TMS Side Effects and Safety: A New Mexico Patient Guide

TMS Side Effects and Safety: A New Mexico Patient Guide

Transcranial magnetic stimulation (TMS) is a non-surgical treatment that uses magnetic pulses to stimulate targeted areas of the brain. It is most often considered for major depressive disorder when other treatments have not provided enough relief or have caused difficult side effects.

TMS does not involve anaesthesia, surgery or electrical current passing through the body. During treatment, a clinician places a magnetic coil against the scalp while you remain awake and seated. A standard course often involves weekday appointments over several weeks.

Like any medical treatment, TMS has possible side effects and risks. Most people tolerate it well, but it is important to understand what may happen, what should be reported, and why a careful pre-treatment assessment matters.

The most common side effects

The most commonly reported effects of TMS are discomfort at the treatment site and headache. These effects are usually mild to moderate and often improve as a person becomes used to treatment.

Scalp discomfort

Some people describe the tapping sensation from the coil as uncomfortable, particularly during the first few sessions. The scalp may feel tender during treatment or for a short time afterwards. Muscles in the forehead or jaw can also twitch while the pulses are being delivered.

The treatment team can often make adjustments to improve comfort. For example, they may reposition the coil slightly, review the intensity settings, or pause if you need a break. It is useful to say something early rather than trying to tolerate pain in silence.

Scalp discomfort should not usually be severe. Tell the clinician if you have persistent pain, a new skin problem at the treatment site, or discomfort that is worsening rather than settling.

Headache

A mild headache is another common side effect. This may occur after an appointment, especially early in a course of treatment. It is generally short-lived.

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

Other temporary effects can include tiredness, light-headedness or facial muscle twitching during a session. These should be discussed with the TMS team, particularly if they affect your ability to drive, work or manage other daily activities afterwards.

Hearing protection matters

TMS equipment makes a repeated clicking sound. Clinics normally provide earplugs or other hearing protection for both the patient and staff. Wearing this protection is an important part of safe treatment.

Tell the clinician if you have hearing loss, tinnitus, ear pain, an ear infection, hearing aids, or another hearing-related concern. They can discuss whether any additional precautions are needed.

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.

A seizure is a sudden episode of abnormal electrical activity in the brain. It can cause involuntary movements, altered awareness or loss of consciousness. TMS clinics prepare for this possibility, even though it is uncommon.

Your risk assessment should include any personal history of seizures or epilepsy, as well as factors that can lower the seizure threshold. These may include severe sleep deprivation, heavy alcohol use or sudden alcohol withdrawal, recreational drug use, and certain prescribed medicines. This does not necessarily mean you cannot have TMS, but it may affect whether treatment is appropriate and how it is planned.

If you have a seizure during or after a course of TMS, seek urgent medical assessment and inform the TMS provider promptly.

When TMS may not be suitable

Before treatment begins, the clinic should ask about implants, medical conditions and previous neurological history. Some people need specialist review before TMS, while others may be advised against it.

Of particular importance are implanted metal objects or electronic devices in or near the head. Magnetic fields can interact with certain implanted devices or metal components. Examples that should always be disclosed include:

• Cochlear implants or other implanted hearing devices
• Deep brain stimulators or implanted neurostimulators
• Metal clips, plates, fragments or other metal in the head
• A history of brain surgery or head injury
• Any implanted device whose type or location you are unsure about

Dental fillings, crowns and braces are commonly not a barrier to TMS, but they should still be mentioned during screening. The clinic can confirm whether they are relevant in your situation.

Pacemakers and other devices elsewhere in the body may require individual review. Do not make assumptions based on information online or on another person’s experience. The TMS provider may need to consult the clinician who manages your device.

Mental health and medical history to discuss

TMS is commonly used for depression. In the United States, it received FDA clearance for major depressive disorder in 2008, and for depression with comorbid anxiety in 2021. However, a diagnosis alone does not determine whether TMS is suitable.

Tell the clinician about your full mental health history, including:

• Previous episodes of mania or hypomania
• Bipolar disorder, psychosis or hallucinations
• Self-harm, suicidal thoughts or a recent mental health crisis
• Substance use, including alcohol, cannabis and non-prescribed drugs
• Previous psychiatric treatments and how you responded to them
• Any previous TMS, electroconvulsive therapy or ketamine-based treatment

For some people with bipolar disorder, treatments for depression can be associated with mood elevation or activation. A clinician needs to consider this history carefully and plan treatment and monitoring appropriately.

You should also mention migraines, neurological conditions, fainting episodes, stroke, brain tumours, serious head injury, sleep disorders and any condition that affects your ability to remain seated comfortably during treatment.

Medicines and changes in routine

Bring an up-to-date list of all medicines, supplements and non-prescription products to your consultation. Include the dose and how often you take each one if possible.

It is especially important to tell the team about medicines that affect the brain or nervous system, including antidepressants, mood stabilisers, antipsychotics, stimulant medicines, sedatives and medicines used for seizures. Do not stop or change prescribed medicines on your own in order to start TMS.

Tell the clinic about changes during your treatment course. This includes a new prescription, a dose change, stopping a medicine, becoming unwell, a major change in sleep, or increased alcohol or drug use. These changes can affect your safety assessment.

What happens during a safety assessment

A responsible provider should review your medical and psychiatric history before starting TMS. They may ask about implants, medicines, previous seizures, pregnancy, hearing, sleep and substance use. They should also explain the expected sensations, possible side effects, alternatives and what to do if concerns arise.

You should have an opportunity to ask practical questions, such as:

• Who will deliver or supervise my sessions?
• What should I do if I develop a headache or feel unwell?
• Who should I contact outside appointment hours?
• Will I be able to drive home after treatment?
• How will medication changes be handled?
• What happens if I miss sessions because of illness or travel?

Clear answers are part of informed consent. It is reasonable to take time to consider the information before deciding.

Safety during a course of treatment

TMS courses commonly involve frequent weekday appointments over several weeks. Keep the clinic informed if your health changes between sessions. A short check-in before treatment can help identify issues that need attention.

Try to attend well rested, hydrated and having eaten normally unless your clinician has advised otherwise. Avoid arriving after a night of very little sleep or following heavy alcohol use. If this happens, contact the clinic before travelling to the appointment so they can advise you.

If your depression worsens, you develop suicidal thoughts, or you feel unable to keep yourself safe, seek urgent support rather than waiting for your next TMS appointment. In an immediate emergency, call emergency services or go to the nearest emergency department.

Finding a TMS provider in New Mexico

TMS Therapy New Mexico currently lists 19 published clinics across the state. Directory listings include clinics in Albuquerque, Anthony, Sunland Park, Santa Fe, Las Cruces, Rio Rancho, Farmington, Silver City and Aztec.

When contacting a clinic, ask how it carries out safety screening, who reviews your medical history, and how it handles concerns during treatment. You can also ask whether it works with your insurance. Plans commonly seen in New Mexico include Presbyterian Health Plan, Blue Cross and Blue Shield of New Mexico, UnitedHealthcare, Cigna, Aetna and Turquoise Care, New Mexico Medicaid. Coverage and authorisation requirements can vary by plan and individual circumstances.

Getting help in New Mexico

Use the TMS Therapy New Mexico clinic listings to compare local providers, read the insurance guide before checking cover, and visit the contact page if you need help using the directory.

This is educational information, not medical advice.