How TMS Therapy Works for Depression: What Patients in Sarasota Should Know

Two in three patients who complete a course of TMS therapy report remission of their depression symptoms. That figure comes from clinical outcome data, and it applies to patients who had already tried antidepressants without adequate relief. If you have been told your options are limited, TMS — transcranial magnetic stimulation — may be worth understanding in detail.

What TMS Actually Does

Transcranial magnetic stimulation is a non-invasive procedure that uses precisely targeted magnetic pulses to stimulate areas of the brain that are underactive in people with depression. It does not involve surgery, anesthesia, or medication. The technology works similarly to an MRI: a small magnetic coil is placed near the head, and electromagnetic pulses are delivered to specific brain regions, activating neurons and prompting the release of neurotransmitters involved in mood regulation.

The effects are not just immediate stimulation. Research shows that TMS therapy promotes neuroplasticity — the brain’s ability to form and strengthen neural pathways — which is one reason why the antidepressant benefits can persist well beyond the treatment course itself (National Center for Biotechnology Information). This is different from how antidepressant medications work, and it explains why TMS is effective for patients whose depression has not responded to pharmacological approaches.

What Makes Our Approach Different

At Cohen & Associates, we are the only practice in the Sarasota region offering neuronavigated, precision-based TMS. We use the NeuroStar Advanced Therapy System together with visor2™ neuronavigation technology, which allows our team to more exactly target the delivery of TMS pulses — applied with or without MRI assistance — to increase the precision and consistency of each treatment. This is not standard across TMS providers.

Our TMS program is led by Samantha Hagan, our TMS coordinator and technician, who brings several years of multi-device TMS experience and has served as a corporate trainer for two separate TMS organizations. The technical competency of the person delivering your sessions is a factor in treatment quality, and we take that seriously.

Sessions at our practice run in as little as three minutes for some protocols, with a standard range of three to twenty minutes depending on the treatment plan — well within the time most patients can fit into a working week. You are awake throughout, there is no sedation, and you can drive yourself to and from every appointment.

What TMS Is FDA-Cleared to Treat

TMS is FDA-cleared for major depressive disorder (MDD) in adult patients who have not achieved satisfactory improvement from prior antidepressant medication. It is also FDA-cleared as an adjunct treatment for obsessive-compulsive disorder (OCD) in adults, and as an adjunct treatment for major depressive disorder in adolescent patients between the ages of 15 and 21. In patients with MDD who also experience significant anxiety symptoms — a presentation clinicians call anxious depression — TMS is cleared for use to address both the depressive and anxiety components simultaneously.

This matters because many patients researching TMS do not realize the adolescent and OCD clearances exist. If you or someone in your family is in one of those groups, these are legitimate clinical options worth discussing with our team (National Center for Biotechnology Information).

What the Treatment Course Looks Like

The recommended TMS course involves sessions five days a week for approximately six weeks — thirty sessions total. Most patients begin noticing changes in two to three weeks. The side effect profile is well-established and mild by comparison to most psychiatric medications: the most common experience is temporary discomfort or tapping sensations at the treatment site during sessions, which typically resolves within the first week (National Institute of Mental Health). There is no weight gain, no sexual side effects, no systemic medication burden.

Results vary by individual. TMS does not work for everyone, and we will not tell you otherwise. What we can tell you is that the evidence base is substantial and peer-reviewed, and that the absence of systemic side effects makes TMS a meaningful option for patients who have had to stop antidepressants due to tolerability issues.

Insurance and Cost

Insurance coverage for TMS varies by plan and patient situation. Because we operate a direct-care practice, the insurance billing process works differently than in a standard in-network setting — our team will walk through the specifics of your coverage before treatment begins, so there are no surprises. We handle prior authorization and coverage verification through our office.

For patients without applicable coverage or whose plans do not cover TMS, we discuss self-pay options during the consultation. We do not list specific session prices on our website; all cost conversations happen directly and transparently before any treatment commitment is made.

FAQ

How do I know if I’m a candidate for TMS?

The primary clinical criteria are a diagnosis of major depressive disorder — or MDD with anxious depression — and a history of not achieving adequate relief from antidepressant medication. OCD and adolescent depression (ages 15–21) are also FDA-cleared indications. The best way to determine candidacy is through a new patient evaluation with our team.

Is TMS painful?

Most patients describe TMS as painless or mildly uncomfortable during sessions, particularly in the first week. The tapping or tingling sensation at the treatment site generally decreases as treatment progresses. No anesthesia is required, and there is no recovery period.

Can I keep taking my antidepressants during TMS?

In many cases, yes — TMS can be used alongside existing medication. Whether to continue, adjust, or taper existing medications is a clinical decision made by your provider based on your history and treatment response. This is discussed during your evaluation.

What happens after the initial six-week course?

Many patients maintain their improvement after completing the standard TMS course. Some return for maintenance sessions if symptoms re-emerge over time. Individual outcomes vary, and your provider will discuss what ongoing support looks like based on how you respond.

Does TMS work for anxiety on its own, without depression?

TMS is FDA-cleared for anxiety symptoms specifically in the context of comorbid major depressive disorder — meaning anxiety that occurs alongside MDD. It is not currently FDA-cleared as a standalone anxiety treatment independent of a depression diagnosis. Discuss your specific presentation with our team to explore your options.

Key Takeaways

• TMS is a non-invasive, medication-free procedure that uses magnetic pulses to stimulate underactive brain regions involved in depression.
• Cohen & Associates is the only practice in the Sarasota region offering neuronavigated, precision-based TMS using the NeuroStar system and visor2™ technology.
• TMS is FDA-cleared for MDD, anxious depression, OCD, and adolescent depression (ages 15–21).
• The standard treatment course is six weeks of sessions, each lasting three to twenty minutes, with no sedation and no systemic side effects.
• Insurance coverage for TMS varies by plan; our team handles prior authorization and coverage verification before treatment begins.

If antidepressants have not given you the relief you were hoping for, that is a clinical signal — not a dead end. At Cohen & Associates, we will tell you plainly whether TMS is a realistic option for your situation. Call us at 941-559-8500 or complete our online contact form to schedule a consultation with our team.

References

1. Mayo Clinic. Transcranial magnetic stimulation. https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625
2. National Center for Biotechnology Information. TMS therapy and neuroplasticity. https://pmc.ncbi.nlm.nih.gov/articles/PMC9313265/
3. National Institute of Mental Health. TMS safety and side effects. https://www.nimh.nih.gov/news/media/2020/sarah-h-lisanby-transcranial-magnetic-stimulation-safety-and-risk
4. National Center for Biotechnology Information. TMS FDA approval and evidence base. https://pmc.ncbi.nlm.nih.gov/articles/PMC8864803/

Medical Disclaimer
The information in this blog is for educational purposes only and does not constitute medical advice. Transcranial magnetic stimulation and other psychiatric treatments should only be pursued under the supervision of a licensed psychiatric provider familiar with your full medical and psychiatric history. Individual results vary. NeuroStar Advanced Therapy is only available by prescription. If you are experiencing a mental health crisis or thoughts of self-harm, please call or text 988 to reach the Suicide and Crisis Lifeline or go to your nearest emergency room.