TMS therapy should not be used in patients with implanted metallic devices or non-removable metallic objects in or around the head (for example, metal plates in the skull, aneurysm coils, etc.) as it could result in serious injury. Patients with braces and metal fillings are acceptable for treatment; however, patients with other metal within their mouth should discuss TMS therapy with their doctor before beginning treatment.

TMS therapy is not recommended for patients with implants controlled by physiological signals. This includes pacemakers, implantable cardioverter defibrillators (ICDs), and vagus nerve stimulators (VNS).

TMS may not be safe for those with documented seizure disorders, since the procedure stimulates the brain and could trigger a seizure.

Side Effects

Over 14,000 active TMS treatments have been safely performed at Sheppard Pratt. The most commonly reported side effect related to TMS was scalp pain or discomfort under the treatment coil during the treatment session. This side effect was generally mild to moderate and occurred less frequently after the first week of treatment. Less than 5 percent of patients treated with TMS therapy discontinued treatment due to side effects.

Seizure has been reported in in less than 0.1% of people who have used the device that we use at Sheppard Pratt. Our doctor will review your individual risk with you before starting TMS treatments. No seizures have occurred in patients receiving TMS at Sheppard Pratt since the program began in 2009.

Other potential side effects associated with TMS therapy include painless muscle twitching, pain or discomfort in the eye or face, or a toothache. These side effects are all generally experienced on the left side of the head.

There is a risk for activation of a manic or hypomanic state with all antidepressant treatments, and some antidepressant treatments have been associated with the emergence or worsening of suicidal thoughts, so your doctor will monitor your symptoms and progress at every TMS session. You should tell your doctor if you experience undesirable sensations, side effects, or worsening of depression (including thoughts of suicide) during treatment with TMS.

If you continue taking medications that cause side effects, the addition of TMS therapy will not make those side effects go away.

TMS therapy did not produce any hearing deficits in clinical trial patients, but the machine makes a loud clicking noise during treatments. You will be asked to wear earplugs as a precaution and for your comfort.