Transcranial magnetic stimulation (TMS) is an FDA-cleared, drug-free treatment for adults with major depression that hasn't improved with antidepressants. Sessions take about 20–30 minutes, you stay awake, and you can drive yourself home. Most patients notice improvement within 3–5 weeks.
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Medically reviewed by Yuli Fradkin, MD, board-certified psychiatrist · Last reviewed October 2026
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Dr Fradkin helped me with treatment-resistant depression using TMS.
Valery Dinner Verified Google ReviewI had a great experience at the Village TMS Center for Autism and Depression. The staff is very kind, professional, and truly cares about their patients. They take the time to listen and explain the treatment process clearly.
kibriyo komilova Verified Google ReviewMy son just finished TMS therapy with Village Group Medical. I am pleased to mention pleasant and welcoming atmosphere of this office. It helped my son relax and agree to undergo the therapy.
Yelena Haskin Verified Google ReviewAs an R.N. for decades I’ve had myriad experiences with institutions and providers. It takes a lot to impress me and that’s what Dr Fradkin and his affable staff have done! My treatments have been attended to with integrity, friendliness and skill. They provided scheduling flexibility, cost transparency, and a comprehensive orientation to my TMS treatments with a smile. Thus I have no reservations advocating Village TMS and award Dr Fradkin and his staff an A+.
Dennis Moriarty Verified Google ReviewI've been using Village Medical Group services for quite some time and can recommend it to everyone. Very easy easy and transparent communications, warm and welcoming office with people who care. George is very knowledgeable, helpful and I really appreciate his help all the time. Dr. Fradkin is amazing specialist that carefully and precisely chose the treatment that helped. I feel safe and comfortable every time I visit the office.
Nikita Khvastunov Verified Google ReviewVery professional and caring team. I enjoyed learning more about this solution and was pleased with the provided service!
Raul Ifraimov Verified Google ReviewTMS session with George went great. Even though I just started and it’s a new experience for me, a cautious supervision and guidance of the specialist helps to get through. I had all my questions being answered before the procedure. Will come again!
Ekaterina Kokovikhina Verified Google ReviewJust had my first TMS session. Feeling great!
Sofia Dro Verified Google ReviewTHE BASICS
TMS therapy is an outpatient treatment for depression that uses focused magnetic pulses to stimulate the left dorsolateral prefrontal cortex, a mood-regulating area that tends to be underactive in depression. The pulses create small electrical currents in the nerve cells under the coil. Repeated daily over several weeks, this stimulation is thought to strengthen communication in the brain networks that regulate mood.
TMS devices are FDA-cleared, the regulatory pathway for medical devices; they are not "FDA-approved" the way a drug is. The first clearance came in 2008 for adults with major depressive disorder who had not improved with antidepressant medication. Later clearances added obsessive-compulsive disorder with the Deep TMS H7 coil (2018), a shorter theta-burst protocol (2018), anxiety symptoms in adults with depression (2021) and adolescents aged 15–21 with depression (2024).
Because nothing enters your bloodstream, TMS doesn't cause the weight gain, sexual side effects or drowsiness that lead many people to stop an antidepressant. Unlike electroconvulsive therapy (ECT), it needs no anaesthesia and does not induce a seizure. You are awake for every session and can go straight back to work afterwards. The National Institute of Mental Health describes TMS alongside the other brain stimulation therapies used in psychiatry.
For a longer introduction, read our complete guide to TMS therapy, which covers the history of TMS and how it has been studied.
Devices are cleared; drugs are approved. TMS is cleared for major depression, OCD (Deep TMS) and anxious depression. It is not cleared for ADHD, PTSD, bipolar depression or generalized anxiety disorder, where any use is off-label.
No
Anaesthesia
No
Systemic Side-Effects
20-30
Min per session
Drive
Yourself home
TYPES OF TMS
All three are FDA-cleared for major depression. They differ in the coil, how deep the stimulation reaches and how long each session takes. Your psychiatrist will explain which type and device your protocol uses. Our comparison of Deep TMS vs standard TMS goes into more detail.
MOST STUDIED
Repetitive TMS (rTMS) uses a figure-8 coil over the left prefrontal cortex. It was the first form of TMS cleared for depression and has the largest body of research, including the multisite sham-controlled trial by O'Reardon et al. (2007) that led to the 2008 clearance.
DEPRESSION, OCD & ANXIOUS DEPRESSION
Deep TMS uses an H-coil that reaches broader and deeper brain areas than a figure-8 coil. Beyond major depression, it is FDA-cleared for OCD (2018) and for reducing anxiety symptoms in adults with depression (2021). For people whose main struggle is OCD or anxious depression, it is the cleared option.
SHORTER SESSIONS
Intermittent theta-burst stimulation delivers pulses in rapid bursts, so the stimulation itself takes only a few minutes. In the THREE-D trial (Blumberger et al., 2018) it was about as effective as standard rTMS. Accelerated schedules such as SAINT give several sessions a day; we don't offer them, but our guide to accelerated TMS and SAINT explains the evidence.
SIDE-BY-SIDE COMPARISON
All four are used when antidepressants haven't been enough. They differ in how they work, how often you come in and what a treatment day looks like. For more detail, see TMS vs ECT, Spravato treatment in NYC and our overview of treatment-resistant depression.
| Treatment | How it works | Regulatory status | Typical schedule | On the day |
|---|---|---|---|---|
|
TMS |
Magnetic pulses stimulate the left prefrontal cortex |
FDA-cleared device for major depression |
About 5 sessions a week; a standard course is usually 30–36 sessions over 6–9 weeks |
20–30 minutes, awake, no anaesthesia; you can drive yourself home |
|
Spravato (esketamine) |
Nasal spray that acts on the brain’s glutamate system |
FDA-approved drug for treatment-resistant depression |
Twice weekly in weeks 1–4, weekly in weeks 5–8, then weekly or every 2 weeks |
At least 2 hours of monitoring in a REMS-certified clinic; no driving until the next day after a restful sleep |
|
IV ketamine |
Low-dose ketamine infusion |
Off-label for depression (FDA-approved only as an anaesthetic) |
A series of infusions set by your psychiatrist |
Monitored infusion; no driving that day, so arrange a ride home |
|
ECT |
Brief electrical stimulation induces a controlled seizure |
Long-established treatment for severe depression |
Several sessions a week, usually over a few weeks |
General anaesthesia each time; possible short-term memory loss |
IS TMS RIGHT FOR YOU?
TMS is cleared for adults with major depression who haven't improved with antidepressant medication. This is the most common reason people come to us.
If weight gain, sexual side effects or fatigue made medication hard to stay on, TMS avoids those systemic effects altogether.
Many insurers ask for two or more failed antidepressant trials, and some also ask for a course of talk therapy. We check your plan's criteria for free.
A course means short visits about five days a week. We're open 8am–9pm on weekdays, with weekend hours, so sessions can fit around work.
Not sure if you qualify? We'll review your treatment history for free.
YOUR COURSE OF TMS
FREE · 15 MIN
A free call covers the basics and your insurance. You then meet a board-certified psychiatrist, who reviews your diagnosis, past medications and safety screening and decides whether TMS fits.
FIRST TREATMENT VISIT
We find the lowest pulse strength that makes your thumb twitch, then use it to set your dose and locate the treatment target. It is done at the start and repeated if needed.
20–30 MIN · 5 DAYS A WEEK
You sit in a reclining chair while the coil taps rhythmically on your scalp. A standard course is usually 30–36 sessions over 6–9 weeks; your psychiatrist sets your schedule.
END OF COURSE
We compare your symptoms with where you started. Some courses end with a short taper, and some patients come back for maintenance sessions if symptoms return.
Want the session-by-session detail? Read how TMS therapy works inside a session, week by week.
Wondering how a course would fit around your week? Ask us.
RESULTS
TMS doesn't work for everyone, and no one can promise you a result. Here is what the research shows and what to expect along the way. Our article on the TMS success rate covers the numbers in more depth.
Response means your depression score drops by at least half. Remission means your symptoms fall to a minimal level. Studies report both, and remission is the harder target to reach.
In clinical studies, active TMS outperformed sham treatment. In a 2012 study of 307 patients treated at 42 US practices (Carpenter et al.), 58% responded and 37% reached remission by clinician rating.
Most patients notice improvement within 3–5 weeks. Sleep, energy or motivation often shift before mood does. If you feel worse at any point, tell your care team the same day.
If you haven't improved by the end of the course, your psychiatrist will talk through other options, such as Spravato, ketamine or a medication change. Patient accounts in our article on TMS therapy reviews, pros and cons cover both kinds of outcome honestly.
Ask us what results are realistic for your history.
SAFETY
The most common side effects are scalp discomfort at the treatment site and mild headaches, mostly in the first week or two. They usually ease as sessions continue, and over-the-counter pain relief helps if needed. In the 2007 multisite trial, the dropout rate for side effects was 4.5%.
Seizures are the most serious risk, and they are rare. Before treatment we screen everyone for metal implants near the head, a history of seizures and medications that can lower the seizure threshold. TMS has not been shown to affect memory or thinking, one of its main differences from ECT.
See the full list in TMS therapy side effects, or our frank answer to the question "Did TMS ruin my life?" for the risks people worry about most.
Nothing enters your bloodstream, so there is no weight gain, sexual side effect or daytime drowsiness from the treatment itself.
Studies have not found memory or cognitive problems from TMS, unlike ECT.
The risk is very low, and screening excludes people for whom it would be higher.
TMS isn't suitable with some metal implants in or near the head, such as cochlear implants, aneurysm clips or deep brain stimulators.
BEYOND DEPRESSION
Deep TMS with the H7 coil has been FDA-cleared since 2018 for adults with OCD. Sessions include brief, guided symptom provocation. Ask us whether this protocol suits you.
Deep TMS is cleared to reduce anxiety symptoms in adults with depression. For anxiety disorders without depression it is off-label. See TMS therapy for anxiety.
TMS is not FDA-cleared for PTSD or ADHD, and the evidence is emerging and mixed. Read about TMS for PTSD and TMS for ADHD.
TMS is not cleared for bipolar depression and carries a risk of switching into mania, so it needs close monitoring. See bipolar depression treatment.
Not sure which applies to you? Ask at your free consultation.
Most major insurance plans cover TMS for depression once their criteria are met, and with insurance most patients pay $0–$50 per session. We verify your benefits for free and handle prior authorization. See TMS therapy cost in NYC and is TMS covered by insurance? for details.
AETNA
BCBS
CIGNA
UNITED
EMPIRE BCBS
OXFORD
MEDICARE
+ MORE CARRIERS
Takes 2 minutes. No commitment.
Two board-certified psychiatrists lead every TMS course here, with psychotherapy available alongside treatment.
Board-Certified Psychiatrist · 25+
Years Experience
I founded Village TMS because so many of my patients had been failed by
standard treatment paths. My approach is unhurried, evidence-driven, and centred on what each person actually needs to feel like themselves again.
Board-Certified Psychiatrist · 15+ Years Experience
I came to TMS after watching patients
cycle through medications that didn't fit them. My focus is precision, matching the right protocol to the right person, and adjusting as we go.
Psychotherapist & Coach ·
Couples Therapy
I help adults and couples build self-awareness and deepen relationships. My work is grounded in Gestalt therapy and informed by EMDR, mindfulness, and transpersonal psychology. I combine deep emotional exploration with practical tools, working in a warm, collaborative space where clients feel genuinely seen and supported.
Short answers to what patients ask us most about TMS for depression.
Most people describe a tapping or knocking feeling on the scalp. It can be uncomfortable for the first few sessions, and some people get a mild headache. Both usually ease within the first week or two, and your care team can adjust the settings if needed.
A standard course is usually 30–36 sessions over 6–9 weeks, about five days a week. Your psychiatrist sets your schedule based on your protocol and how you respond.
Yes. TMS involves no anaesthesia or sedation, so you can drive yourself home and go straight back to work or class.
Usually not. Many patients stay on their current medication during TMS. Don’t stop or change any medication on your own: your psychiatrist reviews everything you take at the evaluation, because a few medications affect seizure risk.
Not everyone responds. If you haven’t improved by the end of the course, we’ll go through other options with you, such as Spravato, ketamine therapy or a change in medication.
It varies. Some people stay well long after a course; others need maintenance sessions or a repeat course if symptoms return. Your psychiatrist will plan follow-up with you at the end of treatment.
Most major plans cover TMS for depression when their criteria are met, usually a diagnosis of major depression plus prior antidepressant trials. We verify your coverage for free and handle prior authorization.
INSIGHTS
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We provide TMS therapy in NYC at 80 Fifth Avenue, Suite 1405, at 14th Street between Union Square and the Flatiron District. Patients come from across Manhattan, Brooklyn, Queens and New Jersey; see getting to Village TMS for transit tips.
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