Transcranial magnetic stimulation (TMS) is an alternative treatment for people with depression and other mental health disorders. It works by enhancing activity in areas of the brain with a magnetic coil that sends alternating pulses to neurons to stimulate the brain. TMS is noninvasive and largely painless, with the most common side effect after treatment being a minor headache.
When used to treat anxiety, TMS has largely effective results. According to a 2022 meta-analysis, out of seven papers analyzing the effect of TMS treatment on patients with anxiety disorders, five published results demonstrated patients had a sustained decrease in anxiety symptoms.
Further, 21 of 25 studies examining the effect of TMS on patients with anxiety symptoms found a long-term improvement in anxiety symptoms for patients after treatment.
Though these results have positive implications for the use of TMS in anxiety treatment, patients with anxiety may still have questions and concerns about TMS treatment, including whether TMS can make anxiety worse.
Many studies have provided evidence to support the use of TMS therapy for anxiety, however, others suggest TMS therapy may actually worsen anxiety symptoms. In 1997, an initial investigation into the use of repetitive TMS in three patients with primary anxiety noted that panic and anxiety in patients increased after fast repetitive treatment over the left or right prefrontal cortex.
Additionally, a 2019 article found that TMS might also increase anxiety in healthy subjects. Again, this finding was thought to be linked to increased activity in the prefrontal cortex, though, this finding was specific to healthy individuals.
While there have been some studies that suggest TMS therapy may have a negative effect on participants, there is much greater evidence demonstrating the benefits of TMS therapy in treating patients with anxiety.
In addition to the 2022 meta-analysis described above, which found TMS therapy produced a lasting alleviation of anxiety symptoms in patients with both anxiety disorders and generalized anxiety symptoms, a separate systemic review from 2019 also described the benefits of TMS treatment for patients with anxiety and PTSD.
This 2019 study found robust evidence from four separate studies supporting the benefit of TMS on patients with generalized anxiety disorder.
Each of these studies showed that TMS therapy had a strong negative effect on the presentation of anxiety symptoms after the intervention, and, as a group, these studies show that repetitive TMS treatment is promising to alleviate symptoms of generalized anxiety disorder.
Though TMS therapy is considered effective in treating anxiety, there are some possible side effects potential patients should be aware of before beginning a TMS session.
While repetitive TMS is a non-invasive form of brain stimulation and the therapy is performed while the patient is awake, participants may still experience some mild to moderate side effects, including:
These side effects will generally improve shortly after the TMS session and are likely to decrease over time as the patient gets used to the TMS sessions.
There are other rare side effects that a patient may experience, including: