12 Important Questions You Might Not Think to Ask About TMS Therapy

October 12, 2022

Living with a mental illness is hard, and sometimes, finding the right treatment for your mental illness can be even harder. Before trying something new for any kind of problem or illness, you’ll want to do your research. Unfortunately, finding information, and even just knowing what questions to ask, isn’t always easy. That’s why we’ve compiled a list of questions that we feel are often overlooked but incredibly important when making a decision about TMS treatment. If you have a question, but you don’t see it addressed in this post, check out our FAQ page for some of the most frequently asked questions about TMS.

1. Can I stop taking antidepressant medications before, during, or after TMS treatment?


Many patients beginning TMS therapy are often taking an antidepressant or other psychiatric medication, and a commonly encountered question is: “Can I stop taking my medications?” or “When can I stop taking my medications?” – The answer to this is: it depends.


The decision to stop taking your medications depends on many factors, but ultimately, it is a decision that should be made in conjunction with your prescribing physician. We typically recommend that patients do not make changes to their medications at the onset of treatment. The main reason we ask patients to refrain from changing their medications early on is so we can properly gauge response to TMS.


If medications are providing at least some benefit, we don’t want to lose that benefit while seeing if TMS can help as well. If a patient is experiencing a lack of response or significant side effects from a certain medication, however, tapering off the medication may be fine, with approval by the TMS physician.

2. Do I need a referral from my doctor/psychiatrist to begin TMS treatment, or can I seek treatment on my own?


No, TMS does not require a referral from your current primary care physician or psychiatrist. It can be helpful to have a verbal recommendation from your current physician when submitting for prior authorization to your insurance, but this is not essential or a requirement for approval.

3. Is it okay to miss appointments?


We highly encourage consistency when it comes to attending your treatment sessions. Life can be unpredictable, however, so missing an appointment on occasion may happen. As a result, many patients wonder what effect missing treatments will have on treatment response. While it is best to attend all 5 sessions each week until the taper, research has shown that missing treatments (infrequently) does not negatively influence the overall efficacy of treatment. (
Do deviations from the 5 sessions per week schedule impact outcomes of transcranial magnetic stimulation for major depressive disorder? (brainstimjrnl.com)) So in short, it is important to consistently attend sessions, but it is also okay if you have to occasionally miss a treatment here or there due to vacation, illness, or other conflict.


4. If my depression improves during treatment, will my anxiety worsen? 


Patients do occasionally report an increase in anxiety symptoms during TMS treatment, but this is not very common and typically mild. The good news is that even if this occurs, or if anxiety is already also present with depression prior to treatment, there are ways that we can treat anxiety as well. Scaling back on the intensity of left-sided treatment and/or adding in a right-sided treatment to target anxiety symptoms can be effective for alleviating anxiety. Read more about
TMS for anxiety


5. Is treatment painful?


TMS should generally not be painful. TMS feels different for each individual, so as a result, we hear varying reports regarding treatment experience. To date, we have not yet had any patients who have discontinued treatment as a result of pain or discomfort. Many patients report that the sensation of the magnetic pulses feels like “a small woodpecker tapping at their skull” or like “hair being pulled.” Some patients report that treatment can be quite relaxing or even that it feels like a massage. In addition, patients almost always report that any initial discomfort with treatment decreases following each subsequent session as the area becomes desensitized to the pulses. TMS in general, is very well tolerated. Read more about
TMS pros and cons


6. Is there a possibility that I will get worse during treatment, and if so, what will happen then? And/or what is “the dip” and how long does it last?


After reading up on TMS, you might encounter reports of patients who experienced a “dip” during treatment. During a standard course of TMS treatment after seeing an improvement in mood, some patients occasionally undergo a period where their mood lowers or "dips" again. For some, this dip in mood can be mild and short-lived, but for others it may be more intense and longer lasting. To date, we do not have a definitive scientific reason for why this dip sometimes occurs. The good news, however, is that we do see patients recover from the dip and respond to treatment.


One theory behind the dip is that when patients begin TMS treatment they often feel excited or hopeful about the potential for response from treatment, resulting in a false sense of improvement, or a placebo response. As treatment moves along, these initial feelings may dissipate, causing what some refer to as "the dip.” However, once treatment actually begins to work (which can take time), patients’ moods lift and they start to feel better again. When patients’ scores are recorded on a graph, this forms what looks like a dip around the beginning-middle of treatment. While this seems like a logical explanation for “the dip,” the ultimate reasoning for why this happens is still unknown. 


7. Are there any negative cognitive effects during TMS, like memory loss, feeling spacey, or experiencing trouble with concentration?


One of the many benefits of TMS therapy is its relative lack of side effects. Unlike other treatments for mental health conditions, like medications or
ECT, TMS does not involve any systemic side effects. Multiple studies have not shown any deleterious effect on cognition short or long term. Patients occasionally have reported feeling tired or spacey early on in treatments, but we have never seen this as dysfunctional or persistent.

8. What should I look for/avoid when choosing a TMS clinic?


We recommend finding a clinic that you feel most comfortable with. You will be committing to an extended treatment and seeing providers five days a week during the initial six weeks of care plus six more sessions during the taper at the end. If you don’t feel a good connection with the TMS physician or the technicians in the clinic, we encourage finding another location. Finding a clinic that is close to you is ideal, but working with a clinic you are most comfortable with may be worth a little extra travel time if needed. You should likewise feel comfortable in the space for the clinic you choose. An open and relaxing atmosphere is best. We also encourage asking how often you will see the TMS physician. At Inspire TMS Denver,
Dr. Clinch checks in with each patient almost every day during a course of treatment. 


If you have additional diagnoses outside depression such as anxiety disorders or PTSD, ask the clinic what additional protocols they provide to address these symptoms and if they charge for additional treatment outside insurance coverage.
Inspire TMS Denver provides off-label treatment free of charge for indications with a solid evidence base supporting use. 

9. Will TMS affect my sleep?


TMS can definitely cause changes in sleep patterns. With improvement in overall depressive and anxiety symptoms as treatment progresses, we typically see improvement in overall sleep quality and quantity. This can vary quite a bit patient to patient, however. Some patients' depressive and/or anxiety symptoms improve, but sleep patterns don’t change. Many often report initial vivid dreams and changes in REM sleep patterns. There are a number of studies looking at sleep changes with TMS and these typically indicate overall improvement in sleep quality. Check out our
TMS for Sleep Disorders page for additional details.


10. Will insurance cover TMS for depression if I also have a diagnosis of bipolar disorder or psychotic symptoms?


Unfortunately, insurance will not cover TMS for Bipolar depression or depression with psychotic symptoms. It is not to say that TMS can’t work in these conditions for some, but insurance does not reimburse in these situations. There is debate as to the overall effectiveness of TMS for these conditions, but it certainly has helped some and we likewise have seen improvement in these situations. Check out our
TMS for Bipolar Depression page for more details.


All insurances cover TMS for unipolar treatment resistant Major Depression. Some also cover OCD and smoking cessation, but this is more limited.


11. What are some of the signs that TMS is working? How long does it take for this to happen?


This can look different from patient to patient, but we often see self-reported patient rating scales improve prior to patients reporting their mood improve. The rating scales contain physiologic symptoms of depression such as appetite changes, sleep pattern disturbances, low energy, concentration struggles, etc. We often see these symptoms improve first. We also commonly hear patients describe family members indicating that they have seen improved affect from those receiving
TMS treatment prior to the patient actually feeling better. Improvements in TMS can take place after just a few sessions, but we don’t know how much this may be influenced by placebo response (improvement that may be unrelated to treatment). Studies show that definite gains can be seen by around ten treatments and most will have some response within thirty treatments. 

12. Which is better: Theta-Burst or standard (10 Hz) TMS?


Neither protocol is better based on the literature. Both are forms of repetitive TMS and treat major depression. Theta burst or iTBS (
intermittent theta burst stimulation ) is a new protocol with FDA approval since 2018 and each treatment is completed in just over three minutes time. Only 600 pulses of iTBS are delivered with each session. The pulse pattern is very rapid with a triplet burst of 50 Hz frequency delivered in a theta pattern. Standard TMS was approved in 2008 and utilizes 3000 pulses each session. The pulses are delivered in a slower frequency of just ten pulses per second or 10 Hz, and it takes about 18.5 minutes to complete each session.


A large study out of Canada comparing the two did not show any statistical difference in response or remission rates, nor tolerability for each treatment. Both protocols were shown to be effective, safe, and well tolerated overall. Many patients elect to utilize the quicker iTBS protocol, but either protocol may be utilized. Some insurance policies state you have to use the original protocol. At Inspire TMS Denver, we are well versed in both protocols and have seen similar results in response and remission rates with each. Check out our
Theta Burst Stimulation page for additional details on iTBS.

Every Question Answered

Want to know more about TMS? Check out this in-depth guide to TMS therapy with transparent and easy to understand explanations about TMS processes, protocols, and treated conditions.

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By Sam Clinch January 27, 2026
Short Answer Yes - most patients can drive after a TMS session because TMS is performed while you’re awake and does not require sedation. If you experience unusual dizziness, severe headache, or are given medication that impairs alertness, don’t drive until you’ve been cleared by the clinic. This short guide explains why driving after TMS is usually safe, how timing and protocols affect daily activities, how TMS compares with in-clinic treatments that do require post-treatment observation, and practical workplace guidance and checklists you can use. Why driving is usually OK after TMS No sedation required. Standard TMS is non-invasive and does not involve anesthesia or sedating drugs, so people are typically able to leave the clinic and drive home after a session. This is a major practical advantage over treatments that require on-site observation. Short, supervised sessions. TMS sessions are brief (a few minutes for iTBS ; session appointments take longer because of prep and setup), and trained staff monitor patients throughout. If you feel unwell, the staff will evaluate you before you leave. Caveat: Always follow your clinic’s instructions. If the team advises you not to drive (for example, after an unusually strong reaction, severe headache, or medication given during treatment), do not drive. Timing and driving by the TMS protocol Standard TMS (1 session/day, weeks): Most patients resume normal activities, including driving, after each session. Schedule sessions before or after work, or at times that minimize disruption. Read More: Standard TMS Accelerated TMS (multiple sessions/day, e.g., 50/5 days): Treatment days are long. Patients often take the day off during an accelerated week. Driving home after each session is usually safe, but because treatment days are lengthy and tiring, many patients arrange transport or plan not to drive the same evening if they feel fatigued. Read More: Accelerated TMS ONE-D / Single-Day (20 sessions in 1–2 days): These compressed visits can be physically and mentally demanding. Expect to need the day(s) off and avoid driving until you feel fully alert and comfortable. ONE-D should be clinician-supervised with clear post-treatment guidance. Read More: One-Day TMS Comparing TMS with Spravato® (esketamine) and ketamine
A man receives a medical procedure with the help of two medical professionals in a clinic setting.
By Sam Clinch January 27, 2026
Quick Summary Headaches are the most common side effect of Transcranial Magnetic Stimulation (TMS) . They’re usually short-lived, mild-to-moderate, and respond to simple self-care (hydration, OTC pain relief, rest). Most important: tell your TMS team if a headache is severe, persistent, or comes with other neurological symptoms - clinics screen for seizure risk and are trained to manage complications. Why TMS can cause headaches (plain language) TMS delivers brief magnetic pulses to areas of the scalp and brain . Those pulses can: Stimulate scalp and neck muscles , causing muscle tension and tenderness. Irritate sensory nerves in the scalp where the coil rests. Cause brief changes in local blood flow or neuronal activity that patients sometimes notice as a headache while the brain adjusts. These mechanisms explain why headaches are common after a session but are usually temporary and manageable. Clinics intentionally screen patients and set stimulation intensity to balance benefit and tolerability. Immediate relief strategies (what patients can do right after a session) Try these first-line, low-risk steps if you get a headache after TMS: Hydrate. Drink water - mild dehydration often makes headaches worse. Rest quietly for 15–30 minutes. Lie down in a dim, quiet room. Over-the-counter analgesics (if appropriate). Acetaminophen or ibuprofen often helps. Check with your clinician if you’re on blood thinners or have medical contraindications. Warm or cool compress. A warm compress can relax tense neck muscles; a cold pack can numb localized scalp pain - use whichever feels better. Neck and shoulder self-stretching. Gentle neck rolls and shoulder stretches relieve muscle tension. Avoid heavy caffeine or alcohol. Small amounts of caffeine sometimes help, but too much can worsen a headache. Alcohol can dehydrate and interfere with recovery. Short walk & fresh air. Light movement and deep breathing reduce tension for some people. Note: If you’ve been prescribed a specific pain plan (for example, the clinic recommended a pre-session analgesic), follow that. Always check with your clinician before taking new medications.
By Sam Clinch January 27, 2026
Quick Summary Transcranial Magnetic Stimulation (TMS) is an outpatient, non-drug treatment for depression and related conditions. Most patients can resume normal activities, including driving, after a session, and many return to work during or after treatment. This guide gives clear timelines for common TMS protocols (standard, accelerated, ONE-D), examples of reasonable workplace accommodations, ready-to-use employer letter templates, anonymized success stories, and a downloadable Employer Packet to simplify communications and approvals. Key points up front Most patients can drive and work after a TMS session. TMS does not require sedation, and patients typically resume normal activities the same day. The timing for returning to full duties varies by protocol. Accelerated protocols and ONE-D compress treatment can be completed in days, requiring planning for multi-hour clinic days; standard TMS involves daily visits over 4–8 weeks. Reasonable accommodations - flexible scheduling, remote work, or phased return - usually allow employees to complete TMS while maintaining employment. Communication and documentation (a short clinician note, expected schedule, and estimated downtime) speed approvals and reduce stress. Basic facts employers & HR should know What TMS is TMS uses magnetic pulses to stimulate targeted brain areas involved in mood . It’s non-invasive, done while the patient is awake, and - unlike ketamine or Spravato® - does not require post-treatment observation that prohibits driving. TMS is performed in an outpatient clinic with physician oversight and safety screening. Safety & suitability Clinics screen for seizure history , implanted metal, and medication interactions before starting mapping and treatment. Mapping is used to personalize stimulation parameters. Employers can rely on a clinician’s assessment and return-to-work guidance. Typical return-to-work timelines (by protocol) Use these as guidelines - individual plans should be based on clinician recommendations and job demands. Standard TMS (typical) Schedule: ~1 session/day, Monday–Friday, for 4–6 weeks (some programs 6–8 weeks). Daily impact: Sessions last ~20–40 minutes; no sedation. Most patients return to work the same day after a session. Work plan: Many patients schedule sessions before or after work, or take short breaks. A phased return (reduced hours first week) is sometimes helpful. Learn More: Standard TMS Accelerated TMS (e.g., 50 sessions / 5 days) Schedule: Multiple sessions/day (often 8–10/day) over 5 consecutive days. A full clinic day can be long. Daily impact: Expect long clinic days; most patients do not work during the treatment week and take time off. Work plan: Employers can allow one week of concentrated leave or flexible unpaid leave to accommodate an accelerated week. Learn More: Accelerated TMS ONE-D (Single-Day) or 1–2 day protocols (20 sessions) Schedule: 20 iTBS sessions in a single intensive visit or across two days. Daily impact: Very condensed; patients usually need the day(s) off for the visit and rest afterward. Employers should treat ONE-D as 1–2 days of medical leave with short-term follow-up. Work plan: ONE-D is attractive to travelers and time-limited professionals but requires a short block of leave. (ONE-D is generally self-pay and offered under supervision at select clinics.) Learn More: One Day TMS
Woman in blue scrubs stands at a reception desk with crossed arms in front of the Inspire TMS Denver logo.
By Sam Clinch January 27, 2026
Quick Overview If you or a patient feels worse during a course of TMS , that reaction is real - and it doesn’t mean treatment has failed or that the clinician has made a mistake. A temporary worsening (often called the TMS “dip”) happens for some people while the brain is adjusting to stimulation. Most importantly, it is usually transient, manageable, and treatable with clear clinical steps and support. What is the “TMS dip”? The TMS dip describes a temporary increase in depressive or anxiety symptoms during a TMS course. Patients may report mood worsening, increased anxiety, irritability, sleep disruption, or more frequent intrusive thoughts. For most patients, the dip is short-lived and improves with continued care; for a small minority, it may require pausing or adjusting treatment. Clinics that specialize in TMS note this phenomenon and have procedures to respond. When does the dip usually happen? Timing: The dip most commonly appears mid-course (around halfway through a typical protocol), but it can occur at any time during treatment. Duration: In most cases, the dip lasts hours to a few days and resolves as the brain adapts to stimulation; in a few cases, clinicians pause or change the plan if symptoms persist. How often: Only a small percentage of patients report intolerable worsening that leads to stopping treatment; serious long-term worsening is not supported by the evidence when patients are correctly screened and monitored. Why does the dip happen? (simple clinical framing) No single explanation covers every patient, but common reasons include: Neurophysiologic adjustment. TMS actively alters neural circuits; as excitatory and inhibitory balances shift, transient symptom fluctuations may occur while new patterns stabilize. Protocol mismatch. Coil location, dose, or timing may be suboptimal for a specific patient; small differences in targeting can change the effect. Proper motor-threshold mapping is essential and sometimes needs re-checking. Medication interactions or withdrawal. Medication changes or interactions can amplify symptoms during stimulation. Comorbid or misdiagnosed conditions. Undetected bipolar spectrum disorders, PTSD, substance use, or medical issues can cause symptom volatility that looks like a dip. Psychological reaction. Increased self-awareness or brief increases in distress as therapy “opens up” material can feel worse before it gets better. What your clinicians should do - a practical, step-by-step response 1 - Immediate triage (same day) Screen for safety: Assess suicidality, intent, psychosis, or sudden functional decline. If safety is a concern, follow urgent protocols (suicide assessment, crisis plan, ER if needed). Check vitals/physical symptoms if relevant (headache, dizziness, unusual movements). 2 - Rapid medication & history check Confirm timing of meds (including any recent changes). Flag high-risk drugs (bupropion, clozapine, tramadol). If new meds or missed doses are identified, coordinate with the prescriber. 3 - Review TMS delivery Re-check mapping & motor threshold. Small targeting or intensity mismatches can matter; re-mapping may be indicated. Consider protocol changes : reduce per-session dose, increase inter-session rest, change coil location, or switch protocols (rTMS ↔ iTBS ). For patients on accelerated schedules, spacing or dose adjustments can reduce adverse fluctuations. 4 - Pause vs continue (clinical decision) Mild, brief dip: Often continue with enhanced monitoring and supportive measures (hydrate, rest, analgesia). Moderate/persistent dip: Consider pausing or slowing down the course and re-evaluating within 48–72 hours. Severe or safety concern: Stop treatment and escalate psychiatric evaluation. 5 - Symptom-targeted support Address headaches (hydration, OTC analgesic), sleep disturbances, and acute anxiety with evidence-based, short-term strategies and coordination with prescribing clinicians. Consider brief psychotherapeutic support if the dip involves increased rumination or trauma material. Learn More: TMS Pros & Cons 6 - Rescue & maintenance options Rescue/extension: If partial benefit is seen but symptoms fluctuate, clinicians may add extra sessions, extend the course, or offer maintenance/booster sessions later. Many clinics offer retreatment or maintenance schedules for sustaining gains. 7 - Documentation & follow-up Document symptom change, interventions, and rationale. Schedule a short re-check within a few days and continue outcome monitoring (PHQ-9/GAD-7 or other PROMs).
By Sam Clinch January 27, 2026
Quick Introduction
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By Sam Clinch January 20, 2026
Who might be a candidate for ONE-D? ONE-D is typically considered for people who: Have treatment-resistant depression or severe depressive symptoms that warrant intensive approaches Want a very time-condensed option (travelers, people with limited availability) Are medically appropriate after careful screening (no contraindicated implants, controlled seizure risk, no untreated substance issues, etc.) Understand that ONE-D may be experimental and require informed consent about augmentation medications and devices. A skilled clinician must determine candidacy after reviewing history, prior TMS (if any), medications, and a psychiatric evaluation. Inspire’s approach emphasizes physician supervision and a personalized plan. Read More: Is TMS right for me? Safety, side effects & monitoring Common short-term effects: Scalp discomfort, brief headache, transient fatigue -similar to standard TMS. Seizure risk: Extremely rare with properly screened patients; clinics follow strict screening protocols (medication review, seizure history). ONE-D’s increased session density requires vigilance; clinical teams are trained and prepared to manage rare events. Medication interaction/augmentation risks: If medications such as D-cycloserine or stimulants (e.g., lisdexamfetamine) are used to augment, the psychiatrist will monitor for side effects and interactions. Augmentation increases potential benefit but also adds clinical considerations. Always discuss risks and alternatives in detail with your provider. ONE-D should only be delivered in a setting with physician oversight, individualized mapping, and appropriate follow-up. It is not a DIY or consumer treatment. How ONE-D compares to other TMS options Standard TMS: 1 session/day for 4–8+ weeks. Best-studied and commonly covered by insurance. 5-day Accelerated TMS (50 sessions in 5 days): Intensive week-long program showing strong outcomes for many patients. Often self-pay but sometimes covered for semi-accelerated variants. ONE-D (20 sessions in 1–2 days): More condensed; attractive for time-limited patients and those seeking an intensive “reset.” Emerging evidence: may use medication augmentation and AMPA equipment; typically self-pay initially (Inspire’s planned price: $3,000). Read More: TMS Pricing Guide What to expect if you choose ONE-D at Inspire Pre-visit consult & screening - psychiatric evaluation, medication review, seizure risk screening. Mapping & motor-threshold determination - before or at the visit to personalize the dose. ONE-D visit (1–2 days) - repeated iTBS sessions with short breaks; staff monitor comfort and vitals. Immediate follow-up & outcome tracking - PHQ-9 or similar scales, and follow-up calls/visits; touch-ups or maintenance discussed if needed. Patient story: why someone might pick ONE-D Some patients travel specifically for accelerated care because it lets them complete a therapeutic course in days rather than weeks. For people balancing work, family, or long travel, ONE-D’s compressed schedule is appealing - especially when paired with physician oversight and clear aftercare. Inspire’s approach highlights convenience while retaining safety and personalization.
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By Sam Clinch January 20, 2026
Quick Summary Most psychiatric meds can be continued through TMS , but certain drugs affect seizure risk or response and require review. Careful pre-treatment medication review, mapping, and collaboration with a psychiatrist are essential for safe and effective TMS. Augmentation strategies (e.g., ONE-D with D-cycloserine or a stimulant) may be used under strict psychiatric supervision and add monitoring requirements. General principles Safety first. Screen for medications and medical conditions that increase seizure risk or interact with planned augmentation strategies. If seizure risk is elevated, weigh alternatives or modify the plan. Efficacy considerations. Some sedating medications (high-dose benzodiazepines) can blunt TMS response; consider minimizing sedative load when clinically safe. Individualize. Decisions to continue, taper, hold, or change medications should be individualized and documented in the psychiatry visit. Shared decision-making and informed consent are essential. Collaboration. The treating psychiatrist (or a TMS-trained prescriber ) should make medication decisions in close communication with the TMS team; TMS clinics should require medication lists and med reconciliation at intake. Medication Guidance Generally continue SSRIs / SNRIs (e.g., sertraline, escitalopram, venlafaxine) - usually safe to keep during TMS; no routine stop required. Mood stabilizers (e.g., lithium) - generally continue; coordinate for bipolar cases. Use with caution / consider adjustment Benzodiazepines (e.g., clonazepam, lorazepam) - may dampen response; consider minimizing dose if clinically safe. Antipsychotics (e.g., risperidone, olanzapine) - usually continue; clozapine needs special attention because of seizure risk. Review & adjust if needed (seizure-risk meds) Bupropion - dose-related seizure risk; discuss taper/hold if other risk factors present. Opioids, tramadol, certain stimulants at high doses - evaluate case-by-case; may increase seizure or sympathetic risk. Action: Flag these at intake and discuss with the psychiatrist before treatment. (Clinics should screen for seizure risk and have protocols.) Augmentation / experimental agents (ONE-D) D-cycloserine, short-acting stimulants (e.g., lisdexamfetamine) - used in some ONE-D protocols as augmentation only under psychiatrist supervision, with informed consent and monitoring. Document timing and monitoring plan. Read More - TMS Vs Medication Medications that most commonly affect seizure risk Higher seizure risk: bupropion, clozapine, tramadol, theophylline (rare). Agents that lower seizure threshold modestly or via interactions: some antipsychotics, certain antibiotics (quinolones — discuss if relevant), stimulants in high doses. Agents that raise seizure threshold (often protective): many anticonvulsants (valproate, carbamazepine, lamotrigine) - however, these can affect TMS response. Action: Flag any high-risk meds during screening and consult psychiatry to mitigate risk. ONE-D and augmentation - special considerations Augmentation meds (e.g., D-cycloserine 125 mg, short-acting stimulants) have been used experimentally to enhance ONE-D effects; they require psychiatric oversight, informed consent, and monitoring for side effects and interactions. Document augmentation rationale and monitoring plan. If using stimulants : evaluate cardiovascular status, anxiety history, and seizure risk. Consider holding stimulant dose or using a lower dose on treatment day, depending on risk/benefit. Medication log: Track timing of augmentation relative to stimulation in the chart (useful for outcome interpretation).
By Sam Clinch December 16, 2025
Short Answer  If you’ve been living with depression for a long time - trying medication after medication, attending therapy, sometimes even pursuing intensive programs - it’s completely understandable to feel exhausted. Treatment fatigue is real: the disappointment after another treatment that doesn’t “stick,” the side effects , the energy it takes to keep trying. That fatigue matters, and it deserves to be acknowledge d. This page is for people who are tired of trying the same things and want a different kind of option: a scientifically supported, non-drug treatment that works by directly engaging the brain’s circuits. Transcranial Magnetic Stimulation (TMS) is an option for many people with long-term, treatment-resistant depression. Below, we explain what TMS does, why it can help when other approaches haven’t, what the evidence says, and how clinics like Inspire TMS Denver approach long-term care with compassion and real outcome tracking.
By Sam Clinch December 16, 2025
How the FDA views affects teen treatment Device- and label-specific: The FDA clears devices and their indications, and those clearances may include age ranges. Because clearance is device- and indication-specific, whether a teenager is “on-label” depends on the device used by the clinic and the diagnosis being treated.  Practical result: Some systems have adolescent labeling, which allows clinics to treat teens consistent with labeling; where devices do not include a teen label, treatment would be off-label and requires extra care and documentation. Inspire explicitly offers TMS to individuals as young as 15 when clinically appropriate and in line with device/label guidance.
By Sam Clinch December 13, 2025
Quick summary (the short answers) Medicare: Often covers TMS for treatment-resistant major depressive disorder when the plan’s clinical criteria (such as prior medication trials) are met and prior authorization is approved. Inspire routinely helps patients with Medicare benefits checks and authorizations. Medicaid: Coverage varies by state . Some state Medicaid plans cover TMS with strict medical necessity criteria; others do not. Inspire collects your insurance details and runs a state-specific benefits check. Pre-authorization: Nearly always required. Insurers want documented prior treatment attempts, objective symptom measures (PHQ-9), and a psychiatrist’s letter of medical necessity. Inspire will run the authorization for you once you approve.
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