TMS (Transcranial Magnetic Stimulation) is best known as a solution for treatment-resistant depression. It works by delivering gentle, targeted magnetic pulses to the prefrontal cortex, which is the part of the brain involved in mood regulation. TMS is a noninvasive treatment, and TMS devices are FDA-cleared for major depressive disorder.
You may have also heard of other brain-based treatments like ECT, neurofeedback, or ketamine therapy. In this article, we’ll break down the difference and how to choose the best option.
| Therapy | Administration | FDA Approvals | Common Side Effects | Invasiveness |
| Neurofeedback | Brainwave training via EEG | — | — | Noninvasive |
| TMS | Magnetic pulses to scalp | Depression (FDA-cleared) | Mild headache, scalp discomfort | Noninvasive |
| Ketamine | IV, nasal spray, or lozenge | General anesthesia only | Dissociation, dizziness, nausea | Minimally invasive |
| ECT | General anesthesia and induced seizure | Severe depression that is treatment-resistant or needs a rapid response (FDA-cleared) | Memory loss, confusion | Noninvasive |
Electroconvulsive Therapy (ECT) vs. TMS
Electroconvulsive therapy (ECT) is one of the oldest forms of brain stimulation used in psychiatry. It’s a more intensive treatment than TMS, requiring general anesthesia and close medical monitoring. Unlike TMS, which targets specific areas of the brain, ECT affects the entire brain and works by inducing a controlled seizure.
While studies show ECT to be effective, especially in severe cases, it often comes with significant side effects such as confusion and memory loss.
Neurofeedback vs. TMS
Neurofeedback, also known as EEG biofeedback, is a noninvasive brain training technique. During a session, electrodes placed on the scalp monitor real-time brainwave activity while the patient watches a video or listens to music. The system uses this input to guide subtle shifts in brainwave patterns.
Ketamine vs. TMS
Ketamine is a general anesthetic administered via IV, nasal spray, or a lozenge. According to Yale Medicine, ketamine treatment may be an option when two or more trials of standard antidepressant medication fail; Yale researchers say ketamine seems to allow the brain to regrow synapses, the connections between neurons.
It also carries dissociative side effects and must be administered under medical supervision. TMS, in contrast, doesn’t involve sedation.
The importance of pairing brain stimulation with traditional therapy
Here’s why:
1. Personalization and adjustment
Your brain and mood change throughout treatment. Regular therapy check-ins help track those changes, fine-tune your care plan, and ensure you’re getting the most out of each session.
2. Sustaining progress
TMS stimulates mood-regulating brain areas—but therapy helps you process emotions, shift negative thinking patterns, and make lasting behavioral changes that keep you well.
3. Increased therapy effectiveness
If talk therapy hasn’t worked for you in the past, don’t give up.
How effective is TMS?
According to Harvard Health, 50% to 60% of people with depression who have tried and failed to improve on medication experience a clinically meaningful response with TMS, and about a third achieve full remission. The same source notes these results are not permanent and relapse is common, though most patients feel better for many months, with an average response lasting a little more than a year. It’s also common for patients to return for subsequent rounds.
Can you do TMS sessions while on medication?
Many people undergo TMS therapy while on medication (like antidepressants), but it’s important to discuss with your provider. They may choose to alter dosage during or after treatment.
Which treatment is right for me?
The best treatment for your mental health needs depends on factors like medical history, symptoms, and how quickly you need relief. For this reason, it’s best to talk to your doctor about your symptoms and goals and come up with a personalized treatment plan together.
Able Psychiatry is one of Chicago’s first TMS providers, offering care for treatment-resistant depression. Our Lincoln Park office provides a welcoming space for personalized treatment tailored to your needs. Learn more about our TMS techniques or reach out to learn more.