Transcranial Magnetic Stimulation (TMS)

Transcranial Magnetic Stimulation (TMS) is a noninvasive, FDA-approved neuromodulation treatment for major depressive disorder (MDD). It is commonly used for treatment-resistant depression (TRD) and other neuropsychiatric conditions that have not responded adequately to medications. TMS uses focused magnetic pulses delivered through a coil placed on the scalp to stimulate specific brain regions involved in mood regulation, particularly the left dorsolateral prefrontal cortex.

At the UTHealth Houston Center for Interventional Psychiatry, TMS is delivered within a structured, evidence-based clinical program and integrated with comprehensive psychiatric care and matched levels of care.

Who May Be Appropriate for TMS

TMS may be considered for patients who:

  • Have major depressive disorder or treatment-resistant depression with inadequate response to antidepressant medications
  • Have not tolerated or benefited from pharmacologic treatments
  • Prefer a noninvasive, non-systemic treatment option
  • Do not require the rapid symptom relief provided by other interventional treatments

All patients undergo a comprehensive evaluation to confirm the diagnosis, review prior treatment history, and assess the appropriateness of TMS therapy.

Treatment Process and Schedule

TMS is administered in an outpatient clinical setting and does not require anesthesia or sedation. The treatment process includes:

  • An initial motor threshold determination and individualized treatment planning session
  • Daily treatment sessions are administered five days per week

A standard course of TMS consists of 36 total treatment sessions, typically delivered as:

  • 20-minute sessions, five times per week for six weeks
  • A tapering phase to sustain antidepressant effects and reduce relapse risk:
    • Three sessions during the first taper week
    • Two sessions during the second taper week
    • One session during the final taper week

Treatment schedules may be adjusted based on clinical response and tolerability.

Safety and Tolerability

TMS is generally well tolerated and does not cause sedation or cognitive impairment. The most common side effects include:

  • Mild scalp discomfort at the stimulation site
  • Headache during or shortly after treatment

These effects are typically transient and resolve with continued treatment. Serious adverse events are rare. Patients can resume normal activities immediately after each session.

Integration With Ongoing Care

TMS therapy is integrated with:

  • Ongoing psychiatric evaluation and medication management
  • Psychotherapy, when indicated
  • Measurement-based symptom monitoring and longitudinal follow-up

TMS is typically provided within outpatient care and may be coordinated with IOP or PHP services when clinically appropriate.

Through this structured, noninvasive, and patient-centered approach, the Center aims to provide safe and effective access to TMS as part of comprehensive care for individuals with treatment-resistant depression and related conditions.