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When Does TMS Therapy Start Working?

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When Does TMS Therapy Start Working?

Many patients who try antidepressants and don’t find relief from their symptoms understandably feel frustrated. If they choose to try TMS, they’re often eager to know how long it will take until they start to feel better. 

What I always tell my patients is that, as with any treatment, it’s difficult to know exactly when someone will start to see relief from their symptoms, and that the time it takes to notice results with TMS depends on each patient. 

In this article, we’ll take a look at how long TMS treatment takes, when patients typically start to see a change in their depression symptoms, and how TMS compares to antidepressants when it comes to treatment time and time to results. 

How Long Does TMS Treatment Take?

At Madison Avenue TMS & Psychiatry, we administer TMS as a one-course treatment of 36 sessions over nine weeks. The first six weeks are considered the intensive part of TMS treatment. During the first six weeks, patients receive one TMS session five days a week. Each session takes roughly 20 minutes. The final three weeks are defined as a taper period. During the taper period, patients receive three TMS sessions in the seventh week, two sessions in the eighth week, and one final session in the ninth week.

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How Long Does It Take for TMS Therapy to Start Working?

Some of our patients here at Madison Avenue TMS & Psychiatry report feeling slightly better as early as two weeks into TMS therapy. Other patients don’t report a noticeable change in symptoms until about week four of treatment.

Like other depression treatments, the time it takes to notice a change in symptoms varies from patient to patient. If it takes longer to notice a change in your symptoms, this doesn’t mean that TMS isn’t working. Ultimately, the effects of TMS are the same, whether that takes two weeks or four weeks: long-lasting relief from depression symptoms.(1)

TMS vs. Antidepressants: Time to Results

Antidepressants are proven to effectively relieve depressive symptoms, especially for individuals with severe depression.(2) But not everyone will see results with antidepressants, and some people may spend months trying to find the right antidepressant that works for them. When it comes to antidepressants, some patients may start to see a change in their symptoms after two weeks. But for some, it can take up to 14 weeks before seeing the benefits of an antidepressant.(3)

Additionally, a course of treatment with antidepressants usually lasts for at least six to nine months after you start to feel better, and some patients (mostly those with recurring depression) may be instructed to take antidepressants indefinitely.

On the other hand, TMS is a nine-week course of treatment and has been shown to have long-lasting results. Research shows that 62.5% of patients who responded well to TMS continued to see the benefits of treatment for one year after their last session.(1) If symptoms start to return, patients may benefit from once-monthly TMS maintenance sessions

For patients who are anxious about leaving their antidepressant, TMS can be performed while taking antidepressants. TMS can augment or increase the effects of an antidepressant.(4) 

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1. Dunner DL, Aaronson ST, Sackeim HA, et al. A multisite, naturalistic, observational study of transcranial magnetic stimulation for patients with pharmacoresistant major depressive disorder: durability of benefit over a 1-year follow-up period. J Clin Psychiatry. 2014;75(12):1394-1401. Link. Accessed October 5, 2022.

2. Depression: How effective are antidepressants? — Institute for Quality and Efficiency in Health Care (IQWiG). Published January 28, 2015. Updated June 18, 2020. Link. Accessed October 24, 2022.

3. Machado-Vieira R, Baumann J, Wheeler-Castillo C, Latov D, Henter ID, Salvadore G, and Zarate CA. The timing of antidepressant effects: A comparison of diverse pharmacological and somatic treatments. Pharmaceuticals. January 2010 6;3(1):19-41. Link. Accessed October 24, 2022.

4. L Bangshan, Zhang Y, Zhang L, and Li L. Repetitive transcranial magnetic stimulation as an augmentative strategy for treatment-resistant depression, a meta-analysis of randomized, double-blind and sham-controlled study. BMC Psychiatry. 2014; 14: 342. Link. Accessed October 24, 2022.

Dr. David Woo

Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.

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