Is TMS Therapy Safe? Side Effects, Risks & What the Research Actually Shows

February 16, 2026

Everything to know about the safety of TMS

Yes. TMS (Transcranial Magnetic Stimulation) is one of the safest treatments available in modern psychiatry.** FDA-cleared since 2008, TMS has been delivered over 5 million times worldwide with an exceptional safety record. The most common side effects are mild headache and scalp discomfort, both temporary and treatable with over-the-counter pain relievers. Serious complications are extremely rare—the seizure risk is approximately 0.01% (1 in 10,000 treatments), which is lower than many commonly prescribed antidepressants.

Unlike medications that circulate through your entire body, TMS works locally and precisely—stimulating specific brain circuits without systemic side effects. There's no weight gain, no sexual dysfunction, no emotional blunting, no cognitive impairment, and no withdrawal symptoms. You can drive yourself home after treatment and return to normal activities immediately.

The Safety Question I Hear Every Day

Here's something I tell every patient who sits in my office nervous about trying TMS: I get it. You've probably been burned before. Maybe a medication that was supposed to help made you gain 30 pounds, killed your libido, or turned you into an emotional zombie. So when someone says "let me stimulate your brain with magnetic pulses," your guard goes up.

That skepticism makes sense. It's actually healthy.

But here's what I've learned after delivering thousands of TMS sessions: the safety profile of this treatment is remarkable. Not "pretty good for a psychiatric treatment" remarkable—genuinely excellent by any medical standard.

Let me walk you through exactly what we know.

Common Side Effects: What Most People Actually Experience

The most frequently reported side effects are mild and temporary:

Headache — Approximately 50% of patients experience some headache during or after treatment, particularly in the first week. We're talking tension-headache level, not migraine. Tylenol or ibuprofen handles it. Most patients say by session four or five, they barely notice it anymore.

Scalp Discomfort — The tapping sensation under the treatment coil can feel strange at first. Patients describe it as a woodpecker-like feeling. Unusual, yes. Painful, rarely. And like the headache, it typically fades as your scalp adjusts to the stimulation.

Facial Twitching — Some patients notice their facial muscles contract slightly during treatment. This is harmless—it's just the magnetic field activating nearby motor neurons. We can usually minimize it by adjusting the coil position.

That's essentially the list. No pages of fine print. No trading one problem for a dozen new ones.

The Seizure Question: Let's Talk Real Numbers

When patients ask about safety, they're usually asking about one thing: seizures. So let's address it directly.

The seizure risk with TMS is approximately 0.01%—that's 1 in 10,000 treatments.

To put that in perspective:

- That's lower than the seizure risk from bupropion (Wellbutrin), one of the most commonly prescribed antidepressants

- It's comparable to the general population's baseline seizure risk

- It's roughly the same odds as being struck by lightning in a given year

In the millions of TMS treatments delivered worldwide, seizures remain extraordinarily rare. And when they do occur, they're almost always in patients who have pre-existing seizure disorders or other neurological risk factors—which is why we screen carefully before treatment.

At Kind Minds, we've delivered thousands of sessions with zero seizures. We plan to keep it that way through careful patient selection and vigilant monitoring.

What TMS Does NOT Cause

This is where TMS really separates itself from other treatments. Here's what you don't have to worry about:

No Weight Gain — Unlike many antidepressants (looking at you, mirtazapine and paroxetine), TMS has zero impact on your metabolism or appetite.

No Sexual Dysfunction — Up to 70% of patients on SSRIs experience some form of sexual side effect. With TMS, this simply isn't a concern.

No Emotional Blunting — I've had so many patients tell me their medication made them feel "flatlined" or like a "muted version" of themselves. TMS doesn't do this. If anything, patients report feeling more emotionally present, not less.

No Cognitive Impairment — No brain fog, no memory problems, no difficulty concentrating. Studies actually show the opposite—many patients report improved cognitive clarity after TMS.

No Sedation — You're fully awake and alert during treatment. You can read, watch videos, or just relax. And you drive yourself home afterward.

No Drug Interactions — Because TMS doesn't involve medication, there's no concern about interactions with your other prescriptions.

No Withdrawal — When treatment ends, it just ends. No tapering, no discontinuation syndrome, no months of trying to get off a medication that made you feel terrible.

TMS vs. Other Treatments: A Safety Comparison

Who Should NOT Have TMS

TMS is safe for most people, but not everyone. We carefully screen every patient, and certain conditions are contraindications:

Absolute Contraindications:

- Metal implants in or near the head (cochlear implants, deep brain stimulators, aneurysm clips, metal plates)

- Active seizure disorder or epilepsy

- History of seizures from any cause

Dental work is generally fine. Fillings, crowns, braces, and dental implants don't interfere with TMS and aren't a safety concern.

Relative Considerations:

- Certain neurological conditions

- Some cardiac devices (evaluated case by case)

- Pregnancy (actually, TMS is often preferred during pregnancy when medication isn't safe)

This is exactly why we do thorough medical screening before starting anyone on treatment. We want TMS to work for you, and that starts with making sure it's safe for your specific situation.

Special Populations: Where TMS Safety Really Shines

Pregnant Women — This is a population I'm especially passionate about. Depression during pregnancy is serious, but many women can't safely take antidepressants. TMS offers a medication-free option that doesn't cross the placental barrier or affect the developing baby.

Older Adults — The lack of cognitive side effects makes TMS particularly valuable for elderly patients, many of whom can't tolerate medication side effects or ECT-related memory impairment.

Teenagers — Emerging research supports TMS safety in adolescents. For teens who haven't responded to therapy and whose parents are concerned about long-term medication effects, TMS offers an alternative.

Patients on Multiple Medications — Because TMS doesn't interact with other drugs, it's often the only viable option for patients already managing complex medication regimens.

Real Safety Is Functional Safety

Here's something I think about a lot: in medicine, we often talk about "clinical safety"—meaning the treatment won't kill you or cause organ damage. But for mental health treatments, we need a broader concept.

Functional safety asks different questions:

- Can you function normally after treatment?

- Can you drive, work, parent, create?

- Will this treatment impair your relationships, your libido, your memory, your ability to feel joy?

By these measures, TMS isn't just "safe." It's arguably the safest effective treatment we have for mood disorders.

It restores sleep instead of disrupting it.

It sharpens cognition instead of dulling it.

It elevates mood without altering consciousness.

It builds resilience instead of creating dependency.

The Research Behind TMS Safety

This isn't guesswork. TMS safety has been studied extensively:

65+ randomized controlled trials on TMS for depression alone
Millions of treatments delivered worldwide since FDA clearance
Long-term follow-up studies showing no delayed adverse effects
Meta-analyses consistently confirming the favorable safety profile

The FDA cleared TMS after rigorous review. Since then, additional indications have been added (OCD in 2018, anxious depression and smoking cessation in 2020) as the evidence base has grown.

Frequently Asked Questions About TMS Safety

Does TMS hurt?

Most patients describe TMS as unusual but tolerable—a tapping or clicking sensation on the scalp. Any discomfort typically decreases after the first few sessions as you acclimate to the treatment.

Can TMS damage your brain?

No. TMS uses magnetic fields similar in strength to an MRI machine. Unlike electroconvulsive therapy, it doesn't induce seizures or require anesthesia. Studies show no structural brain changes from TMS treatment.

Are TMS side effects permanent?

No. The common side effects (headache, scalp discomfort) are temporary and typically resolve within hours. There are no known long-term or permanent side effects from TMS.

Can you drive after TMS treatment?

Yes. You can drive yourself to and from appointments and return to all normal activities immediately after treatment. There's no sedation or impairment.

Is TMS safer than antidepressants?

In terms of side effect profile, yes. TMS causes no systemic side effects (weight gain, sexual dysfunction, GI issues) and has no withdrawal syndrome. The seizure risk is comparable to or lower than many common antidepressants.

The Bottom Line on TMS Safety

After years of delivering TMS and watching patients who had given up on treatment finally find relief, here's what I believe:

The biggest risk with TMS isn't the treatment itself—it's waiting too long to try it.

While you're cycling through medication after medication, dealing with side effects that compromise your quality of life, years pass. Relationships suffer. Careers stall. Life happens in a fog.

TMS offers something rare in psychiatry: a treatment that works without taking something else away. You get relief. You don't sacrifice yourself to get it.

Ready to Learn More?

At Kind Minds, we take safety seriously—starting with a thorough evaluation to ensure TMS is right for your specific situation. Our physician-led team will answer your questions honestly and help you make an informed decision.

Schedule Your Complimentary Consultation →

Medical Disclaimer: This content is for informational purposes only and does not constitute medical advice. Individual results vary. Always consult with a qualified healthcare provider before starting any treatment.

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