Can You Continue Taking Antidepressants During TMS Therapy?

Woman holding a medication pill and yellow cup by a bright window at home

Yes. Most patients can keep taking their antidepressants during TMS therapy, and many do. Transcranial magnetic stimulation and antidepressant medication work in different ways, and the two are often used together. Your provider will review every medication you take before treatment starts and watch how you respond throughout your course. This article explains how the combination works, when changes might make sense, and what to expect along the way.

Understanding TMS Therapy and Antidepressants

What TMS Therapy Is

Transcranial magnetic stimulation uses magnetic pulses to stimulate nerve cells in areas of the brain that help regulate mood. It is non-invasive, requires no anesthesia, and is nearly free of side effects. At Pacific Phoenix Psychiatry & TMS, we use the NeuroStar® Advanced Therapy system to treat depression and obsessive-compulsive disorder, and our team has delivered more than 10,000 TMS treatments. A typical course of TMS therapy involves five treatments per week for six weeks, followed by a taper. We also offer accelerated TMS, which can produce results in as little as 1 to 2 weeks.

This video explains how NeuroStar, a device used for TMS therapy, works at Pacific Phoenix Psychiatry.

How Antidepressants Work

Antidepressants change the levels and activity of brain chemicals such as serotonin, norepinephrine, and dopamine. These chemicals help carry signals between nerve cells. Over several weeks, the shift in brain chemistry can lift mood, improve sleep, and ease anxiety. Antidepressants travel through the whole body. TMS targets a specific region of the brain.

Why Patients Combine TMS and Antidepressants

Many people who come to us for TMS are already on an antidepressant that has helped somewhat but has not fully relieved their symptoms. Rather than stopping a medication that offers partial benefit, they add TMS to address the depression from a second direction. One treatment works on brain chemistry. The other works on brain circuits.

Safety of Taking Antidepressants During TMS

What the Research Shows

Safety is often what sits behind the question “Can You Continue Taking Antidepressants During TMS Therapy?” Clinical studies of TMS have commonly included patients who stayed on stable doses of their antidepressants during treatment. In those studies, the combination was generally well tolerated. This is one reason many patients begin TMS without changing their current prescriptions.

Safety and Tolerability of Combining TMS and Antidepressants

TMS does not enter the bloodstream, so it does not interact with medications the way two pills can. Patients on common antidepressants usually tolerate TMS sessions well. The most frequent complaint is mild scalp discomfort or a headache during the first few sessions, and this tends to fade as treatment continues. Certain medications can lower the seizure threshold, especially at higher doses. Others that calm brain activity, such as some sleep aids or seizure medications, may affect how the brain responds to stimulation. This does not mean these medications rule out TMS. It means your provider needs a full, accurate list of everything you take, including supplements and over-the-counter products.

Effectiveness of Combining TMS and Antidepressant Medication

How Antidepressants May Support TMS Results

Because the two treatments act on the brain in different ways, they may complement each other. Some patients find that a medication they felt was only partly working becomes more helpful once TMS is part of their plan. Others notice their symptoms improve faster than they did with medication alone.

A doctor in a white coat reviews information on a tablet with a seated patient in a clinical exam room, illustrating a discus

Studies on TMS and Antidepressant Effectiveness

Studies have looked at TMS both as a standalone treatment and as an add-on to medication. Many patients in these studies continued their antidepressants and still showed meaningful improvement with TMS. Research on the combination continues to grow, and it supports what we see in our own patients: staying on a stable medication does not prevent a good response.

Whether Antidepressants Interfere With TMS

For most patients, standard antidepressants do not block the benefits of TMS. A small number of medications that strongly quiet brain activity may reduce the effect of stimulation. If you take one of these, your provider will weigh whether it should continue, change, or stay as is during your course.

Medication Management During TMS Treatment

Staying on Antidepressants During TMS

For most patients, we recommend keeping antidepressant doses steady during TMS. A stable dose makes it easier to see how much of your improvement comes from TMS. Our medication management approach starts with a thorough review of your past medications and psychiatric history. We also assess your overall health, including medical conditions that could be adding to your symptoms.

When Adjusting or Stopping Antidepressants May Be Recommended

Your provider may suggest a change in some situations. Some patients also use GeneSight testing to learn how their genes may affect their response to certain medications. Any change happens gradually and under supervision. It can also bring back depression symptoms before TMS has had time to work. Never stop or reduce a medication on your own. Talk with your provider first, even if you are feeling much better.

Antidepressants Commonly Used With TMS

Types of Antidepressants Often Combined With TMS

Patients receiving TMS commonly take selective serotonin reuptake inhibitors, known as SSRIs, or serotonin and norepinephrine reuptake inhibitors, known as SNRIs. Other options include bupropion, mirtazapine, and older classes such as tricyclic antidepressants. Each type has its own profile. Your provider will look at your specific medication and dose, not just the drug class, when planning your treatment.

A young woman smiles while talking to a therapist taking notes on a clipboard during a counseling session

When TMS May Be Used Without Antidepressants

TMS is a drug-free treatment, so it can be an option for patients who cannot tolerate antidepressant side effects or who have tried several medications without relief. Some patients prefer to avoid medication altogether. In these cases, TMS may stand on its own. Patients with treatment-resistant depression may also discuss other options we offer, such as Spravato and IM ketamine therapy.

What to Expect When Combining TMS and Antidepressants

Managing Side Effects

Side effects from TMS are usually mild and short-lived. Scalp tenderness and headaches are the most common, and they often ease within the first week or two. Medication side effects tend to stay the same as before TMS began. If anything new or unusual shows up, tell your treatment team right away so they can help you sort out the cause.

TMS sessions are non-invasive, require no anesthesia, and let you relax comfortably throughout treatment, and some patients even bring a furry friend for comfort.

Monitoring and Ongoing Evaluation

Throughout your course, our team tracks your mood, sleep, energy, and any side effects. Because you come in for regular sessions, there are frequent chances to check in. Our providers include Elia Gonzalez-Rodriguez, Psychiatrist, Darcy Trenkle, MD, Angela Kline, Board Certified Physician Assistant, PA, and Madison S., RN, BSN. You can learn more about our providers and their backgrounds.

Common Concerns About TMS and Antidepressants

Taking Antidepressants Along With TMS Therapy

When patients ask us “Can You Continue Taking Antidepressants During TMS Therapy?” our answer is usually yes. Most antidepressants can continue safely during treatment. The key is an honest, complete medication review before your first session so your provider can plan around anything that needs extra attention.

Using TMS in Place of Antidepressants Long Term

Some patients hope TMS will let them reduce or stop medication over time. This can be a reasonable goal for certain people, especially after a strong and lasting response. It is a decision made together with your provider, with any taper done slowly and with close follow-up.

Questions to Ask Your Provider About TMS and Medication Adjustments

Bringing questions to your appointment helps you get clear answers. Consider asking:

  • Do any of my current medications affect my TMS treatment?

  • Should my doses stay the same during my course?

  • What signs should I report between sessions?

  • Could I lower my medication after TMS, and how would that work?

  • Is traditional TMS or accelerated TMS a better fit for me?

Conclusion

Making the Right Choice for Your Treatment Plan

Most patients can continue their antidepressants during TMS, and the two treatments often work well together. Steady doses, a complete medication review, and gradual, supervised changes are what keep the combination safe.

Consulting With Your Psychiatry Provider

Your provider will look at your history, current medications, and goals to build a plan that fits you. If you are considering TMS and want to know how it fits with your medications, our team can review your situation and help you decide on next steps.

Dr. Elia R. Gonzalez-Rodriguez, board-certified psychiatrist

About the Author

Dr. Elia R. Gonzalez-Rodriguez

A board-certified psychiatrist based in Vancouver, WA and Steilacoom-Lakewood, WA. She believes in taking time to know her patients and learn about their concerns, so she can create individualized treatment plans tailored to their unique needs.

Take the First Step Toward Feeling Better

Dr. Elia R. Gonzalez-Rodriguez

October 20, 2026

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