Patient Guides
TMS Therapy Side Effects: What's Common, What's Rare
By the TMS Nearby editorial team · Reviewed June 12, 2026
One of the main reasons patients choose TMS over additional medication trials is its side-effect profile: no weight gain, no sexual dysfunction, no emotional blunting, and no systemic effects, because the stimulation is localized to the brain region being treated.
That said, TMS isn't side-effect free. Here's an honest accounting of what's common, what's rare, and who shouldn't get TMS at all.
Common, mild side effects
- Scalp discomfort or pain at the stimulation site — affects roughly a third to half of patients early on, and typically fades within the first week as you acclimate.
- Headache after sessions — usually mild, responsive to over-the-counter pain relievers, and most common in the first week.
- Facial twitching or tingling during stimulation, caused by nearby nerves and muscles; coil repositioning often reduces it.
- Lightheadedness immediately after a session, which passes quickly.
Rare but serious risks
Seizure is the most serious known risk of TMS. It's very rare — on the order of 1 in 10,000 to 1 in 30,000 sessions in properly screened patients — and clinics screen carefully for risk factors like seizure history, certain medications, heavy alcohol use, and sleep deprivation.
Treatment-emergent mania or hypomania can occur in patients with undiagnosed bipolar disorder, which is one reason a thorough diagnostic evaluation precedes treatment.
Temporary hearing sensitivity is possible because the coil produces loud clicks; clinics provide earplugs, and hearing protection makes this risk negligible.
Who shouldn't get TMS
- Anyone with non-removable ferromagnetic metal in or near the head — aneurysm clips or coils, cochlear implants, deep brain stimulators, or metallic fragments. (Dental fillings and braces are fine.)
- Patients with a personal history of seizures or epilepsy are evaluated case by case; it's a relative contraindication rather than an absolute one in many clinics.
- Patients with implanted cardiac devices need device-specific evaluation, since some coils must stay a safe distance from pacemakers and defibrillators.
How this compares to antidepressants
Antidepressant side effects — weight change, sexual dysfunction, GI upset, emotional blunting, withdrawal effects — are systemic and persist as long as you take the medication. TMS side effects are localized, occur only around sessions, and almost always fade within the first one to two weeks of the course.
There's also no daily pill and nothing to taper. For patients who've struggled with medication tolerability, this trade-off is frequently the deciding factor.
Frequently asked questions
Does TMS cause memory loss?
No. Unlike electroconvulsive therapy (ECT), TMS has not been shown to cause memory impairment or cognitive side effects. Some studies actually show small improvements in cognitive measures as depression lifts.
Do TMS side effects get better over time?
Yes — scalp discomfort and headaches are most noticeable in the first week and fade substantially as treatment continues. Very few patients discontinue TMS because of side effects (dropout rates in trials are under 5%).
Can TMS make depression worse?
TMS does not typically worsen depression. As with any depression treatment, symptoms can fluctuate during a course, and your clinic will monitor you throughout. Report any worsening to your provider promptly.
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This guide is for educational purposes only and is not medical, legal, or insurance advice. Costs, coverage, and clinical suitability vary by individual, plan, and clinic — always verify directly with your provider and insurer. If you're in crisis, see our crisis resources.