Does TMS Make You Tired?

It’s normal to have questions before starting transcranial magnetic stimulation (TMS). One of those questions may be, “does TMS make you feel tired?” For some patients, the answer is yes. However, like most TMS side effects, any tiredness is usually short-lived, and patients are more likely to feel a bit sleepy or mentally drained after the first few sessions because that’s when their brain is adapting.

Quick answers

• Mental or physical fatigue is a possible side effect of TMS.
• Feeling drained after a session isn’t a sign anything is wrong, just that your brain is processing treatment. 
• TMS fatigue is a commonly reported side effect, especially after the first few sessions. However, post-session fatigue usually doesn’t last long. 
• Fatigue may be more common with accelerated treatment as more sessions are concentrated into a shorter period of time.

Why TMS can leave you feeling tired

TMS therapy is a treatment where repeated magnetic stimulation targets and activates specific regions of the brain. You can think of it like a highly effective mental workout. And just as an exercise class leads to physical fatigue, there may be some mental fatigue after TMS. 

“Usually any tiredness after TMS wears off after the first few sessions,” reports Jennifer Ramsey, PMHNP, a psychiatric nurse practitioner at Radial. She adds that no one has fallen asleep at the clinic, but patients have told her that they took a nap after returning home from a TMS session. 

Like most TMS side effects, fatigue is more common in the first few days and typically eases as the treatment progresses. It’s also not a universal symptom. Some people feel no fatigue or even report feeling more energized after treatment. 

What's normal vs. worth mentioning to your provider

Some TMS recovery time is normal, especially in the beginning. “Your brain is working in a way that you're not used to, so the brain may perceive it as, ‘oh, I need to rest,’” explains Ramsey, “and that's normal.” 

However, she advises that patients should report tiredness in some situations. “They definitely need to report any sleeping problems, and that goes for sleeping excessively or not recovering when they wake up,” says Ramsey.

TMS fatigue is also different from low energy due to depression or a TMS dip, which is when symptoms get worse in the middle of treatment before getting better. “The low energy from depression is probably something they're more used to,” says Ramsey, “Versus the TMS fatigue, [which] would be similar to a workout or doing something that is just physically and mentally draining.”

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