Plain answers to real questions.

TMS — Transcranial Magnetic Stimulation — is an FDA-cleared, non-invasive treatment that uses brief magnetic pulses to stimulate specific brain circuits. The pulses are delivered through a coil placed against the scalp; they pass painlessly through the skull and induce a small electrical current in the cortical tissue underneath. No pills, no anesthesia, no surgery, no recovery time.

ECT (electroconvulsive therapy) uses a strong electrical current applied across the scalp under general anesthesia, producing a generalized seizure. It is highly effective for severe depression but requires anesthesia and produces transient cognitive effects. TMS uses targeted magnetic pulses while you are fully awake; you walk in, sit in a chair, and walk out 20 minutes later. There are no cognitive side effects.

Standard TMS uses a figure-8 coil that produces a focal field reaching about 1.5 cm into the brain. BrainsWay's Deep TMS uses an H-coil that reaches roughly 2–3 cm and stimulates a tissue volume of about 17 cm³ — approximately 5–6× larger than the ~3 cm³ reached by figure-8. The broader, deeper field is the mechanistic basis for Deep TMS's broader FDA-cleared indication set.

Adults (and adolescents 15–21, adjunctive) with major depressive disorder, anxious depression, OCD, late-life depression, or smoking cessation who have inadequate response to first-line treatment. A board-certified psychiatrist evaluates each patient at the consultation. Most adults with treatment-resistant depression qualify.

Patients with a history of seizures, certain metal implants in the head (cochlear implants, deep brain stimulators, ferromagnetic devices above the shoulders), or active mania are not candidates. Patients with significant alcohol intoxication or active substance use disorders that lower the seizure threshold need stabilization first. We screen carefully at consultation.

Deep TMS is NOT FDA-cleared for PTSD. The pivotal BrainsWay PTSD trial (NCT02479906) was terminated for futility — the active arm did not separate from sham. Some figure-8 TMS protocols, particularly when combined with cognitive processing therapy or fMRI-targeted, show promise for PTSD. We treat PTSD with evidence-based psychotherapy and medication; Deep TMS at IPMG TMS is reserved for cleared indications.

There is no FDA clearance for "anxiety alone" with TMS. The clearance is for *anxious depression* — depression with comorbid anxiety. If you have anxiety without depression, Deep TMS is not the indicated treatment.

You sit in a comfortable chair. A cushioned helmet rests on your head. The machine begins delivering pulses, which feel like a gentle tapping against the scalp. You stay awake the entire time and can listen to music, watch TV, or chat with the technician. A standard session is about 20 minutes.

The standard course is 5 sessions per week for about 6 weeks, followed by a few tapering sessions — roughly 30 sessions total. The accelerated SWIFT protocol (FDA-cleared September 2025) compresses the acute phase to 6 days of multiple shorter sessions, followed by a 4-week continuation phase.

Yes. There is no anesthesia and no sedation. Most patients drive themselves to and from sessions, work full-time, exercise, and continue normal activities throughout the course.

Most patients begin to notice symptom changes between weeks 2 and 3. Some respond earlier, some later. Full effect is typically assessed after 30 sessions. With the accelerated SWIFT protocol, median time to remission was about 21 days in the pivotal trial.

Three reasons. (1) BrainsWay holds the most extensive FDA-cleared label of any TMS device — depression, anxious depression, OCD, smoking cessation, late-life depression, adolescent depression, and the accelerated protocol. (2) The H-coil reaches deeper and stimulates a broader cortical volume than the figure-8 coils used by competing devices, with measured advantages in head-to-head comparisons. (3) The broader field is more tolerant of anatomical variation, reducing the proportion of cases where a focal coil "misses" the target due to head shape or scalp-to-cortex distance.

Both. The H1 coil is used for depression-spectrum indications (MDD, anxious depression, late-life, adolescent). The H7 coil is geometrically distinct and used for OCD, where it engages medial prefrontal cortex and anterior cingulate. IPMG TMS deploys both H1 and H7 systems at all 33 IPMG locations.

Yes. The accelerated H1 protocol (5 sessions per day × 6 days, then weekly continuation × 4 weeks) was FDA-cleared in September 2025 and we offer it at IPMG TMS. Eligibility is determined at consultation; not every patient is a fit, but for those who are, the acute phase is dramatically compressed.

Medicare, Medicaid, and most major commercial insurers cover Deep TMS for treatment-resistant depression in adults. Coverage requires documentation of one or more failed adequate antidepressant trials. Coverage for OCD is growing but more variable. Smoking cessation and adolescent indications are typically not covered yet. Our team verifies your specific benefits during the consultation.

A typical 30-session standard course of Deep TMS in the United States runs roughly $10,000–$15,000 without insurance. Accelerated protocols are priced similarly. We provide a cost estimate before you start.

Yes. Across the largest aggregate dataset (Tendler 2024, 884 sham-controlled trial participants), the most common side effects were transient headache and application-site discomfort during the first week. Seizure rate is below 0.1% — lower than the seizure risk of many antidepressant medications. There are no demonstrated cognitive effects.

Mild headache (especially the first week, usually responsive to over-the-counter pain relievers), scalp tingling or tenderness where the helmet sits, brief facial-muscle twitching during pulses, and occasional lightheadedness for a few minutes after a session. Most resolve within the first 1–2 weeks.

No. Multiple cognitive sub-studies — including in the late-life population — show no demonstrable cognitive effects from Deep TMS. This is a meaningful contrast with ECT, which produces transient cognitive effects.

Yes, in most cases. Most patients continue their existing antidepressants during TMS. Some medications (particularly those that lower seizure threshold) may need adjustment; we review your full medication list at consultation. Do not stop any medication without your prescriber's guidance.