The short version: TMS is not shock therapy, is not experimental for depression, does not erase memories and is not a guaranteed or permanent cure. It is an FDA-cleared treatment for depression that has not responded well enough to medication, with mostly mild side effects and a real, but variable, chance of meaningful improvement. Some uses promoted online, such as TMS for anxiety on its own, are not FDA-cleared.
Below are twelve common myths, each with what the evidence actually shows. If you are new to TMS, what TMS therapy is is a good place to start.
The twelve myths at a glance
| The myth | What is actually true |
|---|---|
| Myth 1: TMS is shock therapy | It uses magnetic pulses, with no anesthesia and no seizure intended |
| Myth 2: TMS is experimental | FDA-cleared for depression since 2008 and backed by major guidelines |
| Myth 3: TMS is FDA-approved for anxiety | Cleared for anxiety symptoms that come with depression, not anxiety alone |
| Myth 4: TMS causes memory loss | Reviews found no reliable evidence of cognitive side effects |
| Myth 5: TMS has no side effects | Headache and scalp discomfort are common, though usually mild |
| Myth 6: TMS is very painful | Often uncomfortable at first; usually eases within a week or two |
| Myth 7: Seizures are a common risk | Rare, especially within safety guidelines |
| Myth 8: TMS works for almost everyone | Results vary; trial and clinic numbers differ a lot |
| Myth 9: TMS is a permanent cure | Benefit often lasts, but relapse happens and retreatment is possible |
| Myth 10: TMS is only a last resort | Often considered after one or more medications, before ECT |
| Myth 11: You must stop your medication | TMS can be given with or without antidepressants |
| Myth 12: Insurance never pays for TMS | Many plans cover it for depression when criteria are met |
Myths about what TMS is
Myth 1: "TMS is just shock therapy."
Fact: TMS and ECT are different treatments. ECT passes an electrical current through the brain under general anesthesia. TMS uses magnetic pulses from a coil resting on the scalp, needs no anesthesia, so you stay awake, and it can be done in a clinic or office. The regulation that classifies depression TMS devices describes them as stimulating the brain "without inducing seizure". ECT has a real role, especially for severe or psychotic depression; the physician's guide compares the two in TMS vs ECT.
Myth 2: "TMS is experimental."
Fact: For depression, it is not. The first TMS system for depression was authorized by FDA in 2008. The American Psychiatric Association's 2024 position statement calls TMS "a safe and effective evidence-based medical treatment" for appropriately selected patients when delivered by TMS-trained psychiatrists. Canada's CANMAT guidelines rate it first-line for treatment-resistant depression. Many other uses, from ADHD to autism, really are research-stage, so the label "experimental" depends on the condition. The newer formats are not fringe either: theta burst, a 3-minute version of TMS, was cleared in 2018 after a large randomized trial showed it was non-inferior to (not meaningfully worse than) standard TMS.
Myth 3: "TMS is FDA-approved for anxiety."
Fact: Two wording problems in one sentence. TMS devices are FDA-cleared, not approved; no TMS device has gone through FDA's approval pathway, which is reserved for Class III devices. And the cleared anxiety wording covers decreasing anxiety symptoms in adults who have major depression, not generalized anxiety disorder on its own. For anxiety alone, a 2026 review of sham-controlled trials found only low-strength evidence of improvement. See TMS for anxiety: what is cleared and what is not and is TMS FDA-approved?
Myths about safety and comfort
Myth 4: "TMS causes memory loss."
Fact: A systematic review cited by international safety guidelines found no reliable evidence of cognitive side effects across 31 randomized trials of this type of TMS. In NeuroStar's development program, cognitive function did not change. Memory problems are a known issue with ECT, not TMS. More in does TMS affect memory or thinking.
Myth 5: "TMS has no side effects."
Fact: It does, and saying otherwise is inaccurate. Scalp pain and headache were common in the pivotal trials, and in the NeuroStar program 4.5% of people stopped because of side effects. The honest phrasing is that side effects are usually mild and temporary. The full list is in TMS side effects.
Myth 6: "TMS is extremely painful."
Fact: It is often uncomfortable, especially at first, but usually tolerable. In the large THREE-D trial, patients rated pain at 3.4 out of 10 for standard TMS and 3.8 for theta burst. NeuroStar reports that treatment-site discomfort does not occur for most patients after the first week. For people who are very sensitive, many clinicians build the dose up gradually over the first week, and patients generally develop tolerance to the discomfort over the first two weeks. If it stays hard to tolerate, say so; intensity and coil position both affect how it feels. Read what TMS feels like for the sensations in detail.
Myth 7: "Seizures are a common risk."
Fact: Seizure is the most serious risk, but it is rare. A survey covering 2012 to 2016 found fewer than 1 seizure per 60,000 sessions when TMS was given within guidelines to people without risk factors. Risk is higher with factors such as epilepsy or brain lesions, which is why screening matters. One survey of U.S. clinics found a higher per-patient rate with the deep TMS H-coil than with the most-used figure-8 devices, though the absolute risk was low for both. Alcohol withdrawal, recreational stimulants and sleep deprivation can also lower the seizure threshold, so honesty about them helps keep TMS safe.
Myths about results
Myth 8: "TMS works for 80% to 90% of people."
Fact: Those figures come from open-label clinic data or tiny studies, not sham-controlled trials. A large NeuroStar registry reported response of 58% to 83% across different samples and scales, but patients knew they were being treated and clinics chose whether to report. In sham-controlled trials, the difference in remission between real and sham TMS is typically about 9 to 18 percentage points, partly because sham groups improve too. Canadian guidelines put response rates for hard-to-treat depression at 40% to 50%. Those are worthwhile odds, but they are not near-certainty.
Myth 9: "One course of TMS cures depression for good."
Fact: Benefit often lasts, but not always. A meta-analysis found that among people who responded, about 53% were still responding at 6 months and 46% at 12 months. Across studies, roughly half to about 6 in 10 initial responders were still doing well at one year. Claims that TMS results are permanent are overstated. The good news is that people who relapse can be treated again: in a 2026 retrospective cohort, 82.5% of previous responders responded to a second course. See building a relapse-prevention plan and the physician's guide on how long TMS results last.
Myths about when and how TMS is used
Myth 10: "TMS is only for people who have tried everything."
Fact: The original 2008-era label covered adults who had not improved on one antidepressant in the current episode. Canadian guidelines say TMS is typically used after first-line therapy and medication fail, can be a first choice when medication side effects are a real concern, and should generally be considered before ECT outside emergencies. Guidelines do not treat TMS as the very first treatment for depression, though. When depression is severe with psychosis or acute suicidal thinking, other treatments such as ECT should be considered. If you are thinking about suicide or are in crisis, call or text 988 (the 988 Suicide & Crisis Lifeline) or go to the nearest emergency room.
Myth 11: "You have to stop your antidepressants to have TMS."
Fact: TMS can be given with or without antidepressants, and expert consensus found no evidence that combining them increases side effects. The adolescent clearances are specifically for use alongside medication. In that consensus, a majority of Clinical TMS Society members recommended continuing existing medications during the course, and any medication change during TMS should prompt the team to consider re-checking your motor threshold. Never stop a medication on your own; see medications during TMS.
Myth 12: "Insurance never pays for TMS."
Fact: Many health plans cover TMS for depression when their criteria are met, often through prior authorization. The criteria vary by plan and often include how many medications you have tried. Coverage for other conditions and for maintenance sessions is less common. See does insurance cover TMS? and how many antidepressants you need to try first.
How to spot a myth in TMS marketing
A few red flags are worth knowing when you read ads or clinic websites:
- A single headline success rate with no study named, especially a very high one.
- "FDA-approved" for a TMS device, or any condition that is not on a cleared label.
- "No side effects" or "permanent results".
- A one-day or medication-combined protocol presented as FDA-cleared. One such single-day protocol is not cleared, and the Clinical TMS Society said its evidence does not meet the threshold to recommend it.
For broader myths about depression care, see common depression treatment myths. You can explore more in the TMS patient guide or read about TMS therapy at the practice.
Sources
- Premarket Approval (PMA). U.S. Food and Drug Administration, 2026. fda.gov
- 21 CFR 882.5805 Repetitive transcranial magnetic stimulation system. eCFR, 2026. ecfr.gov
- Premarket Notification 510(k). U.S. Food and Drug Administration, 2026. fda.gov
- De Novo Classification Request DEN070003 (NeuroStar TMS System). U.S. Food and Drug Administration, 2008. accessdata.fda.gov
- 510(k) K083538: NeuroStar TMS Therapy System Model 1.1. U.S. Food and Drug Administration, 2008. accessdata.fda.gov
- 510(k) K220127: NeuroStar Advanced Therapy System. U.S. Food and Drug Administration, 2022. accessdata.fda.gov
- 510(k) Summary K231926: NeuroStar Advanced Therapy System. U.S. Food and Drug Administration, 2024. accessdata.fda.gov
- 510(k) K210201: BrainsWay Deep TMS System. U.S. Food and Drug Administration, 2021. accessdata.fda.gov
- 510(k) Summary K173620: MagVita TMS Therapy System w/Theta Burst Stimulation. U.S. Food and Drug Administration, 2018. accessdata.fda.gov
- Clinical outcomes in a large registry of patients with major depressive disorder treated with Transcranial Magnetic Stimulation. Journal of Affective Disorders, 2020. pubmed.ncbi.nlm.nih.gov
- Effectiveness of theta burst versus high-frequency repetitive transcranial magnetic stimulation in patients with depression (THREE-D): a randomised non-inferiority trial. The Lancet, 2018. pubmed.ncbi.nlm.nih.gov
- Clinical TMS Society's Statement on Level of Evidence for Single-Day TMS combined with Medications. Clinical TMS Society, 2025. clinicaltmssociety.org
- Daily left prefrontal transcranial magnetic stimulation therapy for major depressive disorder: a sham-controlled randomized trial. Archives of General Psychiatry, 2010. pubmed.ncbi.nlm.nih.gov
- Seizures from transcranial magnetic stimulation 2012-2016: Results of a survey of active laboratories and clinics. Clinical Neurophysiology, 2019. europepmc.org
- Seizure risk with repetitive TMS: Survey results from over a half-million treatment sessions. Brain Stimulation, 2021. europepmc.org
- Safety and recommendations for TMS use in healthy subjects and patient populations, with updates on training, ethical and regulatory issues: Expert Guidelines. Clinical Neurophysiology, 2021. europepmc.org
- Transcranial magnetic stimulation in the treatment of major depressive disorder: a comprehensive summary of safety experience from acute exposure, extended exposure, and during reintroduction treatment. Journal of Clinical Psychiatry, 2008. europepmc.org
- Safety Information. Neuronetics (NeuroStar), 2026. neurostar.com
- Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014-2018). Clinical Neurophysiology, 2020. pubmed.ncbi.nlm.nih.gov
- A systematic review of transcranial magnetic stimulation for generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder. BMC Psychiatry, 2026. europepmc.org
- Practice Guideline for the Treatment of Patients With Major Depressive Disorder, Third Edition. American Psychiatric Association, 2010. psychiatryonline.org
- Position Statement on Transcranial Magnetic Stimulation (TMS). American Psychiatric Association, 2024. psychiatry.org
- Consensus Recommendations for the Clinical Application of Repetitive Transcranial Magnetic Stimulation (rTMS) in the Treatment of Depression. Journal of Clinical Psychiatry, 2018. pmc.ncbi.nlm.nih.gov
- Canadian Network for Mood and Anxiety Treatments (CANMAT) 2023 Update on Clinical Guidelines for Management of Major Depressive Disorder in Adults. Canadian Journal of Psychiatry, 2024. pmc.ncbi.nlm.nih.gov
- The cognitive effects of electroconvulsive therapy in community settings. Neuropsychopharmacology, 2007. pubmed.ncbi.nlm.nih.gov
- Durability of antidepressant response to repetitive transcranial magnetic stimulation: Systematic review and meta-analysis. Brain Stimulation, 2019. pubmed.ncbi.nlm.nih.gov
- 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. Journal of Clinical Psychiatry, 2014. pubmed.ncbi.nlm.nih.gov
- Transcranial Magnetic Stimulation Retreatment for Recurrent Depression: A Large Real-World Multisite Cohort Study. Acta Psychiatrica Scandinavica, 2026. pubmed.ncbi.nlm.nih.gov
- Brain Stimulation Therapies. National Institute of Mental Health, 2024. nimh.nih.gov
- The Clinical TMS Society Consensus Review and Treatment Recommendations for TMS Therapy for Major Depressive Disorder. Brain Stimulation, 2016. pmc.ncbi.nlm.nih.gov
- Transcranial Magnetic Stimulation and Cranial Electrical Stimulation (Clinical Policy Bulletin 0469). Aetna, 2026. aetna.com
- Transcranial Magnetic Stimulation (Coverage Policy EN0383). Evernorth Health Services (Cigna), 2026. a.static.cigna.com
- Behavioral Clinical Policy: Transcranial Magnetic Stimulation (BH803TMS112025). Optum Behavioral Health Solutions, 2026. providerexpress.com
FAQs
Is TMS a new treatment?
Not for depression. The first TMS system for depression was authorized by FDA in 2008, and newer protocols such as theta burst and accelerated schedules have been cleared since.
Does TMS put a magnet inside my body?
No. The coil rests against your scalp and nothing enters your body. The magnetic pulses pass through the skull and create small electrical currents in the brain tissue underneath.
If TMS did not work before, will it never work?
Not necessarily. Your psychiatrist can review why a previous course may not have helped, for example the protocol, the number of sessions or the diagnosis, and whether a different approach makes sense.
Is TMS only for depression?
Depression is the main use, but some devices are also cleared for OCD, smoking cessation and, as an add-on treatment, PTSD. Many other uses remain off-label or research-stage.
