TMS Side Effects and Safety

One of the key advantages of Transcranial Magnetic Stimulation (TMS) is its strong safety profile. As a non-invasive treatment for Major Depressive Disorder (MDD) and other mood disorders, TMS has minimal systemic side effects, especially when compared to medications and more invasive procedures like electroconvulsive therapy (ECT). However, as with any medical treatment, it’s important to be aware of the potential side effects and understand the safety considerations.

Common Side Effects of TMS

While TMS is generally well-tolerated, some patients may experience mild side effects, especially in the early stages of treatment. These side effects are usually temporary and subside shortly after treatment sessions.

The most common side effects of TMS include:

• Scalp Discomfort or Pain: The sensation of the magnetic pulses can cause mild discomfort or pain at the treatment site. This is the most frequently reported side effect and is usually temporary, subsiding after a few sessions as the patient becomes accustomed to the treatment. Adjustments in coil placement and pulse intensity can help mitigate this discomfort.

• Headaches: Some patients report experiencing mild to moderate headaches during or after a TMS session. These headaches are typically short-lived and can be managed with over-the-counter pain relievers like ibuprofen or acetaminophen.

• Muscle Twitches or Tension: Because the magnetic pulses stimulate neurons and muscles, some patients may experience slight twitching or tingling in the face or scalp during treatment. This is harmless and generally fades after the session.

• Lightheadedness: In rare cases, patients may feel lightheaded or dizzy after a session, but this typically resolves quickly.

Less Common and Rare Side Effects

Though rare, there are some less common side effects associated with TMS. It is important for patients and clinicians to be aware of these possibilities:

• Seizures: The risk of a seizure during TMS treatment is extremely low, with an incidence rate of about 0.1% (1 in 1,000 patients). TMS is carefully administered with specific protocols designed to minimize this risk. People with a history of epilepsy or other seizure disorders may be more vulnerable, but strict screening processes are in place to identify high-risk patients before treatment begins.

• Hearing Problems: The clicking sound generated by the TMS device can be loud, which is why patients wear earplugs during treatment to prevent hearing damage. While hearing issues are rare, the use of ear protection ensures patient safety.

Mania: In very rare cases, TMS treatment can trigger manic episodes in individuals with bipolar disorder, particularly if the condition is undiagnosed. This is why it’s essential for patients with any history of bipolar disorder to be evaluated by their healthcare provider before starting TMS.