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TMS Side Effects & Safety: What to Expect

NeuroStar TMS has a well-established safety profile developed over more than 15 years of clinical use. Understanding what to expect helps patients make informed decisions and set appropriate expectations before beginning treatment.

Common Side Effects

The most common side effects are mild, localized, and temporary.

Unlike systemic medications, TMS side effects are primarily local — at the site of stimulation — and do not involve the metabolic, hormonal, or gastrointestinal systems. The most commonly reported side effects resolve on their own within the first week or two of treatment.

Most Common Side Effect

Scalp discomfort or mild headache — The tapping sensation of the magnetic coil can cause discomfort at the stimulation site during early sessions. This typically diminishes significantly by the end of the first week as the scalp adapts. OTC pain relievers (acetaminophen or ibuprofen) may be taken prior to sessions if needed.

  • 01
    Scalp discomfort (common, temporary)Present in approximately 30–40% of patients during early sessions. Typically mild, rated 2–4 out of 10 on pain scales. Resolves with continued treatment in virtually all cases.
  • 02
    Mild headache (common, temporary)Some patients experience a mild tension-type headache following early sessions. This typically resolves within an hour and diminishes over the first week.
  • 03
    Facial muscle twitching (during session only)Some patients notice slight twitching of facial muscles during stimulation, particularly early in treatment. This is a direct physiological effect of the magnetic field and is harmless.
  • 04
    Lightheadedness (uncommon)A small percentage of patients report brief lightheadedness following the first few sessions. This is transient and not associated with any lasting effect.
Side Effects NOT Caused by TMS
Weight gain or loss
Sexual dysfunction
Nausea or gastrointestinal effects
Memory impairment
Cognitive blunting or emotional numbing
Sleep disruption
Drug interactions
Withdrawal symptoms on cessation
Seizure Risk

The most serious potential adverse event associated with TMS is seizure, with an estimated incidence of approximately 0.1% across all patients — comparable to the seizure risk of many antidepressant medications. Patients with a personal or strong family history of seizure disorder are typically excluded from TMS treatment. A thorough clinical screening at your consultation identifies and addresses contraindications.

Contraindications

TMS is contraindicated for patients with certain metal implants in or near the head and skull (not including dental fillings), cochlear implants, or implanted medical devices near the stimulation site. Active seizure disorders are also a contraindication. A comprehensive screening is completed at your free consultation.

FAQ
Is TMS safe for long-term use?
TMS has been in clinical use since FDA clearance in 2008, with an extensive safety record across millions of treatments. No long-term adverse effects have been identified in the clinical literature. Retreatment with TMS is considered safe and is covered by most major insurance plans when clinically warranted.
Can TMS cause depression to worsen?
There is no established mechanism by which TMS would worsen depression. However, as with any treatment, not all patients respond. Patients who do not respond to TMS continue to have all other treatment options available to them.
Is TMS safe during pregnancy?
TMS is not formally FDA-approved for use during pregnancy, though there is a growing body of research suggesting it may be safe. For pregnant patients who cannot take antidepressants, TMS is sometimes considered after a thorough risk-benefit discussion with the treating psychiatrist and OB.
Can I drive after a TMS session?
Yes. TMS does not impair cognition, reaction time, or motor function. Patients drive themselves to and from every session throughout the treatment course.

Questions about TMS safety for your specific situation?

Free consultation. We review your medical history and address all contraindications before your first session.