What Is TMS Therapy?
Transcranial magnetic stimulation (TMS) is an FDA-cleared, non-invasive treatment that uses focused magnetic pulses to stimulate the region of the brain that regulates mood. It was developed for people whose depression has not improved with antidepressant medication, and it works through a different mechanism than any pill.
During a session you sit in a chair, awake and alert, while a treatment coil rests against your scalp. The coil delivers brief magnetic pulses, similar in strength to an MRI, to the left dorsolateral prefrontal cortex. This area is consistently underactive in people with depression. Repeated stimulation over several weeks helps restore normal activity in that circuit and in the deeper mood networks connected to it.
At Georgia Behavioral Health in Norcross, TMS is delivered under the direction of Dr. Neha Khurana, MD, a board-certified psychiatrist and Atlanta Magazine Top Doctor for General Psychiatry in 2025 and 2026. We treat patients from Norcross, Peachtree Corners, Duluth, Suwanee, Johns Creek, Lawrenceville and the greater Gwinnett County area.
TMS is one of the few depression treatments that is both FDA-cleared and drug-free. Because the magnetic field acts only on the targeted brain region, TMS does not cause the weight gain, sexual side effects, sedation, or emotional flattening that lead many patients to stop taking antidepressants.
Source: Georgia Behavioral Health TRD Clinic
How Does TMS Work?
Depression is not only a chemical problem. Brain imaging studies show that in depression the prefrontal cortex, the region responsible for planning, motivation and emotional regulation, is less active than it should be, while deeper structures involved in threat and stress are overactive. Antidepressants try to correct this indirectly by changing serotonin or norepinephrine levels throughout the whole body.
TMS goes directly to the source. Each magnetic pulse induces a small electrical current in the neurons beneath the coil. Delivered thousands of times per session, five days a week, these pulses strengthen the connections in the underactive circuit through a process called neuroplasticity. Over the course of treatment, the brain learns to maintain that healthier activity on its own, which is why the benefit of TMS often lasts well beyond the final session.
This is also why TMS can work when medication has not. It does not depend on the serotonin system at all. Read more about why antidepressants stop working and how the GBH TRD Clinic approaches treatment-resistant depression.
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What Does TMS Therapy Treat?
TMS is FDA-cleared for four conditions, and it is used clinically for several more when a psychiatrist determines it is appropriate.
Treatment-Resistant Depression
The original and most studied use. FDA-cleared since 2008 for adults who have not achieved relief from at least one antidepressant.
Learn about our TRD ClinicObsessive-Compulsive Disorder
FDA-cleared for OCD since 2018 using a deeper coil that reaches the circuits involved in compulsive behavior.
Learn about OCD treatmentAnxious Depression
FDA-cleared in 2021 for depression with significant anxiety symptoms, the most common presentation we see in our clinic.
Learn about anxiety treatmentPTSD and Other Conditions
Used off-label for PTSD, bipolar depression and chronic pain when standard treatment has not worked. Candidacy is decided case by case.
Learn about PTSD treatmentWho Is a Candidate for TMS?
TMS may be a good fit if you:
- Have been diagnosed with major depressive disorder and have tried at least one antidepressant without adequate relief
- Cannot tolerate the side effects of antidepressants, or prefer not to take medication
- Have OCD that has not responded to therapy and medication
- Are looking for a treatment you can fit around work, school, or caring for family, since there is no recovery time
- Want an option that can be combined with medication, talk therapy, or SPRAVATO rather than replacing them
Who Should Not Have TMS
TMS is not safe for everyone. During your evaluation we screen carefully for the following:
- Non-removable metal in or near the head, such as aneurysm clips, cochlear implants, deep brain stimulators, or metallic fragments. Dental fillings and braces are fine.
- A personal history of seizures or epilepsy, which raises the small risk of a seizure during treatment
- Implanted devices that could be affected by a magnetic field, including some pacemakers and vagus nerve stimulators
Pregnancy, age, and most medical conditions do not rule TMS out, but they are part of the conversation. A full psychiatric evaluation comes first, every time.
The TMS Treatment Process: What to Expect
Initial Screening
A brief phone or virtual conversation to review your symptoms, treatment history, and insurance so we can tell you quickly whether TMS is worth pursuing.
Psychiatric Evaluation
Dr. Khurana or a member of her team completes a full evaluation, confirms the diagnosis, screens for safety, and reviews other options such as SPRAVATO or IV ketamine so you understand the full picture.
Insurance Authorization
Our office submits the prior authorization to your insurer. Most patients are approved within one to two weeks. We handle the paperwork so you do not have to.
Mapping Session
At your first visit we find your motor threshold, the pulse strength that produces a small twitch in your hand, and use it to set your personal treatment dose and coil position.
Daily Treatment
Sessions run five days a week for about six weeks, followed by a short taper. Each session lasts 20 to 40 minutes depending on protocol. You are awake the whole time and can read, listen to music, or talk with staff.
Follow-Up
We track your symptoms with standardized scales throughout treatment and see you for follow-up after the course ends. If symptoms return months later, a shorter maintenance course is often covered.
What a TMS Session Feels Like
Most patients describe TMS as a firm tapping on the scalp, paired with a clicking sound from the machine. The first two or three sessions can feel intense until you get used to it, and mild scalp soreness or a headache afterward is common in the first week. Both usually fade as treatment continues. You will not feel sedated, foggy, or different when you leave, and you can go straight back to work or drive home.
How Effective Is TMS for Depression?
TMS has been studied in dozens of randomized controlled trials and in large real-world registries since the mid-2000s. Across that research, roughly half to two-thirds of patients with treatment-resistant depression respond to a full course, meaning their symptoms drop by at least half, and about one third reach full remission. For a group of patients who have already failed multiple medications, those numbers are strong.
In a multi-site study of 307 patients treated in routine clinical practice, 58 percent responded to TMS and 37 percent reached remission, results that held up at one-year follow-up for most responders.
Source: Carpenter et al., Depression and Anxiety, 2012; Dunner et al., Journal of Clinical Psychiatry, 2014
Most patients begin to notice change in the third or fourth week. Sleep and energy often improve first, then mood and motivation. Because the effect builds over the course, completing the full protocol matters. Stopping early is the most common reason TMS falls short.
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TMS Side Effects and Safety
TMS has one of the cleanest safety profiles in psychiatry. Because nothing enters the bloodstream, there are no systemic side effects. The effects that do occur are local and short-lived:
- Scalp discomfort or tenderness at the treatment site, most common in the first week
- Mild headache after sessions, which responds to over-the-counter pain relievers
- Facial twitching during pulses, which stops when the pulse stops
- Temporary lightheadedness right after a session
The one serious risk is seizure, which occurs in fewer than 1 in 10,000 sessions and is why we screen for seizure history and certain medications before starting. TMS does not affect memory or cognition, which sets it apart from electroconvulsive therapy (ECT). It is not the same treatment.
TMS Cost and Insurance Coverage in Georgia
Most major insurance plans, including Aetna, Anthem Blue Cross Blue Shield, Cigna, UnitedHealthcare, Humana, and Medicare, cover TMS for major depressive disorder when the patient meets the plan's criteria. In most cases that means a confirmed diagnosis, a documented trial of at least one to four antidepressants without adequate response, and at least one course of psychotherapy.
Our office verifies your benefits and submits the prior authorization before you begin, so you know your expected out-of-pocket cost in advance. Your responsibility depends on your deductible and copay for outpatient specialty care, which applies per session. For patients paying out of pocket, we can discuss self-pay pricing and payment plans during your consultation.
Coverage for OCD and other conditions varies more by plan. Call (678) 861-6463 and we will check your specific policy.
TMS vs. SPRAVATO vs. IV Ketamine
GBH offers all three of the leading interventional treatments for treatment-resistant depression. They are not interchangeable, and many patients are candidates for more than one. Here is how they compare.
| TMS Therapy | SPRAVATO (esketamine) | IV Ketamine | |
|---|---|---|---|
| FDA status | FDA-cleared for depression, OCD, anxious depression | FDA-approved for treatment-resistant depression | FDA-approved anesthetic, used off-label for depression |
| How it is given | Magnetic coil on the scalp | Nasal spray under monitoring | Intravenous infusion |
| Session length | 20 to 40 minutes | About 2 hours including observation | About 2 hours including infusion and monitoring |
| Course | 5 days a week for about 6 weeks | Twice weekly for 4 weeks, then weekly or every other week | Typically 6 infusions over 2 to 3 weeks |
| Sedation or dissociation | None. You drive yourself. | Possible. No driving that day. | Common. No driving that day. |
| Insurance | Usually covered | Usually covered with prior authorization | Not typically covered |
| Speed of response | Gradual, usually weeks 3 to 4 | Can be within hours to days | Can be within hours to days |
Not sure which is right for you? Read our full comparison of TMS therapy vs. SPRAVATO, or book an evaluation and we will walk through the options together. Some patients use IV ketamine or SPRAVATO for faster relief while the TMS course builds.
Ready to Find Out If TMS Is Right for You?
A consultation with our TRD Clinic team takes about an hour and gives you a clear answer on candidacy, insurance, and timing. Serving Norcross, Peachtree Corners, Duluth, Suwanee, Johns Creek and greater Gwinnett County.
Book a TMS ConsultationWhy Choose Georgia Behavioral Health for TMS in Norcross
- Psychiatrist-led care. Every TMS patient is evaluated and followed by a board-certified psychiatrist, not only a technician. Dr. Khurana is an Atlanta Magazine Top Doctor for General Psychiatry in 2025 and 2026.
- A full TRD Clinic under one roof. TMS, SPRAVATO, IV ketamine, medication management, EMDR and talk therapy are all offered here, so your plan is built around you rather than around the one tool a clinic happens to have.
- Insurance handled for you. We run benefits and prior authorization before your first session.
- Convenient location. Our office is at 4720 Peachtree Industrial Blvd, Suite 4101 in Norcross, minutes from Peachtree Corners, Duluth, Johns Creek and Suwanee, with parking on site. Daily sessions are easier when the drive is short.
- Care in English, Korean and Spanish. 한국어 진료 가능합니다. Se habla español.
TMS Resources and Research
From the GBH Blog
→ TMS Therapy vs SPRAVATO: Which Is Right for You? → What Is Treatment-Resistant Depression? Answers to the Questions Patients Are Actually Asking → Why Antidepressants Stop Working → Men's Mental Health and Treatment-Resistant Depression → The Link Between Chronic Stress and Treatment-Resistant DepressionReferring a Patient for TMS?
Download our TRD Clinic Referral Guide. We co-manage with referring therapists and physicians and send progress updates throughout the course.