Frequently Asked Questions

TMS (Transcranial Magnetic Stimulation) is a non-invasive treatment that uses focused magnetic pulses to stimulate specific brain networks involved in mood, pain, and behavior. By delivering pulses at precise frequencies over several weeks, TMS encourages the brain to form new connections — a process called neuroplasticity — helping to "reset" circuits that aren't functioning properly. Sessions are brief, require no anesthesia, and you can drive yourself home immediately after.

TMS and ECT (electroconvulsive therapy) are both brain stimulation treatments for depression, but they differ significantly. TMS is non-invasive, requires no anesthesia, does not induce a seizure, and has minimal cognitive side effects — you can drive yourself home and return to work the same day. ECT requires general anesthesia, induces a controlled seizure, and can cause temporary memory and cognitive effects. Both are effective for depression, with ECT generally reserved for the most severe cases.

Yes. TMS has been FDA cleared for major depressive disorder since 2008 and for obsessive-compulsive disorder (OCD) since 2018. It is also used off-label at UCLA for conditions such as chronic pain, tinnitus, migraine, and PTSD, supported by clinical evidence.

Approximately two-thirds (~66%) of patients treated for depression report substantial benefit from TMS. For OCD, 50 to 60% of patients report improvement. For tinnitus, about 50% report meaningful reduction in symptoms. "Substantial benefit" means the patient reports that their symptoms are significantly better. Results vary by individual, and your UCLA psychiatrist will monitor your progress closely at every session.

At UCLA, a psychiatrist sees you at every session to monitor your progress and make any adjustments to your treatment plan as needed. That daily oversight also means complex cases — depression alongside conditions like pain, OCD, or tinnitus — are watched closely, faculty supervise every session as a teaching institution, and what we learn from each patient helps us keep improving care.

There is no permanent cure for depression — neither medications nor TMS permanently modify the brain to prevent future episodes. However, the benefits of TMS can last indefinitely, and one long-term study found 70% of patients who responded maintained improvement for at least a year. If symptoms return, retreatment using the same protocol is typically effective.

We typically start with standard approaches, such as 10 Hz stimulation to the left dorsolateral prefrontal cortex (LDLPFC), but may augment or change your treatment if you are not receiving substantial benefit. Even patients who don’t respond during treatment sometimes improve significantly in the weeks after the course ends.

No. TMS is non-invasive. Decades of research and thousands of patients show no structural brain damage from standard clinical protocols. TMS uses the same type of non-damaging energy as an MRI, but at lower intensity and focused on a small area of the brain rather than the whole body.

Most patients describe a firm tapping or clicking sensation on the scalp during treatment. This can be uncomfortable during the first few sessions but becomes much more tolerable as you get used to it. Your treatment team can adjust the coil position, use a topical numbing cream (lidocaine), or apply an ice pack to help with any discomfort. The vast majority of patients find treatment very manageable after the initial adjustment period.

Yes. TMS does not cause sedation or impair cognitive function in a way that affects driving. You can drive yourself to and from every appointment, and return to work or your normal activities immediately after each session.

Yes, caffeine is fine before TMS treatment. The important thing is to keep your caffeine habits consistent throughout the treatment course rather than dramatically changing your intake, as caffeine can affect brain excitability and your treatment calibration.

TMS does not cause memory loss. A very small number of patients report subtle, temporary word-finding difficulty during the active treatment course, but this resolves on its own. Most patients notice no cognitive effects at all, and many report improved clarity and focus as their symptoms improve.

Yes, continue all prescribed medications during TMS treatment. Consistent dosing is important — avoid making dramatic changes to your medication regimen before or during your TMS course. Some medications like benzodiazepines and anticonvulsants may theoretically reduce TMS effectiveness, but they are not contraindicated. Never stop or change your medications without consulting your prescribing doctor.

Missing an occasional session is okay. Try to reschedule within the same week if possible. The key is completing the full course of treatment (30 to 36 sessions), even if scheduling varies. You do not need to have treatment at the same time each day, and our team offers flexible scheduling across all three of our locations.

We generally recommend continuing medications that were part of your treatment. Medication changes should always be made in consultation with your prescribing psychiatrist — not unilaterally after TMS. Some patients do successfully reduce medication under physician guidance, but changes made without oversight can lead to relapse.

In general, continue your prescribed medications and avoid making dramatic changes during treatment. Consistent dosing is important. It’s best to avoid taking sedating medications within a few hours of your TMS session if possible, but let your treatment team know what you’re taking so we can calibrate accordingly.

TMS is FDA cleared for major depressive disorder (since 2008) and obsessive-compulsive disorder (since 2018). UCLA also offers TMS as an advanced therapy for chronic pain (fibromyalgia, neuropathy, nerve injury), tinnitus, migraine, PTSD, auditory hallucinations, chronic fatigue, and other conditions where clinical evidence supports its use.

TMS for depression (major depressive disorder) is covered by the vast majority of major insurance plans, including Medicare, and TMS is FDA-cleared for both depression and OCD. Coverage for any individual situation depends on your specific plan and diagnosis — our care management team and insurance specialists will verify your benefits and guide you through the process. Learn more about insurance coverage.

When a treatment isn't covered by your insurance, UCLA offers self-pay options. Our care management team and insurance specialists will review your benefits and explain your options — speak with our clinic intake coordinators and care managers for more information.

TMS is not an established standalone treatment for generalized anxiety disorder or panic attacks. However, anxiety is a very common symptom of depression — and when anxiety is part of depression, it does respond to TMS treatment. Many of our patients report significant improvement in anxiety alongside their mood.

Yes, we have successfully treated many patients with bipolar depression. Insurance typically does not cover TMS for bipolar depression. As with any antidepressant treatment, there is a small risk of triggering mania or hypomania, so patients are usually prescribed a concurrent mood stabilizer.

TMS results can last for months to years. One study found that 70% of patients who responded to TMS maintained their benefit for at least one year. Some patients have not had another depressive episode for many years after treatment. If symptoms do return, retreatment with the same protocol is typically effective. Your psychiatrist may also recommend occasional maintenance sessions (typically 2 to 4 per month) to help sustain your improvement.

The most common side effects are mild and temporary. Scalp discomfort or a tapping sensation at the treatment site typically decreases over the first few sessions. Some patients experience headache similar to a tension headache, easily treated with over-the-counter pain medication. Mild fatigue may occur but rarely interferes with daily activities. All of these side effects typically resolve within the first week of treatment.

The risk of seizure with TMS is extremely low — about 1 in 50,000 sessions or fewer. It exists only during the delivery of pulses, not after or between sessions. During your evaluation we review any related risk factors and coordinate with your care team as needed.

Like all antidepressant treatments, there is a small possibility that symptoms could temporarily worsen. This is unusual and entirely reversible. If it occurs, your UCLA psychiatrist — who meets with you at every single session — will promptly adjust your treatment parameters or change the protocol. This close monitoring is one of the key advantages of receiving TMS at UCLA.

Accelerated TMS delivers the same total treatment — and achieves the same benefits — as a standard 6-week course, but condensed into just 5 days. Multiple theta burst stimulation sessions are delivered each day, separated by rest periods of at least one hour. This "5x5" protocol is ideal for patients who cannot commit to weeks of daily visits. Accelerated TMS is generally available on a self-pay basis; our care management team can review your options. Learn more about accelerated TMS.