discomfort

During treatment, the magnetic coil rests against the head and delivers repeated pulses. Some people describe the sensation as tapping, knocking or tingling on the scalp. It can feel uncomfortable at first, especially while the clinician is finding the right treatment position and intensity.

Scalp discomfort often becomes easier to manage as you become accustomed to the sessions. If it is painful, tell the TMS technician or prescribing clinician straight away. They may be able to adjust the coil position, intensity, padding or treatment settings within the appropriate clinical protocol.

Headache

A mild headache is also relatively common, particularly at the beginning of a course. It may happen after a session and usually settles without lasting effects.

Your clinician can advise whether a usual over-the-counter pain medicine is appropriate for you. Do not assume that any medicine is suitable if you have other health conditions, take regular prescriptions or have been advised to avoid particular pain relief medicines.

Facial muscle twitching or jaw discomfort

The magnetic pulses can stimulate small muscles around the forehead, eye or jaw. This may cause brief twitching during a session. It is generally not harmful, but it can be distracting or uncomfortable.

Some people also notice temporary jaw tension. Let the treatment team know if you have dental pain, a jaw condition, migraines or any issue that makes the sensation difficult to tolerate.

Tiredness, light-headedness or temporary changes in comfort

A small number of people feel tired, light-headed or generally out of sorts after a session. These effects are usually short-lived. It can be sensible to allow a little time after an early appointment to see how you feel before arranging demanding work, travel or other commitments.

A standard TMS course commonly involves about 36 weekday sessions over six to nine weeks. Because appointments are frequent, it is worth discussing practical issues such as work, childcare, transport and fatigue before starting.

The rare risk of seizure

Seizure is the most serious recognised risk associated with TMS, but it is rare when treatment is properly screened and delivered according to established safety procedures.

TMS clinics use assessment and treatment protocols designed to reduce this risk. Your clinician should ask about factors that could increase seizure risk, including a personal history of seizures, certain neurological conditions, head injuries and medicines that may affect seizure threshold.

It is important to report changes during treatment as well as at your initial assessment. For example, tell the clinic if you:

• Start, stop or change a prescribed medicine
• Experience a seizure, fainting episode or unexplained loss of consciousness
• Have a significant head injury
• Are severely sleep-deprived
• Have a major change in alcohol or substance use
• Develop a new neurological symptom

Do not stop medicines suddenly in preparation for TMS unless the clinician responsible for your care tells you to do so. Sudden medication changes can create their own health risks.

Who may not be suitable for TMS?

TMS is not right for everyone. Suitability depends on the type of TMS system being used, where treatment is planned and your individual medical history.

A key safety issue is the presence of certain metal objects or implanted electronic devices in or close to the head. Magnetic pulses may interfere with some devices or create movement or heating risks with certain metal implants. Examples that need careful discussion include:

• Cochlear implants
• Some implanted neurostimulators
• Certain aneurysm clips, stents or other metal implants
• Metal fragments near the head or eyes, including fragments from previous injuries
• Implanted electronic medical devices

This does not mean that every dental filling, brace or medical implant automatically rules out TMS. Dental work and metal elsewhere in the body may be compatible with treatment, depending on the material and location. The clinic needs accurate information so it can check the relevant device guidance.

Pregnancy, breastfeeding, serious neurological illness and complex medical conditions should also be discussed individually. TMS may still be considered in some situations, but the decision should be made with appropriate clinical advice rather than assumptions.

Mental health considerations

TMS is most widely used for depression, but a thorough mental health assessment remains important. Tell the clinician about any previous diagnosis or symptoms of:

• Bipolar disorder, including periods of unusually high energy, little need for sleep or risky behaviour
• Psychosis, such as hallucinations or strongly held beliefs that others do not share
• Severe anxiety, panic attacks or post-traumatic symptoms
• Substance or alcohol dependence
• Thoughts of self-harm or suicide

If you have thoughts of harming yourself or feel unable to stay safe, seek urgent help through emergency services or a local crisis service. TMS appointments are not a substitute for immediate crisis support.

Your TMS clinician should also know who prescribes your current mental health medicines and whether you are seeing a psychiatrist, GP, therapist or other healthcare professional. Coordinated care can help make treatment safer and clearer.

What to tell your TMS clinician

Bring a full and current picture of your health to the assessment. It can be useful to write this down beforehand, especially if you take several medicines or have had treatment in different healthcare settings.

Tell the clinician about:

• All prescribed medicines, over-the-counter medicines, vitamins and supplements
• Recent medication changes, including dose increases or missed doses
• Any history of seizures, epilepsy, concussion, stroke, brain surgery or serious head injury
• Metal implants, retained fragments, hearing implants or implanted medical devices
• Previous ECT, TMS or other mental health treatments and how you responded
• Alcohol, recreational drug or nicotine use
• Sleep problems, including prolonged insomnia
• Pregnancy, breastfeeding or plans to become pregnant
• Hearing problems, tinnitus or sensitivity to sound
• Any current dental, jaw, scalp or skin condition near the treatment area

You should also mention if you are concerned about sitting still, feel claustrophobic in clinical settings, or need adjustments for accessibility. TMS is usually delivered while seated, and clinics may be able to discuss practical support before your first session.

Questions to ask before treatment starts

It is reasonable to ask a clinic how it approaches safety. Useful questions include:

• Who will carry out the assessment and oversee my treatment?
• What side effects should I expect in the first week?
• What should I do if I get a headache or scalp discomfort?
• How will you review medicines and changes in my health during treatment?
• What happens if I miss sessions?
• What is your procedure if I feel unwell during an appointment?
• How will you communicate with my existing doctor or psychiatrist, if appropriate?

Kansas patients may also wish to ask about appointment availability and insurance checks. TMS Therapy Kansas lists 36 published clinics, including listings in Overland Park, Wichita, Leawood, Hays, Atchison, Junction City, Abilene, Manhattan, Lawrence and other Kansas communities. Insurance arrangements vary by clinic and plan. Carriers commonly seen in Kansas include Blue Cross and Blue Shield of Kansas, Blue Cross and Blue Shield of Kansas City, Aetna, Cigna, UnitedHealthcare, Medica and KanCare.

Getting help in Kansas

Use the TMS Therapy Kansas clinic listings to find published providers in your area, review the insurance guide before contacting a clinic, and visit the contact page if you need help using the directory.

This is educational information, not medical advice.