How Successful Is TMS in Treating Depression?

Transcranial magnetic stimulation (TMS) is clinically proven to safely and effectively relieve depressive symptoms, even in patients with treatment-resistant depression. Studies have shown that TMS success rates for depression are around 75%, i.e., 3 out of 4 patients experience relief from their symptoms, with half of patients achieving remission (1). Not only is TMS successful in alleviating symptoms of treatment-resistant depression, but the results are also long-lasting.

Happy couple - TMS success rates

More Effective Than Antidepressants


A comparison of two landmark studies shows that TMS is 2 to 4 times more effective in relieving depressive symptoms in patients with treatment-resistant depression than antidepressants (1,2).

Long-Term Results


62.5% of people who found relief with TMS continued to have fewer depression symptoms one year after treatment (3).

To reach these TMS therapy success rates, a nine-week course of treatment is required. In some cases, maintenance sessions are needed. For some patients, depression symptoms may return in the future. These patients may require a second course of TMS.


TMS Success Rates For Anxiety

Although TMS for anxiety is not as widely studied as its application for depression, research shows promising TMS success rates for anxiety, whether that be comorbid anxiety with depression (known as anxious depression) or general anxiety disorder (GAD).

For instance, one investigation found that 11 out of 13 (84.6%) of individuals diagnosed with GAD exhibited a positive response to TMS treatment, achieving a state of remission (4). In another study, which used low-frequency TMS, the patient experienced a remarkable reduction in anxiety and panic symptoms, with a notable decrease of 78% in symptom severity (5). This suggests that TMS can be a valuable treatment option for individuals struggling with all forms of anxiety.


TMS Success Rates For OCD

Obsessive-compulsive disorder (OCD) affects about 2.3% of adults in the US and is typically treated with talk therapy and selective serotonin reuptake inhibitors (SSRIs) (6). However, studies have shown that 40% to 60% of patients with OCD do not find SSRIs effective; furthermore, these medications can come with undesirable or intolerable symptoms (7).

In the case of individuals who had experimented unsuccessfully with three or more OCD medications , TMS demonstrated marked superiority over a placebo intervention. In TMS trials, the placebo group underwent “sham” TMS procedures. “Sham” procedures were identical to actual TMS but lacked the actual delivery of magnetic pulses to the brain. In this context, 8% of placebo recipients reported some degree of symptom improvement, while 41% of those subjected to genuine TMS reported feeling better (8).

In a comprehensive study conducted across 22 different clinics and hospitals, 57.9% of patients found relief following 29 sessions of TMS, with symptoms typically alleviating from around the 20th session (9).

Another study proposed that deep TMS may be more effective for patients with severe OCD compared to those with mild-to-moderate symptoms (10).

These proven TMS success rates for OCD have contributed to the FDA approval of Deep TMS, as administered by Madison Avenue TMS & Psychiatry, for treatment-resistant OCD.


TMS Success Rates For PTSD

In the case of TMS success rates for PTSD, the treatment has also demonstrated promise. Lifetime prevalence of post-traumatic stress disorder in the US is estimated to be around 6% in the general population and almost double that figure for military veterans returning from active duty (11, 12). As PTSD symptoms are related to and often comorbid with those of anxiety and depression, researchers have investigated whether TMS is also an effective treatment for PTSD, with positive results.

A recent review of the state of TMS treatment for PTSD analyzed the existing literature on using different TMS techniques (right- vs. left- vs. bilateral brain stimulation) and found that TMS usually reduced PTSD symptoms, on average, by about 25%-35%, with response rates between 41 and 62.5% (13).

In another study, 9 patients were exposed to images related to their PTSD trigger before undertaking TMS therapy, with 4 patients (44% total) experiencing improvements and 5 patients (39% total) experiencing remission (14). A 2018 study on military veterans also recorded a 39% success rate using TMS to treat PTSD (15).


What Affects TMS Treatment Success Rates?

The success rate of TMS therapy can vary, but TMS is highly effective for a wide range of people.

Are you a candidate for TMS?

However, some studies have indicated that a few factors may make a person more or less likely to respond to TMS treatment:

  • Age: Patients younger than 60 have been shown to respond better to TMS (17).
  • Personality: People with higher persistence scores (people who are persistent tend to persevere even when frustrated or tired) on the Temperament and Character Inventory (TCI) personality questionnaire respond more quickly to TMS (18). Robert Cloninger’s Temperament and Character Inventory is used by psychiatrists worldwide to identify and group personality types (19).
  • Treatment-Resistance Level: Patients less resistant to antidepressant medications respond more positively to TMS (20). (Though studies suggest that people who are resistant to antidepressants may respond more positively to TMS than to antidepressants.)
  • Taking an Antidepressant at the Same Time: If you’re taking an antidepressant while undergoing TMS, TMS may make the antidepressant more effective, meaning better overall results (20,21).

TMS is not recommended for patients who have a history of seizures or seizure disorders, or who have a permanent metal implant in their head.


Madison Avenue TMS Success Rates

At Madison Avenue TMS & Psychiatry, our TMS depression success rates are consistent with national results. Among our patients, 70% of our patients have responded to TMS therapy, while 40% have achieved remission. Our results were analyzed using technical measurements from the PHQ-9 (Patient Health Questionnaire-9) depression scale.

70% Respond to treatment


Response to TMS treatment is indicated when PHQ-9 depression scores are reduced by at least 50 percent.

40% Achieve remission


Remission from depressive symptoms is indicated when PHQ-9 depression scores fall below a 5 on a 27 point scale.

Learn more about depression treatment in NYC on our website or contact us online to ask a question about TMS therapy success rates.

Are you a candidate for TMS?

TMS Success Rates FAQ

How to make TMS more effective?

There are several ways to enhance the effectiveness of Transcranial Magnetic Stimulation (TMS). These include optimizing treatment parameters, personalizing treatment plans, and combining TMS with other therapies when appropriate.

  • Optimizing parameters for personalized treatment: TMS treatment involves adjusting parameters like frequency, intensity, and duration, as well as targeting the precise brain region for maximum effect. During TMS sessions, your doctor will be present to calibrate the TMS coil according to what will work best for you.
  • Combination therapies: TMS does not have to be taken on its own. In some cases, combining TMS with other treatments like psychotherapy or medication can lead to more significant improvements in certain mental health conditions.

What happens if TMS doesn’t work?

If TMS doesn’t produce the desired results, it may be that more sessions are required, a ‘booster’ course may be needed if symptoms return after some time has passed, or that it is time to explore alternative treatment options.

If you feel that TMS is not working for you, consult with your doctor to take appropriate action. Next steps may include:

  • Reevaluation: TMS treatment involves adjusting parameters like frequency, intensity, and duration, as well as targeting the precise brain region for maximum effect. During TMS sessions, your doctor will be present to calibrate the TMS coil according to what will work best for you.
  • Exploring other therapies: TMS does not have to be taken on its own. In some cases, combining TMS with other treatments like psychotherapy or medication can lead to more significant improvements in certain mental health conditions.
  • Combination therapies: Combining TMS with other treatments, as mentioned earlier, is an option that may work for some patients.

What is the failure rate in TMS?

The “failure rate” in TMS can mean different things depending on how “failure” is measured. For example, instead of saying that TMS has a 75% success rate, we could say it has a 25% failure rate. While TMS is safe, with most people reporting minor side effects, its effectiveness varies from person to person. Many TMS patients experience full remission, while others may experience only partial improvement.

What is the success rate of NeuroStar TMS?

The success rate of NeuroStar TMS can vary depending on the specific clinical trials and the criteria used to define success. According to one real-world study conducted on patients with major depressive disorder (MDD), the NeuroStar TMS device achieved a 63% remission rate among patients (22). NeuroStar TMS is one of the FDA-approved TMS devices for the treatment of major depressive disorder.

What is the success rate of BrainsWay dTMS?

The success rate of BrainsWay deep transcranial magnetic stimulation (dTMS) has been documented by numerous clinical trials that paved the way for the FDA approval of the BrainsWay Deep TMS device for depression and OCD.

In a study involving more than 1,000 individuals receiving Deep TMS treatment for major depressive disorder (MDD), it was observed that approximately 75% of participants achieved a clinical response, with nearly half of the patients achieving full remission. Moreover, BrainsWay’s Deep TMS technology has undergone clinical validation for the treatment of OCD, with remission rates of over 75% (23).


Resources:
  1. Carpenter LL, Janicak PG, Aaronson ST, et al. Transcranial magnetic stimulation (TMS) for major depression: A multisite, naturalistic, observational study of acute treatment outcomes in clinical practice. Depression and Anxiety. July 2012;29(7):587-96. Link. Accessed September 17, 2023.
  2. Gaynes BM, Rush AJ, Madhukar HT, Wisniewski SR, Spencer D, Maurizio F. The STAR*D study: Treating depression in the real world. Cleveland Clinic Journal of Medicine. Jan 2008;75(1):57-66. Link. Accessed September 17, 2023.
  3. 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):1394-401. Link. Accessed September 17, 2023
  4. White D, Tavakoli S. Repetitive transcranial magnetic stimulation for treatment of major depressive disorder with comorbid generalized anxiety disorder. Ann Clin Psychiatry. 2015 Aug;27(3):192-6. Link. Accessed September 17, 2023
  5. Zwanzger, P., Minov, C., Ella, R., Schüle, C., Baghai, T., Möller, H., Rupprecht, R., & Padberg, F. Transcranial Magnetic Stimulation for Panic. American Journal of Psychiatry. 2002;159(2):315. Link. ccessed September 17, 2023.
  6. Harvard Medical School. National Comorbidity Survey (NCSSC). (2017). Link. Accessed September 17, 2023
  7. Del Casale A, Sorice S, Padovano A, Simmaco M, Ferracuti S, Lamis DA, Rapinesi C, Sani G, Girardi P, Kotzalidis GD, Pompili M. Psychopharmacological treatment of obsessive-compulsive disorder (OCD). Curr Neuropharmacol. 2019;17(8):710-736. Link. Accessed May 7, 2023.
  8. Roth Y, Barnea-Ygael N, Carmi L, Storch EA, Tendler A, and Zangen A. Deep transcranial magnetic stimulation for obsessive-compulsive disorder is efficacious even in patients who failed multiple medications and CBT. Psychiatry Research. 2020;290:113179. Link. Accessed May 3, 2022.
  9. Roth et. al. Real-world efficacy of deep TMS for obsessive-compulsive disorder: Post-marketing data collected from twenty-two clinical sites. Journal of Psychiatric Research. 2021;137:667-672. Link. Accessed May 3, 2022.
  10. Nye J. Deep Transcranial Magnetic Stimulation Benefited Patients With Severe Symptoms of Obsessive Compulsive Disorder. Psychiatry Advisor. Link. Accessed May 3, 2022.
  11. Goldstein RB, Smith SM, Chou SP, et al. The epidemiology of DSM-5 posttraumatic stress disorder in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions–III. Soc Psychiatry Psychiatr Epidemiol 2016; 51: 1137–1148. Link. Accessed Septmber 17, 2023.
  12. Hoge CW, Castro CA, Messer SC, et al. Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. N Engl J Med 2004; 351: 13–22. Link. Accessed Septmber 17, 2023.
  13. Petrosino, N. J., Cosmo, C., Berlow, Y. A., Zandvakili, A., & Philip, N. S. Transcranial magnetic stimulation for post-traumatic stress disorder. Therapeutic Advances in Psychopharmacology, 2021;11. Link. Accessed Septmber 17, 2023.
  14. Isserles, M., Shalev, A. Y., Roth, Y., Peri, T., Kutz, I., Zlotnick, E., & Zangen, A. Effectiveness of Deep Transcranial Magnetic Stimulation Combined with a Brief Exposure Procedure in Post-Traumatic Stress Disorder – A Pilot Study. Brain Stimulation. 2013;6(3), 377-383. Link. Accessed Septmber 17, 2023.
  15. Yesavage JA, Fairchild JK, Mi Z, et al. Effect of Repetitive Transcranial Magnetic Stimulation on Treatment-Resistant Major Depression in US Veterans: A Randomized Clinical Trial. JAMA Psychiatry. 2018;75(9):884–893. Link. Accessed Septmber 17, 2023.
  16. Pallanti S, Cantisani A, Grassi G, Antonini S, Cecchelli C, Burian J, Cauli G, and Quercioli L. rTMS age-dependent response in treatment-resistant depressed subjects: a mini-review. CNS Spectrums. March 2012;17(1):24-30. Link. Accessed September 17, 2023.
  17. Siddiqi SH, Chockalingam R, Cloninger R, Lenze EJ, and Cristancho, P. Use of the temperament and character inventory to predict response to repetitive transcranial magnetic stimulation for major depression. Journal of Psychiatric Practice. May 2016;22(3):193-202. Link. Accessed September 17, 2023.
  18. Mochcovitch MD, Nardi AE, and Cardoso A. Temperament and character dimensions and their relationship to major depression and panic disorder. Braz J of Psychiatry. Link. Accessed September 17, 2023.
  19. Fregni F, Marcolin MA, Myczkowski M, Amiaz R, Hasey G, Rumi DO, Rosa M, Rigonatti SP, Camprodon J, Walpoth M, Heaslip J, Grunhaus L, Hausmann A, and Pascual-Leone A. Predictors of antidepressant response in clinical trials of transcranial magnetic stimulation. The International Journal of Neuropsychopharmacology.December 2006;9(6):641-54. Link. Accessed September 17, 2023.
  20. Bangshan L, 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 September 17, 2023.
  21. Rumi DO, Gattaz WF, Rigonatti SP, Rosa MA, Fregni F, Rosa MO, Mansur C, Myczkowski ML, Moreno RA, Marcolin MA. Transcranial magnetic stimulation accelerates the antidepressant effect of amitriptyline in severe depression: a double-blind placebo-controlled study. Biological Psychiatry. 2005 Jan 15;57(2):162-6. Link. Accessed September 17, 2023.
  22. Sackeim HA, et al. Clinical Outcomes in a Large Registry of Patients with Major Depressive Disorder Treated with Transcranial Magnetic Stimulation. J Affective Disorders. 2020; 277(12):65-74. Link. Accessed September 17, 2023.
  23. What evidence exists for deep TMS effectiveness? Brainsway. Link. Accessed September 17, 2023.