Repetitive transcranial
magnetic stimulation

Transcranial magnetic stimulation (TMS) is a non-invasive, evidence-based treatment for depression. Repetitive TMS, or rTMS, uses targeted magnetic pulses delivered through a coil against the scalp. You remain awake and alert, without anaesthesia or sedation.

The magnetic pulses stimulate nerve cells in brain regions involved in mood. Repeated stimulation can change activity and communication within these networks, supporting changes associated with improved mood.

No. TMS does not intentionally cause a seizure, require a general anaesthetic or typically cause memory impairment. ECT uses a controlled electrical stimulus to cause a brief seizure under general anaesthesia. Both are established treatments for depression, but work differently. Your psychiatrist can explain which may be appropriate.

TMS may be suitable for adults with depression who have not improved enough with antidepressants or psychological treatment, or who have difficulty tolerating medication. A specialist assessment is needed. Clinical suitability and Medicare eligibility are separate considerations.

Yes. Perth Clinic accepts referrals from GPs and psychiatrists. A specialist assessment determines whether TMS is clinically appropriate and whether you meet Medicare criteria. If you already see the psychiatrist who will provide your TMS care, ask the team whether a new referral is needed.

Not necessarily. Perth Clinic provides TMS for inpatients and outpatients. Most outpatients attend scheduled appointments and return to their usual activities afterwards, subject to their treating team’s advice.

Eligible patients can receive rebates for up to 35 initial treatment sessions, with mapping as a separate service. Perth Clinic fully bulk bills the included outpatient program for eligible patients. See the fees and Medicare section for inclusions, eligibility and conditional retreatment. The team confirms coverage before you begin.

An MRI is not routinely required before TMS. Your psychiatrist may recommend additional investigations if needed for your care.

Your initial treatment appointment includes mapping to identify the treatment location and stimulation intensity suited to you. A psychiatrist trained in TMS performs mapping and prescribes your individual treatment plan. The team will explain your appointments and answer questions before treatment.

An initial course involves regular sessions over several weeks. Eligible patients can receive up to 35 Medicare-funded treatment sessions. Your psychiatrist prescribes the number and schedule suited to you, and your team will explain the plan.

At Perth Clinic, stimulation may take approximately 3 minutes for intermittent theta burst stimulation (iTBS), or around 20 minutes for certain conventional TMS protocols. These are stimulation times, not the full appointment length. Allow extra time for positioning, preparation and clinical assessment; your team will confirm how long to set aside.

You may feel tapping on your scalp and hear clicking sounds from the coil. Some people notice mild twitching around the forehead or face. You remain awake and can speak with your nurse throughout. Let them know about any discomfort.

Specially trained nursing staff deliver TMS at Perth Clinic under the prescription and clinical supervision of a qualified psychiatrist. Your treatment plan is individualised and your progress is monitored throughout.

Most people tolerate TMS well. Some experience scalp sensitivity, tapping discomfort or headaches, especially in the first few sessions. Discomfort often improves as treatment continues. Tell your nurse so they can help manage it.

Possible side effects include scalp discomfort, headaches, temporary facial muscle twitching and tiredness. Serious complications, including seizures or a shift into mania (unusually elevated mood or energy), are rare. Safety screening and ongoing monitoring help the team assess and manage these risks.

In many cases, yes. TMS is often provided alongside antidepressants and psychological treatment. Tell your team about all medications and any changes during your course. Do not stop or adjust prescribed medication without medical advice.

Most people can drive and return to usual activities after treatment, provided they feel well and have no other medical restrictions. Follow any individual advice from your treating team.

Some metal implants or implanted electronic devices may be unsafe near the treatment coil. Tell the team about all implants and devices before treatment so they can assess whether TMS is safe for you.

TMS has a substantial evidence base for treating depression, particularly when earlier treatments have not provided adequate relief. Responses vary, and improvement cannot be guaranteed. Your psychiatrist can discuss what this means for your situation.

Some people notice improvements within the first few weeks; others may notice meaningful changes later in the course. Your team will monitor progress through clinical reviews and standardised questionnaires.

This varies from person to person. Some maintain improvement for an extended period, while others have symptoms return and need further assessment or treatment.

Maintenance TMS involves ongoing sessions after an initial course to help sustain improvement. Retreatment is a further course considered when symptoms return after a response. The schedule depends on your clinical needs. Medicare’s conditional retreatment entitlement provides up to 15 sessions for eligible patients; it does not mean ongoing maintenance is automatically funded. Read the eligibility and timing conditions.

Where possible, maintain healthy sleep habits, be physically active, stay connected with others, participate in psychological therapy or therapeutic groups, and follow your prescribed treatment plan. These activities support overall mental health and recovery; they have not all been shown to directly increase TMS effectiveness.

Your psychiatrist will review your response and discuss next steps. These may include medication changes, psychological therapies or other treatment options.