What Is TMS Therapy? How It Works, Benefits, and What to Expect

TMS therapy (Transcranial Magnetic Stimulation) is a non-invasive, medication-free treatment that uses magnetic pulses to stimulate targeted areas of the brain linked to depression and other mental health conditions. Delivered through a device placed against the scalp, it requires no anaesthesia, no hospital stay, and no recovery time. TMS is most established as a treatment for major depressive disorder, particularly for people who haven’t had adequate relief from antidepressant medication, though it’s also used or being trialled for anxiety, OCD, PTSD, and chronic pain. In Australia, it’s now partly funded through Medicare for eligible patients with treatment-resistant depression. Below is a breakdown of how it works, what it can treat, and what to expect if you’re considering it.

How Does TMS Therapy Work in the Brain?

A TMS device is positioned against the scalp and emits magnetic pulses that pass painlessly through the skull to reach a targeted area of brain tissue, most often the left prefrontal cortex, a region closely linked to mood regulation. Rather than circulating medication through your bloodstream, these pulses act locally, either exciting or calming activity in the brain circuits believed to be underactive in conditions like depression.

The underlying goal is neuroplasticity, the brain’s ability to reorganise itself and build new neural connections. Repeated stimulation over multiple sessions helps retrain this circuit, similar to how physiotherapy helps a muscle relearn movement after injury. This is why TMS therapy is delivered as a course of sessions rather than a single treatment. The cumulative effect is what drives lasting change, not any individual session.

You’ll often see TMS referred to by a couple of related names: rTMS (repetitive TMS, the standard protocol) and iTBS (intermittent Theta Burst Stimulation), a newer, faster variant that delivers a similar dose of stimulation in a fraction of the session time. Both fall under the umbrella term “TMS therapy.”

What Conditions Does TMS Therapy Treat?

Depression treatment is the primary and most clinically established use, but the evidence base extends further:

• Well-established: Major depressive disorder, treatment-resistant depression, seasonal affective disorder, postnatal depression, and the depressive phase of bipolar disorder
• Supported by growing evidence: Generalised anxiety disorder and chronic pain
• Being trialled or used off-label: OCD, PTSD, ADHD, addiction, and in some clinics, depersonalisation disorder and borderline personality disorder

Most Australian TMS clinics report that the large majority of their patients, commonly cited around 70%, are being treated for depression specifically.

Is TMS Therapy Covered by Medicare in Australia?

Yes. Since November 2021, rTMS has been listed on the Medicare Benefits Schedule (MBS), following a $288.5 million government investment aimed at improving access to treatment for major depressive disorder. This was a significant shift. Before that, a full course cost several thousand dollars out of pocket.

To access the Medicare rebate, you generally need to meet criteria set by the MBS listing:

• Be an adult with a diagnosed major depressive episode
• Have not had an adequate response after trialling at least two different classes of antidepressant medication (unless contraindicated)
• Have also tried psychological therapy, unless it’s judged inappropriate
• Have not received MBS-funded rTMS before

Eligible patients can access an initial course of up to 35 sessions, plus a further 15-session retreatment course if they relapse after initially responding, a lifetime cap of 50 Medicare-funded sessions in total. 

A referral from a GP or psychiatrist and an assessment with a TMS-accredited psychiatrist are required before treatment starts; clinics typically charge a one-off consultation fee for this assessment, separate from the Medicare-covered sessions. Veterans may also access funding through DVA, and eligible workers through WorkCover.

How Does TMS Therapy Compare to Antidepressants and ECT?

TMS therapy occupies a middle ground: it acts directly on the brain like ECT, but without sedation, seizure induction, or hospitalisation, and it avoids the systemic side effects that make many antidepressants hard to tolerate long-term.

What Happens During a TMS Therapy Session?

1. Referral and assessment: your GP or psychiatrist refers you, followed by an assessment with a TMS psychiatrist to confirm suitability.
2. Brain mapping: before treatment starts, the clinic identifies the precise stimulation site and calibrates the pulse intensity to your individual brain.
3. The session: you sit in a chair, fully clothed and awake, while the device rests against your scalp. You’ll feel a tapping sensation and hear a clicking sound with each pulse. A standard rTMS session runs roughly 20–40 minutes; iTBS sessions can be under 10 minutes.
4. Straight back to your day: there’s no sedation, so you can drive, work, or exercise immediately afterwards.
5. The course: sessions are usually scheduled five days a week over several weeks. Many people notice initial improvement somewhere around the 10–15 session mark, with fuller effects building over the full course.
6. Maintenance: some patients return for occasional top-up sessions later to sustain results.

How Effective Is TMS Therapy, and What Are the Side Effects?

Clinical remission rates for depression are commonly reported around 60%, meaning a majority of patients are no longer clinically depressed by the end of treatment, with many others reporting meaningful symptom reduction even without full remission. Reported side effects are generally mild: scalp discomfort, tension headache, or fatigue on treatment days, most of which ease as sessions continue. The most serious risk, seizure, is rare, estimated at roughly 1 in 50,000 sessions, far lower than the risks associated with many alternative interventions.

Is TMS Therapy Right for You?

TMS therapy is generally worth discussing with your doctor if you’ve tried medication without adequate relief, want to avoid systemic side effects, or have a diagnosis that meets the Medicare eligibility criteria above. It isn’t a first-line treatment for everyone, and understanding the mechanism, the process, and the funding pathway puts you in a much stronger position for that first conversation with your GP.

If you’re ready to take the next step, book a clinic appointment or explore our Medicare TMS offering to check your eligibility.

Frequently Asked Questions

Q1. Is TMS therapy painful? 

Ans. No. Most people feel a tapping or knocking sensation on the scalp rather than pain. Mild headaches can occur, particularly in early sessions, and usually ease as treatment continues.

Q2. How many antidepressants do I need to have tried before Medicare covers TMS therapy? 

Ans. Under current MBS rules, you generally need to have tried at least two different classes of antidepressant medication without adequate improvement, and to have attempted psychological therapy unless inappropriate.

Q3. How long does it take for TMS therapy to work? 

Ans. Many patients begin noticing changes around session 10–15, though a full course (often five sessions a week for several weeks) is needed to assess overall response.

Q4. Is there a limit to how many TMS sessions Medicare will fund? 

Ans. Yes. Medicare funds an initial course of up to 35 sessions, plus one retreatment course of up to 15 sessions if needed, a lifetime cap of 50 MBS-funded sessions.

Q5. Can TMS therapy be combined with antidepressants or therapy? 

Ans. Yes. TMS therapy is commonly used alongside existing medication and psychotherapy, and many patients see stronger outcomes when it’s combined with ongoing counselling.

Q6. Does TMS therapy cause memory loss like ECT? 

Ans. No. There’s no evidence linking TMS therapy to memory loss. It doesn’t induce a seizure and only stimulates a small, targeted brain region, unlike ECT.