For many Australians living with depression, the story is painfully familiar. Several rounds of antidepressants, an ever-changing pill box, side effects that chip away at day-to-day life, and only partial relief. After a while, the thought of trying yet another medication can feel exhausting. Against that backdrop, interest in transcranial magnetic stimulation, or TMS, has grown steadily in Australia and overseas as an alternative way to treat depression that does not rely on more tablets.
Why antidepressant medication can leave people worn out
Antidepressants save lives, and for many people they work well enough. Still, a sizeable group either does not respond fully or cannot tolerate the side effects. Weight gain, sexual difficulties, gastrointestinal upset, emotional “numbing” and sleep disruption are often mentioned in clinic rooms. Some people also worry about being on medication long term, or feel uncomfortable when doses need to keep going up.
Guidelines from the Royal Australian and New Zealand College of Psychiatrists (RANZCP) note that a meaningful proportion of people with major depressive disorder meet criteria for treatment-resistant depression after trying at least two adequate courses of medication. At that point, psychiatrists are encouraged to consider other biological options such as TMS alongside psychological therapies and lifestyle approaches.
Whats’s Transcranial Magnetic Stimulation?
Transcranial magnetic stimulation, or TMS, uses a coil placed on the scalp to deliver brief magnetic pulses to specific areas of the brain involved in mood regulation. These pulses induce tiny electrical currents that influence how brain cells communicate, with the aim of improving depressive symptoms. The person stays awake, no anaesthetic is needed, and treatment is delivered in an outpatient setting.
In Australia, TMS is now available in a growing number of public and private clinics. Clinics offering TMS therapy for depression often works in close collaboration with GPs and psychiatrists, so that it fits into an overall treatment plan rather than standing alone.
How TMS differs from medication
The most obvious difference is where the treatment acts. Antidepressant tablets enter the bloodstream and affect the whole body. This can help, but it also explains why people may experience digestive upset, weight changes, sexual side effects or interactions with other medicines.
TMS, by contrast, targets a specific region of the brain through the skull, without circulating through the rest of the body. TMS can improve depressive symptoms without the systemic side effects associated with oral antidepressants, which is one reason it appeals to people who feel they have reached the end of the road with medication.
That said, psychiatrists often combine TMS and medication, especially for those with severe or long-standing depression. Combining the two has been shown in research to provide better symptom relief than sham TMS plus medication, with no marked increase in adverse events.
Also Read: How Many TMS Sessions Do You Need, and How Soon Might You Feel Better?
Safety and side effects
TMS has been studied carefully for safety, including in older adults.
The most common side effects are mild scalp discomfort at the stimulation site, muscle twitching in the face and short-lived headaches. These usually settle over the first few sessions and are rarely severe enough to stop treatment. RANZCP notes that fewer than 2% of patients in trials discontinue because of stimulation-related discomfort.
Seizures during TMS are very rare when standard safety guidelines are followed. Studies have not found evidence that TMS harms cognitive function. Some research even suggests small improvements in attention and memory in certain groups. This contrasts with some medications, which can cause sedation, mental “fog” or memory problems in susceptible people.
People with a history of seizures, metal in or around the skull, or certain neurological conditions need very careful assessment before proceeding. That is why experts emphasise specialist oversight and proper screening.
Who might benefit, and what to discuss with your doctor
For someone who feels burnt out after multiple medication trials, TMS can offer a different path. It may be suitable if:
- You have tried at least one or two antidepressants at adequate doses without enough improvement
- Side effects from medication are limiting your quality of life
- You prefer a non-invasive treatment that does not require anaesthetic or hospital admission.
TMS is not appropriate for everyone. For some people, psychological therapy, lifestyle changes, electroconvulsive therapy, ketamine-based treatments or new medication combinations may be more suitable. Most clinicians now see TMS as one piece of a broader depression treatment plan, rather than a standalone solution that replaces everything else.
Taking the next step
Feeling tired of medication trials does not mean you are out of options. TMS offers a non-drug approach that taps into the brain’s own circuitry, backed by growing evidence. Talk to Sydney-based TMS clinics that can work with your existing care team to decide whether TMS is worth considering in your situation.
