What is TMS treatment?

TMS (transcranial magnetic stimulation) is a non-invasive treatment that is used for the treatment of major depression, OCD, PTSD, and many other conditions. During treatment, a coil placed over the head sends magnetic currents through the scalp and skull to activate neurons in areas of the brain that are believed to be in control of mood regulation.

Before any pulses are administered, TMS therapy requires extensive mapping of an individual’s brain to better target where the electric currents should be applied for best results.

Tms therapy process

4.5 million


4.5 million people in the United States who have depression don’t benefit from antidepressants.

In 2008


In 2008, TMS was approved by the FDA as an alternative.

1.5 million


1.5 million TMS treatments have been delivered to 60,000 patients to date.

in 19 minutes


Treatment is delivered in 19 minutes.

Authorized by the US Food and Drug Administration in 2008, TMS is an outpatient treatment, administered without the need for anesthesia, that allows patients to return to normal activity directly following treatment. Side effects reported after treatment are minimal, with most patients only experiencing minor discomfort. Patients undergoing TMS are not required to participate in any additional medication regimen.

At Madison Avenue TMS & Psychiatry, your care is our highest priority. We are dedicated to providing you with all the necessary tools and information that will make your TMS therapy as comfortable and effective as possible.

Our friendly staff is available to address any of your questions or concerns every step of the way. They will help you understand how TMS is used in the treatment of depression, what to expect from TMS therapy, and support you in your mental health journey.

How Does TMS Work in the Brain to Treat Depression?

  • We use the BrainsWay transcranial magnetic stimulator to direct magnetic pulses to a specific area of the brain involved in mood regulation called the dorsolateral prefrontal cortex (or DLPFC).
  • An electric current passes through a magnetic coil positioned over the head, generating a magnetic field that stimulates neurons (nerve cells) in the brain that are thought to be underactive in a person with depression.
  • TMS requires multiple treatment sessions over a period of 9 weeks. Over time, TMS allows neurons to change the way they communicate with each other, forming new communication pathways and new patterns of behavior.

Learn more about what happens in the brain after a TMS session.

Who Can Benefit from TMS

TMS is recommended for patients who:

  • Have tried various rounds of different medications and psychotherapy with no relief from their symptoms
  • Wish to avoid the side effects of medication (such as sexual dysfunction and weight gain)
  • Are planning to become pregnant
  • Do not have a seizure disorder or a history of seizures
  • Do not have any metal implant within the head

How Effective Is TMS Treatment?

30 clinical trials with 2,000 patients showed TMS to be effective for treating depression

In real world naturalistic studies, between 58% and 75% of patients treated with TMS experienced significant improvement1

Recorded data for over 1000 participants undergoing a course of Deep TMS treatment for MDD, one out of two achieving remission of the patients went into remission, which is the full relief of their symptoms

People treated with TMS were 2-4 times more likely to achieve remission from depression symptoms, compared to people treated with antidepressants alone3

62.5% of people treated with TMS who experienced relief continued to show improvement after 1 year4


What to Expect from TMS Therapy, from Start to Finish

TMS therapy screening - phone

Preliminary Phone Screening

If you’re interested in finding out whether TMS treatment is right for you, please take our quiz. If you’d like to commence treatment, please contact us for a preliminary phone screening.

During this initial conversation, we will gather some basic information and ask about your insurance coverage, as well as answer any questions you may have about undergoing TMS therapy. Once we’ve contacted your insurance company, we will reach out to you again to discuss insurance coverage/payment options.

TMS treatment evaluation

Pre-Treatment Evaluation

This consultation is a chance for Dr. David Woo to get to know you, your symptoms, and your medical history to determine if TMS therapy is the best treatment option for you, and to tell you more about the TMS treatment process. After this appointment, we will submit a pre-authorization to your insurance company and coordinate your insurance coverage. We are also able to work with you to arrange an out-of-pocket payment plan, if necessary.

TMS brain mapping treatment

Brain Mapping + First Treatment

The first step for successful TMS treatment is effective mapping of the patient’s brain to determine which point on the head should receive stimulation. During the mapping session, the technician will use the TMS device to send magnetic pulses and register the brain’s response until the optimal point is identified. This visit will take approximately 45 minutes, and includes both the mapping process and the first TMS treatment.

TMS treatment weekly course

6-Week Treatment Course

Patients come in for treatment five days per week (Monday-Friday) for six weeks. After mapping, subsequent treatment sessions last approximately 20 minutes. Our treatment rooms are designed for your comfort, and we invite you to relax, watch television, or listen to your favorite music during sessions. Patients are asked to complete a weekly evaluation to measure progress. If determined necessary at any point during treatment, the technician may perform a re-mapping to improve treatment effectiveness.

TMS weekly taper period

3-Week Taper Period

After the six-week treatment course, there is a three-week taper period. Patients will need to come into the office for three TMS sessions in the seventh week, two sessions in the eighth week, and one final session in the ninth week.


Conditions that Transcranial Magnetic Stimulation (TMS) Can Treat

In the United States, TMS is only FDA-approved for treatment-resistant major depressive disorder (MDD) and obsessive-compulsive disorder (OCD). However, many clinical trials have shown that TMS can safely and effectively treat other conditions, such as:

  • Anxiety
  • PTSD (post-traumatic stress disorder)
  • Parkinson’s disease
  • ADHD
  • Addiction/substance abuse disorders
  • Alcohol addiction
  • Tobacco/nicotine addiction

Learn more about other conditions TMS can treat.

Myths and Facts

TMS and ECT are the same procedure.

TMS is not the same as electroconvulsive therapy (ECT, formerly called “electroshock therapy” or “shock treatment”). While both therapies are used to treat major depression, ECT is usually administered in a hospital with anesthesia, which adds to the risk and recovery time of the procedure. Most physicians recommend ECT as an emergency measure because it is invasive and can lead to serious side effects, like memory loss. TMS is a different form of brain stimulation. It’s a non-invasive outpatient procedure that has demonstrated few to no side effects.


TMS isn’t safe.

The safety and effectiveness of TMS have been supported by over 30 medical studies and multiple meta-analyses. It was approved by the FDA in October of 2008 and is widely considered a very low-risk procedure by the medical community as TMS does not require anesthesia and can be performed as an outpatient procedure.

Most patients only report minor discomfort as a side effect and can continue their life as usual directly following each procedure.

Other reported side effects of TMS treatment include:

  • Difficulty sleeping
  • Eye pain
  • Facial pain/toothache
  • Muscle twitch

In very rare cases (0.1%), patients may experience seizures after treatment. But it is important to note that no adverse cognitive effects, including memory loss, have been reported following TMS.

Patients and caregivers should be vigilant of behavioral changes during treatment — especially if they notice an increase in suicidal thoughts or behavior, or depression symptoms worsen.

Overall, the side effects of TMS treatment are few and low in severity when compared to the commonly-reported side effects of antidepressant medications. TMS provides a safe and effective alternative to these treatment methods. Learn more about TMS therapy success rates.


Nothing has worked for me, so TMS won’t work either.

TMS is recommended for patients who have tried many other therapies – including multiple medications and psychotherapy – with no relief. Clinical data for over 1000 participants undergoing a course of Deep TMS treatment for MDD, some 75% of participants achieved a clinical response, with one out of two achieving remission.


TMS isn’t covered by insurance.

Nearly all major insurance providers offer coverage for TMS. Even if we’re not in-network with your insurance plan, we can negotiate coverage as an out-of-network provider in most cases. Learn more about TMS and insurance here. You can also learn more about TMS therapy costs.


Frequently Asked Questions on TMS Treatment

1. What are the side effects of TMS?

There are only a few (usually minor) side effects reported by patients, and the majority of patients do not stop treatment due to them. The most common side effect reported by patients is slight pain or discomfort in the treatment area, usually only reported in the first week. Learn more about the potential side effects of TMS.

2. What can I do and not do after a TMS session?

You can return to your normal daily activities immediately after each TMS session.

3. Can TMS be combined with other depression treatments, like my current medication?

TMS can be combined with most antidepressant medications, but Dr. Woo will evaluate all of your current medications and their compatibility during your pre-treatment evaluation appointment. You’re welcome to continue any psychotherapy you’re currently undergoing, or if you’re interested, we can offer you psychotherapy and medication management.

4. When will I start to see results with TMS?

The time it takes to see results with TMS will vary from patient to patient. Some patients report an improvement in depression symptoms in as little as 2 weeks, while others don’t notice an improvement until week 4 or 5. Patients who take longer to notice symptom relief are still receiving effective treatment and can still experience long-lasting relief from their depression symptoms. Learn more about what can affect your time to results.

5. How long do TMS results last?

How long the effects of TMS last will vary from patient to patient. Studies show that patients who achieve remission from depression are more likely to continue to show signs of remission or response to treatment even one year after completing a round of treatment. In some cases, patients may need a maintenance session of TMS. Learn more about what influences how long TMS results can last.

6. Who will I interact with during treatment?

Throughout therapy at Madison Avenue TMS & Psychiatry, you will see a technician at each of your appointments, who will guide you through each treatment. Dr. Woo will check in on your progress at least weekly, and he’s available for additional check-ins anytime you’d like.

7. Is TMS right for me?

TMS is considered when patients do not see improvement in depression symptoms after trying at least 2 types of antidepressants. TMS cannot be administered to patients who have implanted metallic devices in or around the head (such as aneurysm clips or coils and electrodes that monitor brain activity) or who have electrical implants (such as pacemakers and ICDs). Learn more about who is a good candidate for TMS.


What is rTMS?

Repetitive transcranial magnetic stimulation (rTMS) is a painless, noninvasive treatment for depression in which coils are placed above the patient’s head to administer repetitive electromagnetic pulses to specific areas of the brain. The rTMS procedure is used to create changes in the centers of the brain that control mood regulation and depression, leading to the alleviation of depression symptoms in those who undergo it.

How does rTMS therapy differ from TMS?

In a clinical setting, there’s no difference. All TMS therapy programs that are available to patients for the treatment of depression are technically rTMS, even though physicians typically drop the “r” and refer to them as “TMS.”

Even though the names differ, the treatment program and benefits for patients are exactly the same. If you want to know more about rTMS, click here.


Resources:
  1. Carpenter LL et al. Transcranial magnetic stimulation (TMS) for major depression: a multisite, naturalistic, observational study of acute treatment outcomes in clinical practice. Depress Anxiety. Link. 2012;29(7):587-96.
  2. O’Reardon JP et al. Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: A multisite randomized controlled trial. Biol Psychiatry. Link. 2007; 62(11):1208-16.
  3. George MS et al. Daily Left Prefrontal Transcranial Magnetic Stimulation Therapy for Major Depressive Disorder. Arch Gen Psychiatry. Link. 2010;67(5):507-16.
  4. Dunner DL 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. Link. 2014;75(12):1394-401.
  5. L.Carmi et al. Deep Transcranial Magnetic Stimulation (TMS) in Obsessive Compulsive Disorder (Ocd) Patients. European Psychiatry. Published March 2015. Link. Accessed July 09, 2020.
  6. Paulesu E, Sambugaro E, Torti T, Danelli L, Ferri F, Scialfa G, Sberna M, Ruggiero GM, Bottini G, Sassaroli S. Neural correlates of worry in generalized anxiety disorder and in normal controls: a functional MRI study. Psychological Medicine. 2010;40(1):117-124. Link. Accessed July 09, 2020.
  7. Namgung E, Kim M, and Yoon S. Repetitive transcranial magnetic stimulation in trauma-related conditions. Neuropsychiatric Disease and Treatment. 2019;15:701–712. Link. Accessed July 09, 2020.
  8. Khedr EM, Al-Fawal B, Abdel Wraith A, Saber M, Hasan AM, Bassiony A, Nasr Eldein A, Ahmeda, and Rothwell JC. The Effect of 20 Hz versus 1 Hz Repetitive Transcranial Magnetic Stimulation on Motor Dysfunction in Parkinson’s Disease: Which Is More Beneficial? Journal of Parkinson’s Disease. 2019;9(2):379-387. Link. Accessed July 09, 2020.
  9. Cao P, Xing J, Cao Y, Cheng Q, Sun X, Kang Q, Dai L, Zhou X, and Song Z. Clinical effects of repetitive transcranial magnetic stimulation combined with atomoxetine in the treatment of attention-deficit hyperactivity disorder. Neuropsychiatric Disease and Treatment. 2018;14:3231-3240. Link. Accessed July 09, 2020.
  10. FDA NEWS RELEASE. FDA permits marketing of transcranial magnetic stimulation for treatment of obsessive compulsive disorder. Press Announcements. Published August 17, 2018. Link. Accessed August 28, 2020.

Patient Reviews

  • Zocdoc user
    Zocdoc user
    11-01-2022
    ZocDoc

    Dr. Woo is by far the best psychiatrist I've had. He is very attentive and seems to genuinely care. As opposed to other psychiatrists I've seen, he actually takes his time to listen and provide feedback given the information I provide. Other psychiatrists I've seen last no more than 15 minutes in a session. Dr. Woo however, takes up the whole time slot (usually 30-45 minutes). He is also very up to date with technology which is really helpful (i.e. he confirms appointments via email and fills out forms electronically when possible).

  • Zocdoc user
    Zocdoc user
    11-01-2022
    ZocDoc

    He put me at ease and was matter of fact and informative.

  • Zocdoc user
    Zocdoc user
    11-01-2022
    ZocDoc

    Dr. Woo is compassionate, understanding, and attentive. He really works to address your personal needs and troubleshoot whatever problems you are having. Additionally, when I told him I didn't like a certain medication, he would honor my wishes and let me try something new. Unlike many of my other doctors who would completely disregard my adverse reactions and personal opinion. I would absolutely recommend him 100%.

  • Zocdoc user
    Zocdoc user
    11-01-2022
    ZocDoc

    Dr. Woo is extremely easy to work with.

  • Zocdoc user
    Zocdoc user
    11-01-2022
    ZocDoc

    Very kind and understanding.

  • Zocdoc user
    Zocdoc user
    11-01-2022
    ZocDoc

    I was a patient of Dr. Woo's for 4 years. He was wonderful and even after my insurance no longer covered my visits with him, I still saw him. I only left because I moved to Boston. He was helpful with medication, understanding, and easy to talk to. He was also really great with email and responded promptly to all my questions! This was a HUGE plus for me. I hope I can find someone like Dr. Woo in my new city! I recommend him to anyone!

  • Zocdoc user
    Zocdoc user
    11-01-2022
    ZocDoc

    Dr. Woo is the best psychiatrist I have ever seen. He is punctual, professional, and a great listener. He has never tried to over-medicate and always talks about how I'm feeling beyond meds. Highly recommend!

  • Zocdoc user
    Zocdoc user
    11-01-2022
    ZocDoc

    Dr. Woo was very thorough and asked good questions. He pointed out some things that I didn't know before and I left feeling very positive about the visit.

  • Zocdoc user
    Zocdoc user
    11-01-2022
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    Great

  • Zocdoc user
    Zocdoc user
    11-01-2022
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    Made me feel very comfortable right away, easy to talk to, very on point. Feel lucky to have found him.

  • Zocdoc user
    Zocdoc user
    11-01-2022
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    great Dr.

  • Zocdoc user
    Zocdoc user
    11-01-2022
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    Warm, thoughtful and seeks to truly understand you and your family history. Beautiful & clean office, as well as prompt email communication!

  • Zocdoc user
    Zocdoc user
    11-01-2022
    ZocDoc

    Dr. Woo was phenomenal. He spent extra time getting to know my entire background and went out of his way to be detailed and thorough. He was kind, patient, and listened to my concerns regarding previous medications. I have seen many doctors (mainly because my insurance changed several times and there was no overlap), and he is by far one of the best.

  • Zocdoc user
    Zocdoc user
    11-01-2022
    ZocDoc

    Very professional and thorough...felt very comfortable

  • Zocdoc user
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    11-01-2022
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    Great to work with. I screwed up on the appt time and he was very accommodating. Thanks, doc!

  • Zocdoc user
    Zocdoc user
    23-02-2016
    ZocDoc

    Dr. Woo was very professional, knowledgeable and prompt. He really listened to me and I feel he best understood my needs. Best doctor's appointment (all fields) in a long time. Also, he followed through when he said he would follow up and when as well. Thank you Dr. Woo.

  • Zocdoc user
    Zocdoc user
    10-12-2015
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    I haven't seen him in a while but I can tell you that had I not moved, I would still be going to him. He is what a doctor should be, especially a psychiatrist. The appointments were 15 minutes, but it felt like longer because Dr. Woo is extremely insightful, he doesn't just acknowledge a concern, he explores it fully. He educates about symptoms, treatment options and medications. He very much normalizes whatever is happening so that you get a sense that someone believes in you, that you aren't "crazy." When something isn't working, he believes you versus making you feel as if the issue were your fault. He also remembers details so every time you see him a bulk of the appointment is not taken up with the doctor simply trying to remember who you are. Dr. Woo remembers you and I truly believe this quality, as well as the ones noted above, are what keep his clients coming to him. His dynamic is what I seek when I look for new doctors now. He is the standard I set for them. I am truly grateful to him and would recommend him with the utmost confidence in his skillset.

  • Zocdoc user
    Zocdoc user
    10-08-2015
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    Professional, courteous, smart, great listener. Dr Woo is an excellent physician in every way. I was fortuante to have found him after my first doctor passed on. Highly recommended!!

  • Zocdoc user
    Zocdoc user
    25-10-2015
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    I love Dr. David! Has been treating me for 3 years and I wouldn't want to go anywhere else.

  • Zocdoc user
    Zocdoc user
    03-07-2014
    ZocDoc

    Dr Woo has been an excellent psychiatrist for me. He is sensitive, respectfully, intelligent, and experienced. I appreciate his tech savvy nature. He's very responsive via email, easy to book appointments with, and accepts credit cards for co-pays. Interestingly, I like the decor of his office, which helps when talking about sensitive subjects.

  • Zocdoc user
    Zocdoc user
    27-04-2014
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    He's second to none.

  • Zocdoc user
    Zocdoc user
    02-01-2014
    ZocDoc

    Dr. Woo was efficient, effective, and succinct. I was impressed with his knowledge of medicine and enjoyed my appointment. Excited to go back.

  • Zocdoc user
    Zocdoc user
    16-12-2013
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    Guy listens and doesn't bs you - very straightforward with all options, genuinely wants to find the best solution for you.

  • Zocdoc user
    Zocdoc user
    03-12-2013
    ZocDoc

    Dr. Woo is great!

  • Zocdoc user
    Zocdoc user
    19-08-2013
    ZocDoc

    A great listener. Sincerely interested. I could not ask for more on my first visit.

  • Zocdoc user
    Zocdoc user
    10-10-2013
    ZocDoc

    Great Doctor

  • Zocdoc user
    Zocdoc user
    05-07-2013
    ZocDoc

    Dr. Woo is very professional, knowledgeable and easy to talk to. I would definitely recommend him!

  • Zocdoc user
    Zocdoc user
    25-06-2013
    ZocDoc

    He is Great. I was going through a terrible crisis/breakdown with a few trial and error he finally got me on the right medication and I feel great. He'll work with you till he finds the right solution. He is very patient and doesn"t make you feel rushed.

  • Zocdoc user
    Zocdoc user
    25-06-2013
    ZocDoc

    I really liked Dr. Woo and I would highly recommend him!

  • Zocdoc user
    Zocdoc user
    30-05-2013
    ZocDoc

    He was very attentive and easy to talk to. He listened intently and was empathetic. He understood my concerns and is working me with to resolve my issues. He is very approachable and welcoming.

  • Zocdoc user
    Zocdoc user
    21-05-2013
    ZocDoc

    Dr. Woo spent more than the allotted 45 mins to chat with us. He clearly cares and ask deep thoughtful questions. His key strength is his ability to actively listen. Overall highly recommended!

  • Zocdoc user
    Zocdoc user
    06-05-2013
    ZocDoc

    Great. Have scheduled a follow up.

  • Zocdoc user
    Zocdoc user
    22-04-2013
    ZocDoc

    Dr. Woo was wonderful! I was seen right away, he took his time to get to know me and made me feel very comfortable! He asked good questions and was very warm and sympathetic! I would absolutely recommend Dr. Woo to anyone!!!!

  • Zocdoc user