Repetitive transcranial magnetic stimulation (rTMS) is usually done on an outpatient basis in a doctor's office or clinic. It requires a series of treatment sessions to be effective. Generally, sessions are carried out daily, five times a week for four to six weeks.
Your first treatment
Before treatment begins, your doctor will need to identify the best place to put the magnets on your head and the best dose of magnetic energy for you. Your first appointment typically lasts about 60 minutes.
Most likely, during your first appointment:
- You'll be taken to a treatment room, asked to sit in a reclining chair and given earplugs to wear during the procedure.
- An electromagnetic coil will be placed against your head and switched off and on repeatedly to produce stimulating pulses. This results in a tapping or clicking sound that usually lasts for a few seconds, followed by a pause. You'll also feel a tapping sensation on your forehead. This part of the process is called mapping.
- Your doctor will determine the amount of magnetic energy needed by increasing the magnetic dose until your fingers or hands twitch. Known as your motor threshold, this is used as a reference point in determining the right dose for you. During the course of treatment, the amount of stimulation can be changed, depending on your symptoms and side effects.
During each treatment
Once the coil placement and dose are identified, you're ready to begin. Here's what to expect during each treatment:
- You'll sit in a comfortable chair, wearing ear plugs, with the magnetic coil placed against your head.
- When the machine is turned on, you'll hear clicking sounds and feel tapping on your forehead.
- The procedure will last about 40 minutes, and you'll remain awake and alert. You may feel some scalp discomfort during the treatment and for a short time afterward.
After each treatment
You can return to your normal daily activities after your treatment. Typically, between treatments, you can expect to work and drive.
There are different ways to perform the procedure. Techniques may change as experts learn more about the most effective ways to perform treatments.
Aug. 10, 2017
- Brain stimulation therapies. National Institute of Mental Health. http://www.nimh.nih.gov/health/topics/brain-stimulation-therapies/brain-stimulation-therapies.shtml. Accessed Sept. 21, 2015.
- Repetitive transcranial magnetic stimulation (rTMS). National Alliance on Mental Illness. https://www2.nami.org/Template.cfm?Section=About_Treatments_and_Supports&Template=/ContentManagement/ContentDisplay.cfm&ContentID=164338. Accessed Sept. 21, 2015.
- Holtzheimer PE. Unipolar depression in adults: Treatment with transcranial magnetic stimulation (TMS). http://www.uptodate.com/home. Accessed Sept. 21, 2015.
- Janicak PG, et al. Transcranial magnetic stimulation for the treatment of major depression. Neuropsychiatric Disease and Treatment. 2015;11:1549.
- Research report: Psychiatry and psychology, 2014-2015. Mayo Clinic. http://www.mayo.edu/pmts/mc0700-mc0799/mc0710-11.pdf. Accessed Sept. 22, 2015.
- AskMayoExpert. Transcranial magnetic stimulation. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
- Wall C, et al. Neurocognitive effects of repetitive transcranial magnetic stimulation in adolescents with major depressive disorder. Frontiers in Psychiatry. 2013;4:165.
- Kung S (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 29, 2015.
- Croarkin PE (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 26, 2015.
Transcranial magnetic stimulation