A New Consensus on Transcranial Magnetic Stimulation (TMS)


April 21, 2025

Written by Joao L. de Quevedo, MD, PhD

A newly published expert review is shedding light on how Transcranial Magnetic Stimulation (TMS) is changing the way we treat depression. This update, backed by leading medical groups like the National Network of Depression Centers (NNDC), the Clinical TMS Society, and the International Federation of Clinical Neurophysiology, highlights how far TMS has come in just a few years.

So, what does this mean for people living with depression? Let’s break it down.

What is TMS, and How Does it work?

TMS is a noninvasive treatment that uses magnetic pulses to stimulate specific areas of the brain involved in mood regulation, mainly the prefrontal cortex. It’s FDA-approved for adults with major depressive disorder (MDD) who haven’t found relief with medication or therapy. As of 2024, it’s also approved for teens aged 15 and up.

Unlike medications, TMS doesn’t cause systemic side effects like weight gain or fatigue. Treatment is typically done in a clinic five days a week for several weeks.

Does It Work?

Yes. The expert panel reviewed nearly 2,400 studies and confirmed that TMS is safe and effective, even for people whose depression hasn’t responded to medications. In real-world settings, up to 83% of patients show improvement, and more than half may achieve full remission.

Newer versions of TMS, like theta burst stimulation (iTBS), are just as effective but take less time, sometimes just a few minutes per session.

Is It Safe?

TMS is generally very well tolerated. The most common side effects are mild, like scalp discomfort or headaches. Serious side effects, such as seizures, are extremely rare. The risk is even lower than for some commonly used antidepressants.

The review also emphasized the importance of personalized evaluations to ensure TMS fits each patient well.

What About Special Populations?

The new review also looked at how TMS works in different groups:

  • Teens: Now FDA-cleared for ages 15+, with good safety data.
  • Seniors: TMS offers an alternative to medications, which can cause more side effects in older adults.
  • Pregnant or postpartum women: TMS may be a safe option when medications aren’t recommended.

Although more research is needed, early signs are promising.

What’s Next for TMS?

Experts are optimistic. New protocols are being developed that work faster and more precisely. Some even show promise in reducing suicidal thoughts and improving anxiety symptoms. Researchers are also exploring how TMS might help with other conditions, like bipolar depression and post-stroke depression.

TMS in Houston

The UTHealth Houston Center for Interventional Psychiatry has been at the forefront of TMS treatment for over a decade. Our experienced team offers cutting-edge therapies for individuals with treatment-resistant depression, providing hope and healing to many in the community. 

Why This Matters

Depression is one of the leading causes of disability worldwide. For those who haven’t responded to medications or therapy, TMS offers real hope, with growing evidence to back it up. And with broader approval, improved technology, and more flexible treatment options, access to this life-changing therapy is steadily increasing.

Source
Trapp, N. T., et al. (2025). Consensus review and considerations on TMS to treat depression. Clinical Neurophysiology, 170, 206–233. https://doi.org/10.1016/j.clinph.2024.12.015

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