Transcranial Magnetic Stimulation (TMS)

Transcranial magnetic stimulation is a noninvasive, nondrug, evidence-based therapy that is typically used to treat major depressive disorder. TMS uses focused magnetic pulses that are similar in strength to those used in an MRI to stimulate the dorsolateral prefrontal cortex (dlPFC). The dlPFC is a region of the brain that regulates mood and is underactive in people who have depression. By reactivating the nerve cells, TMS causes the natural release of neurotransmitters like serotonin, norepinephrine and dopamine. 

TMS is recognized by the American Psychiatric Association as an effective treatment option for adults who have major depressive disorder but have not experienced adequate relief from antidepressant medication. Because TMS targets a specific area of the brain rather than the whole body, it does not cause the systemic side effects that are often associated with antidepressant medications, such as weight gain, sexual dysfunction and gastrointestinal distress. 

Key features of TMS: 

• Noninvasive 
• Nondrug 
• Nonsystemic 
• FDA-cleared for major depressive disorder 
• Performed while a person is awake and alert 
• No anesthesia, sedation or recovery time needed 

Traditional TMS treatment can require sessions of 20-40 minutes a day, five days a week, for four to six weeks. Express TMS uses an FDA-cleared theta-burst stimulation protocol that dramatically shortens each session while preserving clinical effectiveness. 

How Express TMS is different: 

• Faster sessions: Each Express TMS session lasts approximately three minutes, compared with the 21-minute sessions of standard TMS. 

• Accelerated course: A full course of TMS is typically 36 sessions. The Express TMS protocol allows multiple sessions to be safely delivered in a single day, which is supported by research from Stanford’s SAINT trial. 

• Completed during residential care: Residents can complete all 36 sessions in approximately two to three weeks, fully within the average time frame of a residential stay at Sierra Tucson. 

After a comprehensive psychiatric evaluation, our medical team determines whether transcranial magnetic stimulation is clinically appropriate for a resident. Treatment is delivered on-site by a qualified medical professional, with close monitoring taking place throughout each session. 

During a TMS session, a small magnetic coil is placed against the scalp over the dorsolateral prefrontal cortex. The device delivers brief, focused magnetic pulses that pass painlessly through the scalp and skull to stimulate underactive neurons. Residents remain awake, alert and able to resume normal activities immediately afterward. 

Side effects, if they occur, are typically mild and temporary. The most common are scalp discomfort and a mild headache near the site of stimulation. 

Residents who complete a full course of TMS at Sierra Tucson benefit from two important advantages over receiving it in an outpatient setting: 

• Lasting results: The clinical effectiveness of TMS relies on a person completing the full protocol. Studies show that approximately 1 in 2 people report significant improvement in depression symptoms, and 1 in 3 become symptom-free. Many experience sustained relief well beyond the treatment period, often reducing or eliminating the need for ongoing medication. 

• Seamless continuing care: Due to the fact that the entire course of TMS at Sierra Tucson is completed on-site, residents can leave our care without the burden of needing to find a local TMS provider to continue treatment after discharge. 

TMS at Sierra Tucson is delivered as part of our broader clinical model, which includes psychiatric care, individual and group therapy, integrative services and 24/7 nursing support. This combined approach gives residents the opportunity to receive fully comprehensive care that leads to lasting healing. 

TMS may be an appropriate option for residents who meet the following criteria: 

• Diagnosed with major depressive disorder without psychotic features 

• Have a history of inadequate response to antidepressant medication 

• Are able to manage daily responsibilities but experience significant struggles with low mood, motivation or engagement 

• Are motivated and committed to participating in the full course of treatment 

A psychiatric evaluation is required to confirm a diagnosis, review medical and psychiatric history, and screen for contraindications such as a personal history of seizures, certain implanted metallic or electronic devices, or other neurological conditions that may increase risk for negative effects. 

Below are answers to some of the most frequently asked questions about TMS. 

Is TMS the same as electroconvulsive therapy (ECT)? 

No. TMS and ECT are different types of treatment. TMS is noninvasive, does not require anesthesia, does not induce a seizure and does not run the risk for causing memory loss. Residents remain awake throughout each session and resume normal activity immediately afterward. 

Is TMS cleared by the FDA? 

Yes. TMS is cleared by the Food and Drug Administration (FDA) for the treatment of major depressive disorder in adults who have not received adequate benefit from antidepressant medication. The accelerated protocol used in Express TMS is also FDA-cleared. 

How long does TMS take to work? 

Many residents begin to notice improvements in depression symptoms during the course of treatment. Because Express TMS condenses a full course into two to three weeks, residents often experience clinical response before finishing their residential stay. 

Does insurance cover TMS? 

Most major insurance plans provide coverage for TMS when clinical criteria are met. Our admissions coordinators can verify your benefits and review coverage details with you. 

What are the side effects of TMS? 

Potential side effects are minimal and typically temporary. The most common are mild scalp discomfort and headache during or shortly after a session. TMS does not cause the systemic side effects commonly associated with antidepressant medication. 

Who should not receive TMS? 

TMS is not appropriate for individuals who have certain implanted metallic hardware near the head, cochlear implants or implanted electronic devices such as pacemakers. People who have a history of seizures or epilepsy should not receive TMS treatment. A full medical screening is conducted before treatment begins.

If you are suffering from depression and your symptoms have not been alleviated by medication, and if you are looking for a clinically advanced, evidence-based alternative, Express TMS at Sierra Tucson may be the perfect option for you. Our admissions team is available to answer any questions you may have, verify your insurance benefits and guide you through the assessment process.