TMS Therapy Side Effects
Transcranial Magnetic Stimulation (TMS) is a non-invasive treatment method designed to address various mental health disorders, such as depression, anxiety, and obsessive-compulsive disorder. This innovative therapy has gained significant attention in recent years due to its potential for providing relief to patients who may not have responded well to traditional treatments like medication or psychotherapy.
How TMS Works
TMS therapy works by utilizing magnetic fields to stimulate specific nerve cells in the brain. During a TMS session, an electromagnetic coil is placed against the patient’s scalp, targeting a particular area of the brain that is believed to be involved in the specific mental health condition being treated. The coil generates a series of magnetic pulses that penetrate the skull and reach the brain tissue beneath, inducing electrical currents within the targeted nerve cells. This stimulation aims to regulate the activity of these nerve cells which will help to alleviate symptoms associated with the mental health disorder.
Advantages of TMS Therapy
One of the key advantages of TMS therapy is its non-invasive nature, which means there are no incisions or implants involved in the procedure. It also does not require anesthesia or sedation, and patients remain awake and alert throughout the treatment. As a result, TMS therapy is considered a safe and well-tolerated option for many individuals seeking relief from their mental health symptoms.
Side Effects of TMS Therapy
As with any medical treatment, TMS therapy can be associated with some side effects. While TMS therapy has been proven to be a safe and effective method for treating various mental health disorders, patients need to be aware of the potential side effects before undergoing treatment.
Generally, the side effects of TMS therapy are considered mild and temporary, often resolving on their own shortly after the treatment session. However, it’s important to note that the severity and duration of these side effects can vary from person to person, depending on individual factors such as overall health, age, and sensitivity to the treatment.
Some common side effects experienced by TMS patients include headaches, scalp discomfort, facial twitching, and dizziness. These side effects are typically manageable and do not interfere significantly with the patient’s daily activities. In most cases, they subside within a few hours to a couple of days after the treatment session.
Less common side effects, such as seizures, mania or hypomania, hearing impairment, and memory issues, may occur in rare cases. Although these side effects are infrequent, patients must discuss any concerns with their healthcare provider and inform them of any pre-existing conditions or medications that may increase the risk of experiencing these side effects.
Types of TMS Therapy Side Effects
As patients consider TMS for treating mental health disorders, understanding the potential side effects is crucial. In this section, we will explore the various types of TMS therapy side effects, from common to less common occurrences. This knowledge will empower patients and healthcare providers to effectively anticipate, manage, and address any concerns that may emerge during treatment, ultimately contributing to a more positive and successful therapeutic experience.
Common Side Effects of TMS Therapy
The most common side effects associated with TMS therapy include a range of mild to moderate symptoms that patients may experience during the course of their treatment. These side effects are generally temporary and tend to subside shortly after each session.
Headaches are one of the most common side effects experienced by patients undergoing Transcranial Magnetic Stimulation (TMS) therapy. In fact, studies have reported that approximately 30% to 50% of TMS patients may experience headaches at some point during their treatment course.
There are several potential causes for headaches in TMS patients, including:
- Magnetic stimulation: The magnetic pulses delivered during TMS therapy can cause mild discomfort or irritation in the scalp, facial muscles, and nerves, which may contribute to headaches.
- Muscle tension: The involuntary muscle contractions or twitching induced by the magnetic pulses can lead to muscle tension and subsequent headaches.
- Anxiety and stress: The anticipation or anxiety associated with TMS therapy, especially during the initial sessions, may also cause tension headaches.
Managing and Preventing Headaches
Fortunately, there are several strategies to manage and prevent headaches in TMS patients:
- Over-the-counter pain relievers: Non-prescription pain medications, such as ibuprofen, naproxen, or acetaminophen, can be taken before or after TMS therapy sessions to alleviate headache symptoms. However, it is important to consult the healthcare provider before taking any medication.
- Gradual increase of stimulation intensity: Some clinicians may choose to start TMS therapy at a lower intensity and gradually increase it over time, allowing the patient to better tolerate the treatment and reduce the likelihood of headaches.
- Relaxation techniques: Practicing relaxation techniques, such as deep breathing exercises, progressive muscle relaxation, or meditation, can help reduce stress and anxiety, which may contribute to headaches.
- Proper coil positioning: Ensuring that the TMS coil is correctly positioned on the patient’s head can minimize discomfort and reduce the chances of developing a headache.
- Hydration: Staying well-hydrated before and after TMS therapy sessions can also help prevent headaches.
Scalp discomfort is another common side effect experienced by patients during and after TMS therapy sessions. The sensation of scalp discomfort can vary from mild tenderness or irritation to a more intense feeling of pressure or pain at the site where the magnetic coil is placed.
Sensation of Scalp Discomfort
During TMS sessions, patients may feel a tapping or knocking sensation on their scalp as the magnetic pulses are delivered. This may cause some discomfort, particularly during the initial sessions when the patient is still getting accustomed to the treatment. The magnetic pulses can activate nearby nerves and muscles, which might contribute to the sensation of discomfort. Post-treatment, the area where the coil was placed may remain tender or sensitive for a short period.
Minimizing Scalp Discomfort
There are several strategies to help minimize scalp discomfort during and after TMS therapy:
- Adjusting coil placement: Ensuring that the TMS coil is accurately positioned on the patient’s head can help reduce discomfort. A healthcare provider may make minor adjustments to the coil’s placement or angle to alleviate any undue pressure or irritation.
- Over-the-counter pain relievers: Non-prescription pain medications, such as ibuprofen, naproxen, or acetaminophen, can be taken before or after TMS therapy sessions to alleviate scalp discomfort. However, it is important to consult the healthcare provider before taking any medication.
- Applying ice or cold packs: Applying an ice pack or cold compress to the affected area after the session may help to reduce inflammation and provide relief from discomfort.
- Gradual increase of stimulation intensity: Some clinicians may choose to start TMS therapy at a lower intensity and gradually increase it over time, allowing the patient to better tolerate the treatment and minimize scalp discomfort.
- Soft padding or cushioning: In some cases, using soft padding or cushioning between the coil and the patient’s scalp can help reduce the pressure and discomfort experienced during TMS sessions.
Facial twitching is a side effect that some patients may experience during TMS therapy sessions. Although it can be surprising or uncomfortable, it is generally harmless and temporary, subsiding once the session is completed.
Why Facial Twitching Occurs
Facial twitching during TMS therapy can be attributed to the magnetic pulses delivered by the treatment coil. These pulses are designed to stimulate specific areas of the brain, but they can also inadvertently activate nearby nerves and muscles, including those in the face. As a result, patients may experience involuntary muscle contractions or twitching, typically around the eyes, mouth, or jaw.
Harmless and Temporary Nature of Facial Twitching
It is important to emphasize that facial twitching during TMS therapy is not harmful and usually resolves on its own after the session. The twitching does not indicate any damage to the nerves or muscles and is simply a response to the magnetic stimulation. In most cases, the intensity of the twitching decreases as the patient’s body becomes more accustomed to the treatment over time.To further reassure patients, healthcare providers can explain the reasons behind facial twitching and offer guidance on how to manage this side effect if it causes discomfort. For example, adjusting the coil placement or reducing the stimulation intensity may help minimize facial twitching during TMS sessions.
Some patients may experience dizziness during or after TMS sessions. Although it is generally mild and short-lived, it is important to be aware of this potential side effect and know how to manage it effectively.
Potential for Dizziness in TMS Therapy
Dizziness during or after TMS therapy can result from several factors:
- Magnetic stimulation: The magnetic pulses delivered during TMS therapy can stimulate not only the targeted brain areas but also nearby nerves and muscles, which may lead to a sensation of lightheadedness or dizziness.
- Anxiety or stress: Some patients may feel anxious or stressed during their initial TMS sessions, which can contribute to feelings of dizziness.
- Changes in blood pressure: Temporary fluctuations in blood pressure during TMS therapy might also cause dizziness.
To manage dizziness during or after TMS therapy sessions, patients can follow these tips:
- Sitting or lying down: If dizziness occurs during a session, patients should inform their healthcare provider, who may recommend sitting or lying down until the sensation passes. After the session, patients should take a few moments to rest before standing up to minimize dizziness.
- Deep breathing exercises: Practicing deep, slow breaths can help alleviate dizziness by promoting relaxation and increasing oxygen levels in the blood.
- Hydration: Ensuring proper hydration before and after TMS therapy sessions can help prevent dizziness caused by dehydration.
- Gradual increase of stimulation intensity: Some clinicians may choose to start TMS therapy at a lower intensity and gradually increase it over time, allowing the patient to better tolerate the treatment and reduce the likelihood of dizziness.
Less Common Side Effects of TMS Therapy
While most patients tolerate TMS therapy well and experience minimal side effects, some less common side effects may occur in a smaller percentage of individuals undergoing treatment.
Seizures are an extremely rare side effect associated with Transcranial Magnetic Stimulation (TMS) therapy. Patients and healthcare providers must be aware of this potential risk, understand the contributing factors, and take necessary precautions to minimize the likelihood of seizures during TMS therapy.
Rare Occurrence of Seizures in TMS Therapy
The risk of seizures during TMS therapy is very low, with an estimated incidence rate of less than 1 in 60,000 sessions. The magnetic pulses used in TMS therapy are designed to stimulate specific brain regions without causing undue stress on the brain’s electrical activity. As a result, the vast majority of patients who undergo TMS therapy do not experience seizures.
Risk Factors and Precautions
Certain factors can increase the risk of seizures during TMS therapy, including:
- Pre-existing seizure disorders: Individuals with a history of epilepsy or other seizure disorders may be at a higher risk of experiencing seizures during TMS therapy.
- Medication interactions: Some medications, particularly those that lower the seizure threshold, can increase the risk of seizures during TMS therapy. Patients need to discuss their current medications with their healthcare provider before starting TMS treatment.
- Incorrect TMS settings: Inadequate stimulation parameters or improper placement of the TMS coil can also contribute to the risk of seizures. Healthcare providers should follow established guidelines for TMS settings and coil positioning.
Minimizing the Risk of Seizures
To minimize the risk of seizures during TMS therapy, healthcare providers take several precautions, including:
- Thorough patient screening: Prior to initiating TMS therapy, healthcare providers should conduct a detailed assessment of the patient’s medical history, including any history of seizures or seizure disorders.
- Adjusting medication regimens: If necessary, healthcare providers may recommend adjustments to the patient’s medications to minimize the risk of seizures during TMS therapy.
- Adhering to guidelines: Following established guidelines for TMS settings and coil positioning is crucial for reducing the likelihood of seizures.
Mania or Hypomania
Mania and hypomania are potential side effects of Transcranial Magnetic Stimulation (TMS) therapy, particularly for patients with a history of bipolar disorder. Although these side effects are relatively uncommon, being aware of the possibility and closely monitoring patients for mood changes can help ensure a safe and effective treatment experience. Open communication between patients and healthcare providers is vital in addressing any concerns that may arise during treatment.
Experiencing Mania or Hypomania During TMS Therapy
Mania and hypomania are characterized by elevated mood, increased energy, and accelerated thinking. These symptoms can manifest in patients undergoing TMS therapy, albeit infrequently. The risk of experiencing mania or hypomania is higher in individuals with bipolar disorder, as TMS therapy may inadvertently trigger a manic or hypomanic episode.
Monitoring and Addressing Symptoms
Healthcare professionals play a critical role in monitoring and addressing symptoms of mania or hypomania during TMS therapy. Some of the steps taken by healthcare professionals include:
- Thorough patient assessment: Before initiating TMS therapy, healthcare providers should conduct a comprehensive evaluation of the patient’s medical history, including any previous episodes of mania or hypomania, and determine if TMS is an appropriate treatment option.
- Close monitoring of mood changes: Throughout the course of TMS therapy, healthcare providers should closely monitor patients for any significant mood changes, particularly those indicative of mania or hypomania. Regular check-ins and open communication between patients and healthcare providers are essential for early detection and intervention.
- Adjusting treatment parameters: If a patient exhibits symptoms of mania or hypomania during TMS therapy, healthcare providers may consider adjusting the treatment parameters, such as reducing the stimulation intensity or altering the stimulation site, to mitigate these symptoms.
- Medication management: In some cases, healthcare providers may recommend medication adjustments or additional medications to help manage symptoms of mania or hypomania during TMS therapy.
Hearing Loss or Impairment
Temporary hearing loss or impairment constitutes a potential side effect of TMS. Though typically mild and short-lived, it remains crucial for patients and healthcare providers to be aware of this possibility and take appropriate measures to protect hearing during TMS sessions.
Temporary Hearing Loss or Impairment During TMS Therapy
The magnetic pulses generated during TMS therapy can produce loud clicking sounds, which may cause temporary hearing discomfort or impairment in some patients. In most cases, these effects are transient and resolve shortly after the session. However, repeated exposure to loud sounds during TMS therapy may increase the risk of temporary or even permanent hearing loss.
Recommendations for Protecting Hearing
To minimize the risk of hearing loss or impairment during TMS therapy, patients and healthcare providers can take several precautions, including:
- Wearing earplugs: Providing earplugs for patients during TMS sessions can significantly reduce the intensity of the clicking sounds, protecting their hearing. Both disposable and reusable earplugs are available, and patients should choose the type that offers the best comfort and noise reduction for their needs.
- Using headphones: In some TMS clinics, noise-canceling headphones may be offered as an alternative to earplugs. These headphones can help block out the loud clicking sounds while also allowing patients to listen to music or other audio content during their sessions, which can enhance relaxation and comfort.
- Proper coil positioning: Healthcare providers should ensure the TMS coil is positioned correctly, as improper placement may increase the volume of the clicking sounds and potentially exacerbate hearing-related side effects.
- Regular hearing assessments: Patients undergoing TMS therapy, especially those with pre-existing hearing conditions, should consider regular hearing assessments to monitor any changes in their hearing status.
Memory Loss or Impairment
Memory loss or impairment represents a rare potential side effect of TMS therapy. Patients and healthcare providers need to understand the infrequent nature of this occurrence and recognize that, in most cases, any memory issues are temporary and resolve spontaneously.
The Rare Possibility of Memory Loss or Impairment After TMS Therapy
The likelihood of experiencing memory loss or impairment following TMS therapy is minimal. This non-invasive treatment targets specific brain areas involved in mood regulation without causing significant disruption to cognitive functioning. Consequently, the vast majority of patients who undergo TMS therapy do not experience memory-related side effects.
Temporary Nature of Memory Issues
In the rare instances where patients do experience memory loss or impairment after TMS therapy, these issues are typically short-lived and resolved on their own without requiring additional intervention. Patients can take solace in knowing that TMS therapy has a low risk of causing long-term cognitive difficulties.It is important to maintain open communication with healthcare providers throughout TMS therapy. Patients should promptly report any concerns related to memory or cognitive functioning, allowing healthcare professionals to monitor and address potential side effects as needed.
Factors That Contribute to Side Effects of TMS Therapy
TMS therapy is generally considered safe and well-tolerated; however, some patients may still experience side effects during the treatment process. Understanding the factors that contribute to these side effects can help healthcare providers minimize risks and enhance the overall treatment experience for patients.
Understanding how individual patient factors can affect the likelihood and severity of side effects during Transcranial Magnetic Stimulation (TMS) therapy is essential for healthcare providers to optimize treatment outcomes. The following are some of the key patient factors:
A patient’s overall health can significantly impact their experience during TMS therapy. Pre-existing medical conditions, such as neurological disorders or chronic pain, may increase the risk of side effects or exacerbate their severity. Patients should discuss their medical history with their healthcare provider to ensure that TMS therapy is tailored to their specific needs and minimize any potential risks.
Certain medications may interact with TMS therapy, increasing the likelihood of side effects. For example, drugs that affect brain function, such as antidepressants or anticonvulsants, can potentially alter the brain’s response to TMS. Additionally, medications that lower the seizure threshold might heighten the risk of seizures during treatment. Patients must inform their healthcare providers about all medications they are taking to allow for potential adjustments and ensure a safe treatment experience.
Age may also play a role in a patient’s experience of side effects during TMS therapy. Older individuals might be more susceptible to side effects due to age-related changes in brain structure and function. Furthermore, older patients may have a higher likelihood of pre-existing medical conditions or be taking multiple medications, both of which could contribute to an increased risk of side effects. Healthcare providers should consider a patient’s age when developing a TMS treatment plan to account for any potential age-related risks.
While research on gender differences in TMS therapy side effects is limited, some studies suggest that men and women may experience side effects differently. For instance, women might be more susceptible to headaches or discomfort during TMS therapy due to hormonal fluctuations. However, more research is needed to fully understand any gender-related differences in side effects and how they may impact TMS therapy outcomes.
Technical factors play a crucial role in determining the likelihood and severity of side effects during TMS sessions. To optimize patient outcomes and minimize potential risks, healthcare providers must consider the following aspects:
The intensity of magnetic stimulation used in TMS therapy can directly impact the occurrence and severity of side effects. Higher stimulation intensities may increase the risk of side effects such as headaches, discomfort, or even seizures. Healthcare providers should carefully determine the appropriate stimulation intensity for each patient to balance treatment efficacy with potential side effects.
The duration of TMS therapy sessions can also influence the likelihood of side effects. Longer treatment sessions might heighten the risk of side effects due to prolonged exposure to magnetic stimulation. However, shorter sessions may not provide sufficient therapeutic benefits. Healthcare providers should work with patients to establish an optimal treatment duration that balances efficacy and tolerability.
Coil Type and Placement
Different TMS coil types and placements can impact the side effects experienced by patients. The choice of the coil and its placement on the patient’s head can affect the brain regions targeted during therapy, potentially influencing both treatment outcomes and side effects. Proper coil selection and placement are essential for maximizing treatment efficacy and minimizing adverse effects.
Frequency of Sessions
The frequency of TMS therapy sessions can also affect side effects. More frequent sessions may increase the likelihood of side effects due to repeated exposure to magnetic stimulation. However, less frequent sessions may not provide adequate therapeutic benefits. Healthcare providers should consider the patient’s individual needs and tolerance when determining the appropriate frequency of TMS sessions.
Managing and Minimizing TMS Therapy Side Effects
To ensure a safe and effective TMS therapy experience, healthcare providers must take proactive steps to manage and minimize potential side effects. This involves pre-treatment preparations, attentive care during treatment, and post-treatment follow-up.
- Comprehensive Patient Evaluation
Conducting a thorough patient evaluation before beginning TMS therapy is crucial for identifying any factors that may increase the risk of side effects. This assessment should include a detailed medical history, a review of medications, and a discussion of any pre-existing conditions. By understanding each patient’s unique needs, healthcare providers can develop a tailored treatment plan to minimize potential risks.
- Discussing Potential Side Effects
Setting realistic expectations is essential for a positive patient experience. Healthcare providers should discuss potential side effects with patients before starting TMS therapy, ensuring they understand the risks and benefits of the treatment. This open dialogue can also help alleviate any anxiety or concerns patients may have about the therapy process.
- Personalizing Treatment Parameters
Customized treatment plans can significantly reduce the likelihood of side effects. By adjusting stimulation intensity, treatment duration, coil type and placement, and session frequency, healthcare providers can tailor TMS therapy to each patient’s individual needs and tolerances.
- Monitoring Patient’s Comfort
Healthcare professionals play a vital role in ensuring patient comfort during TMS sessions. They should closely monitor patients for any signs of discomfort or distress and make necessary adjustments to alleviate these issues.
- Adjusting Parameters as Needed
If a patient experiences side effects during TMS therapy, healthcare providers can adjust treatment parameters, such as stimulation intensity or coil placement, to minimize discomfort. Regular communication between the patient and treatment team can help identify any issues and make timely adjustments.
- Encouraging Communication with the Treatment Team
Open communication between patients and their treatment team is essential for addressing any concerns or side effects that arise during therapy. Patients should feel comfortable discussing their experiences and sharing any discomfort or side effects they encounter.
- Follow-up Appointments
Regular follow-up appointments are necessary to monitor side effects and overall progress after TMS therapy. These appointments enable healthcare providers to assess the patient’s response to treatment and make any necessary adjustments to their treatment plan.
- Tracking and Reporting Side Effects
Patients should be encouraged to track and report any side effects they experience after TMS therapy. This information can help healthcare providers better understand the patient’s response to treatment and make appropriate adjustments if needed.
- Adjusting Future Treatments if Necessary
If a patient continues to experience side effects, healthcare providers may need to modify future TMS treatments to reduce discomfort. This could involve adjusting treatment parameters or exploring alternative treatment options.
Weighing the Benefits and Risks of TMS Therapy
When considering Transcranial Magnetic Stimulation (TMS) therapy as a treatment option for mental health disorders, it is essential to weigh its benefits and risks. This involves understanding the therapy’s effectiveness, comparing it to alternative treatments, and making an informed decision based on individual needs and goals.
Understanding the Effectiveness of TMS Therapy
TMS therapy has demonstrated promising success rates in treating mental health disorders, particularly major depressive disorder. Clinical studies have reported response rates ranging from 45% to 60%, with remission rates between 30% and 40%. However, individual results may vary, and some patients might require additional treatment sessions or supplementary therapies to achieve optimal outcomes.
Research on the long-term outcomes of TMS therapy suggests that it can provide sustained symptom relief for many patients. In some cases, TMS therapy has been shown to maintain its therapeutic effects for up to one year or more after treatment. However, the long-term effectiveness of TMS therapy can depend on factors such as the severity of the mental health condition, patient adherence to follow-up care, and the use of adjunctive treatments.
Comparing TMS Therapy to Alternative Treatments
Both TMS therapy and medication-based treatments can be effective in managing mental health disorders. However, TMS therapy is typically associated with fewer side effects compared to medications, which can cause issues like weight gain, sexual dysfunction, and gastrointestinal problems. For patients who have not responded well to medications or cannot tolerate their side effects, TMS therapy may be a suitable option.
Psychotherapy, or talk therapy, is another common treatment for mental health disorders. While both TMS therapy and psychotherapy can be effective, they target different aspects of mental health and may work best when used together. TMS therapy focuses on altering brain activity, while psychotherapy helps patients develop coping strategies and address the underlying causes of their mental health issues.
Electroconvulsive Therapy (ECT)
TMS therapy is often compared to ECT due to its shared use of electrical stimulation to treat mental health conditions. However, TMS therapy is generally considered less invasive and has fewer side effects than ECT. While ECT requires anesthesia and can cause memory loss, TMS therapy is a non-invasive outpatient procedure with minimal cognitive side effects.
Making an Informed Decision about TMS Therapy
Assessing Individual Needs and Goals
Patients should consider their unique needs and goals when deciding on a treatment option. Factors such as the severity of the mental health condition, personal preferences, and past treatment experiences can all play a role in determining whether TMS therapy is the right choice.
Consulting with Healthcare Professionals
Before deciding on TMS therapy, it is essential to discuss treatment options with healthcare professionals. They can provide expert guidance on the potential benefits and risks of TMS therapy, taking into account the patient’s specific situation and medical history.
Considering Personal Tolerance for Side Effects
When weighing the potential benefits of TMS therapy, patients should also consider their personal tolerance for side effects. While TMS therapy is generally well-tolerated, some individuals may experience discomfort or other side effects during treatment. It is important to balance the potential therapeutic benefits with the likelihood and severity of side effects.
Being informed and prepared is crucial for ensuring a positive treatment experience. Patients should have a thorough understanding of potential side effects before beginning TMS therapy and maintain open communication with their healthcare providers throughout the process.
Finding the most appropriate treatment option for mental health disorders is a personal journey. Patients should explore all available options and consult with healthcare professionals to determine the best approach for their unique needs. By staying informed and working closely with their treatment team, they can maximize the benefits of TMS therapy and improve their overall mental health and well-being.
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FAQs about the Side Effects of TMS Therapy
By addressing common inquiries and concerns about TMS therapy side effects, patients can make well-informed decisions regarding their treatment.
The most common side effects of TMS therapy are headache, scalp discomfort, and tingling. However, these generally subside within a few hours after the treatment session is completed.
No, there are no serious or long-term side effects associated with TMS therapy. The procedure is generally well-tolerated and safe. Patients may experience some temporary discomfort during treatment but should not have any lasting adverse effects.
TMS therapy is generally considered to be safe and effective for treating a variety of mental health conditions. It is often used as an alternative to medication and psychotherapy due to its low risk of side effects, lack of cognitive impairment, and long-term effectiveness. In comparison to ECT, TMS therapy has fewer side effects and does not require anesthesia or cause memory loss.
Patients should consider their individual needs and goals when deciding on a treatment option. It is also important to discuss all potential benefits and risks with healthcare professionals and weigh the likelihood and severity of side effects against the potential therapeutic benefits of TMS therapy.
Patients should maintain open and honest communication with their healthcare team about any potential side effects they may experience. It is also important to ask questions and voice concerns throughout the treatment process to ensure that their needs are being met and their comfort levels remain high. With the right support, patients can maximize the benefits of TMS therapy while minimizing discomfort.
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