Is TMS Therapy Safe? What Louisville Patients With Treatment-Resistant Depression Should Know

March 24, 2026

Is TMS Therapy Safe? What Louisville Patients With Treatment-Resistant Depression Should Know

When depression does not improve after trying multiple medications, it can feel discouraging. For many Louisville residents living with treatment-resistant depression, Transcranial Magnetic Stimulation (TMS) has emerged as a promising alternative. Yet before committing to any new treatment, the first question many prospective patients ask is: is TMS therapy safe? It is a reasonable and important question, and the clinical evidence accumulated over more than a decade provides a reassuring answer. In this article, Hagan Health breaks down what patients should understand about the safety, side effects, and overall experience of TMS therapy for treatment-resistant depression.

Understanding TMS Therapy and How It Works

TMS is a non-invasive brain stimulation technique that uses focused magnetic pulses to stimulate nerve cells in regions of the brain associated with mood regulation. Unlike medications, which circulate throughout the entire body, TMS targets specific areas of the prefrontal cortex without entering the bloodstream. This non-systemic approach is one of the primary reasons TMS has attracted attention as a treatment for depression that has not responded to traditional antidepressant therapies.

During a TMS session, a magnetic coil is placed against the patient’s scalp. The coil delivers brief magnetic pulses that pass through the skull and stimulate neurons in the targeted brain region. No surgery, sedation, or anesthesia is required. Patients remain fully awake and alert throughout the procedure and can return to their normal daily activities immediately afterward, including driving.

TMS received FDA clearance for the treatment of major depressive disorder, and it has since become an established option for patients whose depression has not adequately responded to medication. A standard course of treatment typically involves sessions administered over several weeks, with each session lasting approximately 20 to 30 minutes.

Is TMS Therapy Safe? What Clinical Evidence Shows

Is TMS therapy safe for individuals with treatment-resistant depression? The clinical data gathered since FDA clearance strongly supports the safety of this treatment. TMS has been studied extensively in clinical trials involving thousands of participants, and it has consistently demonstrated a favorable safety profile compared to many other depression treatments.

One of the most significant safety advantages of TMS is its non-systemic nature. Because the magnetic pulses are delivered directly to a targeted brain region rather than entering the bloodstream, patients typically do not experience the systemic side effects commonly associated with antidepressant medications, such as weight gain, sexual dysfunction, gastrointestinal discomfort, or drowsiness. For patients in Louisville who have struggled with these medication side effects, this distinction can be especially meaningful.

Common Side Effects of TMS

Like any medical procedure, TMS does carry the possibility of side effects, though they tend to be mild and temporary. The most frequently reported side effects include:

  • Mild to moderate scalp discomfort or soreness at the treatment site
  • Headache during or shortly after the session
  • Tingling or twitching of facial muscles during stimulation
  • Lightheadedness immediately following treatment

For most patients, these effects diminish over the first few sessions as the body adjusts to the stimulation. Over-the-counter pain relievers may help manage any headache or scalp tenderness. Serious adverse events are rare, with the risk of seizure estimated at approximately 0.1% or less across clinical studies. This extremely low incidence makes TMS one of the lower-risk interventions available for treatment-resistant depression.

Who Should Exercise Caution

While TMS is considered safe for most adults, certain individuals may need additional screening or may not be appropriate candidates. Patients with metallic implants in or near the head, such as cochlear implants, metal plates, or certain types of stents, should discuss their medical history thoroughly with their provider. Individuals with a history of seizures or epilepsy also require careful evaluation before beginning treatment. At Hagan Health, every patient undergoes a comprehensive assessment to determine candidacy and to ensure the highest level of safety throughout the treatment process.

How TMS Compares to Other Depression Treatments

Understanding the safety of TMS becomes even clearer when it is placed alongside other treatment options for depression that has not responded to medication.

TMS Versus Antidepressant Medications

Antidepressant medications remain a first-line treatment for major depressive disorder, and they are effective for many people. However, when a patient has tried multiple medications without adequate improvement, the cumulative burden of side effects can become significant. Common medication-related side effects include weight changes, fatigue, emotional blunting, insomnia, and sexual dysfunction. Because TMS does not introduce any chemicals into the body, it avoids these systemic effects entirely.

TMS Versus Electroconvulsive Therapy (ECT)

Electroconvulsive therapy has long been considered one of the most effective treatments for severe, treatment-resistant depression. However, ECT requires general anesthesia, induces controlled seizures, and may cause short-term memory loss or cognitive side effects. TMS, by contrast, requires no anesthesia, does not induce seizures intentionally, and has not been associated with memory impairment. For Louisville patients seeking an effective intervention with a milder side effect profile, TMS may represent a more accessible option.

It is important to note that each treatment has its own clinical indications, and the best choice depends on individual circumstances. Patients should consult with a qualified provider to determine which approach is most appropriate for their situation.

What Louisville Patients Can Expect at Hagan Health

At Hagan Health, located in Louisville, KY, patients receive TMS therapy in a comfortable clinical setting under the supervision of experienced professionals. The treatment process begins with an initial evaluation to confirm the diagnosis of treatment-resistant depression and to ensure the patient is a suitable candidate for TMS.

The Treatment Protocol

A typical course of TMS at Hagan Health involves a series of sessions conducted over approximately six weeks. Each session generally lasts around 20 to 30 minutes, during which the patient sits in a reclined chair. There is no recovery time needed, and patients are free to resume their daily activities immediately after each session. Many patients continue working, attending school, or managing their regular schedules throughout the treatment period without interruption.

Ongoing Monitoring and Support

Patient safety does not stop at the treatment chair. At Hagan Health, patients are monitored throughout their course of therapy, with regular check-ins to assess progress, manage any side effects, and adjust treatment parameters as needed. This attentive approach helps ensure that each patient’s experience is as safe and effective as possible. Patients may also continue their existing medication regimens or therapy sessions during TMS treatment, as coordinated care often yields the best outcomes.

Insurance Coverage for TMS in Louisville

Cost and coverage are often top concerns for patients exploring new treatment options. TMS therapy is frequently covered by insurance for patients with treatment-resistant depression who have not responded adequately to prior medication trials. Hagan Health accepts several major insurance plans for TMS, including Aetna, Cigna, TRICARE, Medicare, Anthem, and Beacon/Carelon. Patients are encouraged to contact Hagan Health directly to verify their specific coverage and learn more about their options.

The growing acceptance of TMS by major insurers reflects the broader medical community’s recognition of this treatment as a clinically validated, medically appropriate intervention for depression that has not responded to standard approaches. For Louisville-area residents covered by one of these plans, TMS may be a more financially accessible option than many assume.

Is TMS Therapy Safe Enough to Consider? Key Takeaways

For patients in Louisville who are living with treatment-resistant depression and weighing their next steps, the question of whether TMS therapy is safe deserves a thorough, evidence-based answer. The research consistently indicates that TMS carries a low risk of serious side effects, avoids the systemic complications associated with medications, and does not require anesthesia or sedation. While mild, temporary discomfort at the treatment site is common, most patients tolerate the procedure well and report that side effects diminish quickly.

No medical treatment is entirely without risk, and TMS is no exception. However, its overall safety profile, combined with the meaningful improvements many patients experience in depressive symptoms, has established it as a well-regarded option in the treatment of depression that has not responded to medication. Studies have shown that a significant proportion of patients experience measurable symptom improvement, and many achieve remission during or after a full course of treatment.

Take the Next Step With Hagan Health

If you or a loved one in the Louisville area has been living with treatment-resistant depression and is exploring alternatives to medication, TMS therapy may be worth discussing with a qualified provider. Hagan Health offers comprehensive evaluations and personalized treatment plans designed to help patients move toward meaningful improvement. Contact Hagan Health today to learn more about TMS therapy, ask questions about candidacy, or schedule a consultation. Taking the first step toward understanding your options is an important part of the path forward.

smoking

Smoking Addiction

BrainsWay Deep TMS is a noninvasive, FDA-cleared, outpatient brain stimulation procedure with proven clinical results to help patients to quit smoking.  Known as the addiction coil, the H4 coil was specifically designed for targeting the deep areas of the brain involved in addictions.

A large study in 14 centers examined adults who had been long-term heavy smokers, all having failed prior quit attempts using medication, therapy, or other methods. Of those that completed Deep TMS treatment, 28% achieved four consecutive weeks without smoking, most of them not smoking for at least three months after treatment.  Among all participants in the study, the average number of cigarettes smoked per week over the course of treatment was reduced by 75%.  

TMS has none of the side effects commonly found in medication to treat smoking cessation. TMS is well-tolerated with years of safety data supporting Deep TMS. Patients may initially experience minor headaches or pain at the site of treatment which typically subside after the first few sessions. There is no preparation, no anesthesia, and patients are able to resume daily activities immediately after each treatment session. Treatments are done in our office. Each treatment session lasts 25-30 minutes. They are done daily on weekdays for 3 weeks followed by a weekly session for another 3 weeks.

BrainsWay Deep TMS offers a fresh approach that may help to quit smoking using cutting-edge neuroscience. Clinically proven and well-tolerated, Deep TMS is the first non-invasive technology that is FDA-cleared to treat smoking addiction.

addiction

OCD

Deep TMS has recently be approved by the FDA for treatment of obsessive-compulsive disorder (OCD).  OCD traditionally has been treated primarily with exposure psychotherapy, and while it is also treated with medication such as fluvoxamine, OCD does not respond well to medication management.  Medication improves symtpoms greater than 30% in only 50% of patients, and half of OCD patients stop taking their medication due to side effects.  And while exposure therapy might improve OCD, as many as 80% of patients continue to have symptoms after psychotherapy, according to some studies.

BrainsWay Deep TMS is a noninvasive, FDA-cleared, outpatient brain stimulation procedure with proven clinical results for improving the symptoms of OCD.  The technology stimulates the brain using its patented H-coil, known as the H7 coil, resulting in a deep and broad penetration of the magnetic field into areas of the brain that are affected in OCD. Deep TMS is safe and well-tolerated, has a very low rate of side effects, and does not require anesthesia.  

Research has proven a higher level of improvement using Deep TMS.  Almost 68% of OCD patients were able to reduce symptoms by more than 30%, and 87% of those who responded saw sustained improvement for at least a year.

depression

Depression

Major depression was the diagnosis first approved for treatment with TMS, and it is still the most commonly treated condition. Most patients are treated with TMS after failures of medications and psychotherapy, as insurance companies will pay for TMS treatment only after medication failures.  However, TMS treats depression much better than medication, and some would argue that TMS should be the first treatment instead of the last.  

When patients have not improved with medication, they are considered to be “treatment-resistant”. And in treatment-resistant depression, TMS treatment results in significant improvement, defined as more than a 50% reduction in symptoms, in more than 80% of patients.  And more than 60% of patients achieve remission.  That is a very high and a very impressive number of people who are happy for the first time in many years after TMS treatment.

TMS treatments for depression are done in a series of 36 treatments.  Patients have a 20-minute treatment 5 days a week for six weeks followed by 6 more treatments in a tapering schedule over three more weeks. No preparation is needed, and there is no recovery time.  After each treatment, patients are able to leave and go about their day.  Except for a rare seizure, which occurs in 1 of 1000 patients, TMS has only minor side effects of mild headache or scalp soreness in the first few days. 

It is said that after successful TMS treatment, that there is a 50% chance of relapse of depression within the first year.  However, at Hagan Health we consider that statistic to be too high, and our relapse rate is lower.  While treatments are done by certified and experienced treaters, Dr. Hagan is closely involved in determining the location and strengths of settings to provide the most accurate treatment.  In addition, Dr. Hagan meets with patients every week or two before and during treatment, and periodically after treatment, in order to insure the best possible results.  Depression varies from patient to patient, and it is important to get the know the patient and the thoughts, feelings, and circumstances that might lead to relapse.  Using cognitive therapy techniques, patients are taught to be aware of triggers and to be prepared with the cognitive tools used to reduce the chances of relapsing. 

TMS for Anxious Depression

Recently TMS has been cleared by the FDA for treatment of Anxious Depression.  This condition is one in which anxious distress is a major part of the clinical picture while depression remains the predominant diagnosis.  Anxiety which is treated along with depression is also significantly improved, while TMS is not currently considered appropriate for the treatment of anxiety without depression.

Dr. Hagan Bio

So the lesson Al taught me was about my lack of happiness related to feelings of inadequacy. Even though I had become a brain surgeon, I did not have a healthy self-regard. Al explained to me that my father, in his drive to succeed and to push me to succeed, would never let me savor a victory, that whenever I achieved something important, he would ask, . “How could you have done it better?” Or “what is next?”. He was setting the bar at perfection, such that nothing less than perfection was going to be good enough. Al said, “Nobody is perfect”, and that I would be much happier deciding what degree of imperfection I was going to settle for. When one sets the bar at perfection, then every effort falls short of perfection and is therefore a relative failure, it becomes yet more evidence of one’s belief that he is fundamentally flawed and inadequate. He said that we are all always doing our best, and that is not fair for my father or for me myself to tell myself that I am not good enough. It was the single most important piece of wisdom that I would learn for the next several decades, and I have told this story many times to those who, like me, grew up to have similar issues.

After seeing Al for a year, another year or two went by. One day at church I was listening to a talk from a psychotherapist who had grown up in a family in which his mother was an alcoholic and his father was a workaholic. His story sounded so much like mine that I decided to see him professionally to “learn more about this garbage in my head”. I saw Paul for two years.

A few years later, life had become quite stressful. I was married with three small children, practicing neurosurgery full time and doing some farming on the side. It was at this time that I started seeing my third therapist, the one that I would see for most of the next 10 years. Keith was a psychiatrist, an MD like me, who did only psychotherapy. A few months after starting my therapy with Keith, I realized that I liked what he did better than what I did. The process of therapy is that of developing an increasing awareness of how one got to be the way he or she is, starting with childhood issues. Specifically, this type of therapy is called “psychodynamic psychotherapy”.

Dr_Hagan
Terry

Three years into my experience with Keith, I made the final decision that I would rather be a psychiatrist, because I came to love the process of developing insight into one’s own psychology. As I closed my neurosurgery practice and completed a residency in psychiatry, I was so grateful the entire time for the opportunity to turn myself into a psychiatrist. “Who gets to do that?!” Years later a patient was looking at the books on my bookshelf and asked, “So you were a neurosurgeon; did you like it?” I had been asked many times why I decided to give up neurosurgery to become a psychiatrist, but no one had ever asked if I liked neurosurgery. The answer had to be that no, I did not. I did not like who I was. But I have loved psychiatry from the very beginning, and I really appreciate the contribution it has had in my own personal development.

But because of my heavy early experience in psychotherapy, I also became proficient and experienced in both psychodynamic psychotherapy and in cognitive behavioral therapy (CBT). And I attended the Cincinnati Psychoanalytic Institute for a year to take my psychotherapy skills to a higher level.

During the 17 years that I have been practicing psychiatry, I have continued to grow. The most gratifying experiences I have had have been when I have settled into a psychotherapy relationship with a patient, while there have been many, others with whom I have combined psychiatry with psychodynamic therapy, practicing psychodynamic psychiatry.

Terry
Dr. Hagan Bio

During these same years, I have also been on several mission trips, which have given me perspectives that I would never have learned otherwise. The concepts of loving your neighbor, giving of your time and resources, being kind and gentle and gracious, have come to define me.

I have always been at the head of my own practice, managing my own business. I have experience with other businesses as well, such as being a successful alpaca breeder for 10 years. “They do not teach business in medical school.” In a growing psychiatry practice, running the business is something you learn from necessity.