Yes, for most people you can drive after TMS. Standard TMS uses no anesthesia or sedation, and you are awake the whole time, so there is nothing in the treatment itself that stops you from driving, working or going to class afterward. Cleveland Clinic notes that you can go back to your normal day after a session, though a provider may suggest someone drive you to and from the first appointment.
The real challenge is time, not recovery: a standard course means a visit every weekday for about six weeks. This guide covers how long each visit takes, how people fit it around a job or classes, the workplace protections that may apply in New York, and when a shorter accelerated schedule might make sense.
Driving: TMS compared with other depression treatments
Driving rules are one of the clearest practical differences between TMS and other options for hard-to-treat depression.
| Treatment | Anesthesia or sedation | Driving afterward |
|---|---|---|
| TMS | None; you are awake | Usually fine; ask about the first visit |
| Spravato (esketamine) | No anesthesia, but at least 2 hours of monitoring after each dose | Not until the next day after a restful sleep |
| ECT | General anesthesia | Needs a ride; ask the ECT team about restrictions |
A few cautions still apply to TMS. If you have a headache or feel lightheaded after a session, wait until it passes. If you ever have a seizure, which is rare, driving rules for seizures apply, and the team will advise you. And if a new medication makes you drowsy, that matters more than the TMS. Our article on what TMS feels like describes the usual sensations.
How much time does a TMS course take?
The National Institute of Mental Health describes a typical course as daily sessions five days a week for four to six weeks, with each session lasting anywhere from 3 to 40 minutes. The spread depends on the protocol:
| Protocol | Stimulation time per session | Typical schedule |
|---|---|---|
| Standard 10 Hz | About 19 to 37.5 minutes | Weekdays for 6 weeks, then a taper |
| Theta-burst (iTBS) | A little over 3 minutes | Weekdays for several weeks |
| Deep TMS (H-coil) | About 20 minutes of a 30-minute session in the pivotal trial | Weekdays for several weeks |
Add time for check-in, putting in earplugs and positioning the coil, plus travel. The first visit is longer, because the team measures your motor threshold and maps the treatment spot; see the first TMS session. For the full calendar, see a typical course week by week.
Fitting TMS around work
Most people keep working during TMS. What helps:
- Pick a fixed slot. Early morning, lunchtime or right after work are the usual choices. Ask the clinic which slots are realistic before you start.
- Plan the first week loosely. Scalp discomfort and headache are most noticeable early; NeuroStar's safety information says scalp discomfort does not occur for most patients after the first week. Avoid scheduling big presentations right after early sessions if you can.
- Remote days help. If you work from home some days, booking TMS on those days cuts travel.
- Protect sleep. Sleep deprivation is one of the factors that can lower seizure threshold, so late nights to make up lost work time are a poor trade. See caffeine, alcohol and sleep during TMS.
- Tell the team about shift work. Irregular hours affect sleep and scheduling, and the team can plan around them.
Workplace protections in New York
You do not have to tell your employer you are getting TMS, but if you need schedule changes or time off, these laws may help. This is general information, not legal advice; check details with HR or an employment lawyer.
Family and Medical Leave Act (FMLA)
FMLA gives eligible employees up to 12 workweeks of unpaid, job-protected leave in a 12-month period, and employers must keep your group health insurance going during it. You are generally eligible if you have worked for a covered employer for at least 12 months and 1,250 hours, at a worksite with at least 50 employees within 75 miles. When medically necessary, FMLA leave can be taken in separate blocks of time rather than all at once, which can suit daily TMS visits. Ask HR what paperwork your employer uses.
Reasonable accommodation under the ADA
The US Equal Employment Opportunity Commission says conditions like major depression should easily qualify for protection, and lists "altered break and work schedules (e.g., scheduling work around therapy appointments)" and unpaid leave among possible accommodations. You can start by telling a supervisor or HR that you need a change for a medical reason; no special wording is required, though the employer may ask for the request in writing, and your medical information must generally be kept confidential.
New York paid sick leave
New York State requires employers to provide up to 40 hours of sick leave a year, or up to 56 hours at employers with 100 or more employees, and it can be used for the diagnosis, care or treatment of a mental or physical health condition. Sick leave alone will not cover a full course, but it can cover the first-day mapping visit and occasional sessions that clash with work.
How much to tell your manager
Many people say only that they have a daily medical appointment for a few weeks. Others find it easier to explain more. Either is reasonable. If you want a formal schedule change, it helps to put the request in writing, keep it short, say how long you expect to need it, and propose a solution, such as starting an hour later or making up time at the end of the day. Our guide to preparing for TMS includes a planning checklist you can adapt.
Studying during TMS
College and graduate students face the same arithmetic: a weekday appointment for about six weeks. A few tips:
- Start a course at the beginning of a term or during a lighter stretch, not during exams.
- Build sessions into your class timetable as if they were a class.
- Campus disability or accessibility offices can arrange academic accommodations for a documented health condition; ask early.
- TMS has not been shown to impair thinking. A systematic review of 31 randomized trials found no reliable evidence of cognitive side effects. More in does TMS affect memory or thinking.
Accelerated TMS if you are short on time
Accelerated protocols compress treatment into fewer days with several sessions per day. SAINT, for example, is 10 sessions a day for 5 days, with sessions spaced 50 minutes apart in the original study. That means a few full days away from work rather than six weeks of short visits. Other cleared accelerated schedules differ; BrainsWay's still spans six weeks.
The catches are coverage and evidence. Aetna, Cigna and UnitedHealthcare policies currently treat accelerated protocols as experimental or unproven, so they may be self-pay. See is accelerated TMS covered by insurance, and for the science, Dr. Lewis's guide to accelerated TMS.
Getting to sessions
A treatment you have to reach every weekday works best if it is close to home, work or school. Before you commit, map the trip at the time of day you would go, and have a backup for bad-weather days. Our guide to fitting daily TMS sessions into a Brooklyn week covers transit and timing around Park Slope and nearby neighborhoods.
For an overview of the treatment, visit the TMS guide or the TMS therapy page.
Sources
- Brain Stimulation Therapies. National Institute of Mental Health, 2024. nimh.nih.gov
- Transcranial Magnetic Stimulation (TMS). Cleveland Clinic, 2026. my.clevelandclinic.org
- SPRAVATO (esketamine) nasal spray, CIII - Prescribing Information. Janssen / DailyMed (NLM), 2026. dailymed.nlm.nih.gov
- SPRAVATO (esketamine) nasal spray, CIII - Prescribing Information, section 5.9 Impaired Ability to Drive and Operate Machinery. Janssen / DailyMed (NLM), 2026. dailymed.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
- K231926 510(k) Summary - NeuroStar Advanced Therapy System. U.S. FDA, 2024. accessdata.fda.gov
- K173620 510(k) Summary - MagVita TMS Therapy System w/Theta Burst Stimulation. U.S. FDA, 2018. accessdata.fda.gov
- Efficacy and safety of deep transcranial magnetic stimulation for major depression: a prospective multicenter randomized controlled trial. World Psychiatry, 2015. pmc.ncbi.nlm.nih.gov
- Safety Information. NeuroStar (Neuronetics), 2026. neurostar.com
- 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
- Fact Sheet #28: The Family and Medical Leave Act. U.S. Department of Labor, Wage and Hour Division, 2025. dol.gov
- Depression, PTSD, & Other Mental Health Conditions in the Workplace: Your Legal Rights. U.S. Equal Employment Opportunity Commission, n.d.. eeoc.gov
- Paid Sick Leave Eligibility and Information. New York State, 2026. ny.gov
- K220177 510(k) Summary - Magnus Neuromodulation System with SAINT Technology. U.S. FDA, 2022. accessdata.fda.gov
- Stanford Accelerated Intelligent Neuromodulation Therapy for Treatment-Resistant Depression. American Journal of Psychiatry, 2020. pubmed.ncbi.nlm.nih.gov
- 510(k) Premarket Notification K251449 (BrainsWay accelerated Deep TMS) and 510(k) summary. U.S. FDA, 2025. accessdata.fda.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
- Transcranial Magnetic Stimulation for Treating Physical Health Conditions (2026T0536W). UnitedHealthcare, 2026. uhcprovider.com
FAQs
Do I need someone to drive me to my first TMS appointment?
Not usually, but some providers suggest it for the first visit, which is longer and includes mapping. Ask the clinic when you book.
Can I go straight back to work after a session?
Usually yes. There is no anesthesia or recovery period. Some people have a mild headache or scalp soreness early in the course, which typically fades.
Can I do TMS on my lunch break?
Sometimes, if the clinic is close and you have a short protocol such as theta-burst. Standard sessions plus check-in and travel can take longer than a typical lunch hour.
Do I have to tell my employer why I need time off?
You do not have to share details with coworkers. If you request an accommodation, your employer may ask you to put the request in writing, and your medical information must generally be kept confidential.
Is it safe to drive after Spravato like after TMS?
No. The Spravato label says not to drive until the next day after a restful sleep. TMS has no such restriction.
