Understanding TMS Fatigue and Other Side Effects of Transcranial Magnetic Stimulation

A Brief History and FDA Approval of TMS

When compared to traditional depression treatments, TMS stands out for its safety. Unlike antidepressants, which affect the entire body and can cause issues like weight gain or sexual side effects, TMS works only on specific regions of the brain.

And unlike electroconvulsive therapy, it requires no anesthesia, no hospital stay, and no recovery time. It's non-invasive, targeted, and entirely drug-free.

While some patients notice mild side effects, such as temporary TMS fatigue or slight scalp discomfort, these are far gentler than those linked to medication. Most people leave their sessions feeling clear-headed and can immediately return to work, errands, or anything else their day has in store.

Like any form of therapy, TMS can come with a few side effects. But the good news is that they're almost always mild and temporary. Here are the most common ones and what to expect:

• Mild scalp discomfort or tenderness: You may feel slight pressure or sensitivity where the coil rests, but this typically eases within minutes after a session.
• Headaches or tension-type pain: Some patients experience mild headaches early on, similar to muscle tension, which can be relieved with over-the-counter pain medication.
• Facial tingling or twitching: Small, brief twitches in the face or jaw are common and harmless responses to the magnetic pulses.
• Temporary sleep changes: Your sleep patterns may shift slightly at first, but tend to normalize as treatment continues.
• TMS fatigue or brief mental tiredness: Feeling mentally drained after a session can happen as your brain adapts to increased activity. It's usually a good sign of progress.

Occasionally, patients experience a short "TMS dip," a temporary phase of worsened mood or fatigue that resolves as the brain rewires and begins to heal.

What Causes TMS Fatigue?

In most cases, TMS fatigue occurs simply because your brain is working overtime. As Transcranial Magnetic Stimulation increases activity in mood-related regions, your neurons begin firing more often and using more energy (much like your muscles do after a good workout). This can leave you feeling mentally tired or a bit foggy after sessions.

Other factors can contribute too, such as tension headaches or mild pain, not getting enough sleep or hydration, longer or more frequent sessions, or even the emotional release that comes with therapy.

The important thing to remember is that TMS fatigue isn't a red flag to worry about. It's usually a normal, temporary part of the brain's healing process, showing that new neural connections are forming and strengthening. But if you have concerns, always bring them up to your medical provider.

Rare but Serious Side Effects of TMS

While Transcranial Magnetic Stimulation is considered very safe, a few rare side effects are worth mentioning. The most serious, though extremely uncommon, is a seizure, which occurs in less than 0.1% of patients and is largely prevented through careful screening and safety measures.

Manic episodes may occur in individuals with bipolar disorder, which is why a complete psychiatric history is reviewed before treatment begins.

Occasionally, persistent headaches or hearing issues can develop if proper ear protection isn't used during sessions. Fortunately, clinics must follow strict protocols to minimize these risks, making serious complications from TMS exceptionally rare.

While TMS fatigue and other mild side effects are common early in treatment, there's plenty you can do to feel your best throughout the process.

• Stay hydrated: Drink plenty of water before and after each session to help your brain and body recover more efficiently.
• Prioritize sleep: Aim for 7–8 hours of rest each night so your brain has time to recharge and process new neural activity. Sleep is when our bodies heal and recover.
• Practice relaxation or mindfulness: Deep breathing, meditation, or light stretching before your session can help reduce tension and anxiety.
• Eat balanced meals: Fuel your body with nutritious foods and avoid caffeine right before treatment to prevent jitters or restlessness.
• Communicate with your provider: If you experience discomfort or persistent fatigue, ask your clinician about adjusting the coil position or stimulation intensity.
• Incorporate light exercise: Gentle movement, like walking or yoga, promotes circulation and reduces sluggishness.
• Stick to a consistent routine: Regular sleep, meals, and relaxation habits help stabilize energy levels and ease TMS fatigue as your brain adapts to treatment.

When to Contact a Doctor About TMS Side Effects

Although TMS fatigue and other side effects are usually mild, it's important to know when to reach out for extra support. Contact your provider if you experience severe or persistent headaches, fatigue that lasts for several days, or noticeable mood changes like increased anxiety or thoughts of self-harm. You should also report any unusual physical sensations or signs of seizure activity, even if they seem minor.

Don't wait or try to push through. Early communication allows your clinician to make quick adjustments to guarantee your treatment stays comfortable and effective.

This is paragraph text. Click it or hit the Manage Text button to change the font, color, size, format, and more. To set up site-wide paragraph and title styles, go to Site Theme.