TMS Therapy for Depression in Glendale, CA

When Medication and Therapy Are Not Enough

Depression can feel exhausting, isolating, and stubborn. If you have tried medication and therapy and still feel stuck, that does not mean nothing will work. It may mean your treatment needs a different mechanism. TMS offers a more targeted approach: instead of working through your whole body the way medication does, it uses magnetic pulses to stimulate the specific brain networks involved in mood regulation. You can read more about how TMS differs from antidepressants, ketamine, and ECT.

If the First Medication Has Not Worked

Remission means a period in which the signs and symptoms of a condition lessen or disappear. It is the goal of depression treatment, and it is the number worth asking about.

Each additional antidepressant is less likely to reach it than the one before. In STAR*D, the largest study of sequential antidepressant treatment, remission rates fell at every step: 36.8% on the first medication, 30.6% on the second, then 13.7% and 13.0% on the third and fourth.

TMS is not another medication, and it has been compared directly against trying one. In a multicenter randomized trial of 89 adults who had not responded to at least two treatments, eight weeks of TMS produced a higher response rate than switching antidepressants, 37.5% against 14.6%, and a higher remission rate, 27.1% against 4.9%. A second randomized trial, in 278 adults, compared adding TMS against switching antidepressants and against adding an antipsychotic: TMS was the only one of the two add-on strategies that outperformed a switch on the study's primary measure.

This is also what the major treatment guidelines advise. Both the Canadian Network for Mood and Anxiety Treatments and the US Department of Veterans Affairs and Department of Defense recommend considering TMS for patients who have not responded adequately to two or more medication trials.

Outside of trials, results reported from routine practice have been higher. A review of 1,351 patients treated with the BrainsWay H1 coil across 21 clinics found 81.6% responded and 65.3% reached remission after 30 sessions, with most of those who improved still improved at the next assessment. In the interest of transparency, the device manufacturer co-authored that study. We include it because it describes what treatment has looked like in ordinary clinical use across many clinics, rather than under trial conditions here.

Those are trial averages and general recommendations, not a promise about any individual. Whether TMS is the right next step for you is a clinical judgment your physician makes after evaluation and safety screening.

Sources (6)

1. Tendler A, Goerigk S, Zibman S, et al. Deep TMS H1 coil treatment for depression: results from a large post marketing data analysis. Psychiatry Res. 2023;324:115179. doi:10.1016/j.psychres.2023.115179
2. Rush AJ, Trivedi MH, Wisniewski SR, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry. 2006;163(11):1905–1917.
3. Dalhuisen I, van Oostrom I, Spijker J, et al. rTMS as a next step in antidepressant nonresponders: a randomized comparison with current antidepressant treatment approaches. Am J Psychiatry. 2024;181(9):806–814. doi:10.1176/appi.ajp.20230556
4. Papakostas GI, Trivedi MH, Shelton RC, et al. Comparative effectiveness research trial for antidepressant incomplete and non-responders with treatment resistant depression (ASCERTAIN-TRD): a randomized clinical trial. Mol Psychiatry. 2024;29(8):2287–2295. doi:10.1038/s41380-024-02468-x
5. Lam RW, Kennedy SH, Adams C, et al. CANMAT 2023 update on clinical guidelines for management of major depressive disorder in adults. Can J Psychiatry. 2024;69(9):641–687. doi:10.1177/07067437241245384
6. US Department of Veterans Affairs / Department of Defense. Clinical Practice Guideline for the Management of Major Depressive Disorder, 2022, Recommendation 17.

Common Depression Symptoms

Depression looks different from person to person. Symptoms we commonly hear about include:

• Low mood, numbness, or irritability
• Loss of interest or pleasure
• Low energy, fatigue, or slowed thinking
• Sleep changes (too much or too little)
• Appetite or weight changes
• Difficulty concentrating
• Feeling hopeless or “not like yourself”

If your depression also comes with racing thoughts, restlessness, or constant worry, you may want to read about TMS for anxious depression, Deep TMS is FDA-cleared to reduce anxiety symptoms that occur with depression in adults.

Are You a Candidate for TMS?

You may be a fit if you:

• Have MDD and have not improved enough with medication or therapy
• Cannot tolerate medication side effects
• Prefer a non-drug approach
• Are medically appropriate after screening

Candidacy is confirmed in a consultation, not a checklist, your history and safety screening matter more than any single factor. Most people we treat for depression are adults; see our overview of adult TMS therapy in Los Angeles.

Safety & Side Effects

Most side effects are mild and short-term, commonly headache or scalp discomfort during or after sessions, and comfort typically improves as your body adapts. Seizure is a rare risk of TMS; we screen for it at every visit, see our full safety and seizure-risk detail on What Is TMS?. We go over safety, and anything that would make TMS a poor fit for you, during your consultation, including screening for metal in or around the head.

Cost & Insurance

Many insurance plans cover TMS for depression. Our team can verify your benefits and explain expected out-of-pocket costs before you start, so there are no surprises. If you have questions about your specific plan, reach out to our Glendale office and we will check for you.

For the plans we work with, what prior authorization involves, and what a coverage check looks like from your side, see insurance and benefits verification.

Depression Is Not the Only Thing We Treat With Deep TMS

Depression is the most common reason patients come to us, but it is not the only condition BrainsWay Deep TMS is FDA-cleared to treat. Obsessive-compulsive disorder is treated on the same system using a different coil, a different target, and a different protocol. If intrusive thoughts, rituals, or compulsions are part of the picture for you, read about Deep TMS for OCD, including how that course is structured and what response is measured on.