Transcranial magnetic stimulation (TMS) uses electromagnetic pulses to stimulate nerve cells in the brain, which improves depression and other conditions. Now FDA-cleared to treat adolescents as young as 15, it offers a new option beyond therapy and medication. Where those options don't work for everyone and may have unwanted side effects, TMS is noninvasive, usually well-tolerated, and, most importantly, effective without the risk of increasing suicidal ideation.

It’s not easy to watch your child struggle with depression or other mental health challenges. Therapy and medication can help some teens, but not everyone has the same results or gets the relief they need. At that point, many families start to wonder what they can do next. 

Transcranial magnetic stimulation, or TMS, is one option that is getting more attention as a treatment for teens with depression and some other mental health conditions. TMS is a noninvasive procedure that uses magnetic pulses to stimulate areas of the brain involved in mood and emotion regulation. In November of 2025, the U.S. Food and Drug Administration (FDA) cleared deep TMS to treat major depressive disorder in people ages 15 to 21. 

TMS has been used for years in adults–one consensus review found broad evidence for its safety and efficacy in the treatment of depression in adults. Its use in adolescent care is newer and has understandably raised questions for both teens and parents.

Research is still emerging, but the current evidence is highly encouraging. The FDA’s clearance indicates that the agency has reviewed the available evidence and determined the treatment is safe and effective for this age group–and, importantly, is approved as a first line adjunctive treatment for depression, in addition to regular psychiatric care. That’s a meaningful step for many reasons, and different from the adult approval in which the FDA specified it was only for those who hadn’t responded to oral medicines first.

More than 5 million U.S. teens experience at least one major depressive episode each year. Because rates of depression and anxiety among teens are rising, many families are increasingly interested in exploring treatments that can help. Getting FDA clearance helps make the treatment more accessible to many teens–it’s already covered by national payors like Cigna and United.

“TMS offers the first non-psychotherapy treatment option that doesn't increase the risk of suicide attempts,” says Dr. MaryEllen Eller, MD, a board-certified psychiatrist and regional medical director at Radial.

This article can help you determine if TMS might be a helpful next step. We'll talk about what TMS is, how it works, and what the research says about its safety and efficacy. We'll also explore what the treatment experience is like for adolescents, as well as some practical considerations like cost, insurance coverage, and the time commitment needed, so you can make the decision that works best for your teen and your family. 

What is TMS and how does it work?

Transcranial magnetic stimulation (TMS) is a brain-based treatment that uses magnetic pulses to stimulate specific brain regions. It often targets the left dorsolateral prefrontal cortex (DLPFC), where it is believed to increase connections and neuronal activity. The DLPFC is associated with a range of functions, including mood regulation and executive functions like attention, working memory, and decision-making.

While it might sound intimidating at first, patients often report positive experiences and find it much less intense than it sounds. During TMS treatment, a helmet containing a magnetic coil is placed on the scalp to deliver brief magnetic pulses that activate targeted brain regions.

So why would someone choose this teen depression treatment? There are some key benefits that make it an appealing option:

• Non-invasive (no surgery or implants)
• No anesthesia or sedation is required
• Minimal side effects that are usually mild and temporary, such as headaches or scalp discomfort
• Available as outpatient treatment, so teens can go back to school, work, and other normal activities quickly
• Can lead to lasting symptom improvement even after treatment is complete

Standout Box: One key point: TMS is not the same as electroconvulsive therapy (ECT). TMS doesn’t involve electric shocks. It also doesn't cause seizures or require anesthesia. Unlike ECT, TMS has not been shown to cause memory loss, and adverse cognitive side effects are uncommon. Research has actually found that TMS can produce positive cognitive effects, including improvements in memory and concentration that may be impaired due to depression.

Types of TMS

While TMS is often used as an umbrella term, there are actually a few different types. These differ primarily in terms of how the magnetic pulses are delivered and how far they reach into the brain. 

You do not need to know all the technical details to make an informed decision about which one is right for your teen, but it can be helpful to know more about some of the basic differences.

• Standard or repetitive TMS (rTMS): This type uses repeated magnetic pulses that induce electrical stimulation of targeted brain areas. This type is the most studied form and has been used for adults for many years.
• Deep TMS (dTMS): This type uses a specialized coil to target deeper brain structures involved in mood regulation. Deep TMS is one of several FDA-cleared approaches to treat major depressive disorder in people between the ages of 15 and 21.
• Theta burst stimulation (TBS): A form of TMS that delivers magnetic pulses in rapid bursts that are designed to mimic the brain's natural theta waves. It's faster than traditional TMS, making it a more convenient option for some people.
• Other variations: There are also other treatment protocols and schedules. SAINT TMS, for example, is an accelerated TMS protocol that involves more treatment sessions over a shorter period of time. SAINT targets a specific brain area for a given individual based on special brain imaging known as fMRI. While not specifically FDA-cleared for teens, evidence suggests that these methods may also be safe and effective.

Conditions TMS can treat

TMS is currently FDA-cleared only for certain conditions, including different types of depression, OCD, and migraines. However, it has also been shown to be safe and effective for the treatment of other conditions.

FDA-cleared uses 

• For teens and young adults between the ages of 15 and 21, rTMS and Deep TMS are approved to treat major depressive disorder. 
• For adults, TMS is also FDA-cleared for treatment-resistant depression, anxious depression, obsessive-compulsive disorder, migraines, and smoking cessation. 

Conditions with growing evidence

TMS has also shown promise for other conditions, including:

• Parkinson's disease, fibromyalgia, and pain symptoms
• Anxiety
• Attention-deficit hyperactivity disorder (ADHD)
• Post-traumatic stress disorder (PTSD)
• Postpartum depression
• Bipolar disorder
• Stroke recovery
• Addiction

Deep TMS has been shown to be helpful for adolescents with treatment-resistant depression with signs of clinical improvement often occurring within two weeks of starting treatment.

Understanding the TMS age limit can help families decide whether this treatment is worth exploring. FDA clearance currently starts at age 15 for depression, but it may also be helpful for other conditions. 

A Radial clinician can help you get clear, personalized answers about TMS and whether it might be a helpful next step for your teen based on their age, symptoms, and treatment history.

How effective is TMS for teens?

If you are considering TMS for your teen, one of the big questions you probably have is: Does it work? The research on effectiveness is growing, and the results are promising. However, there are some gaps where more evidence is needed, and this treatment doesn't work for everyone. Understanding what the data shows can help you set realistic expectations when it comes to treatment.

Depression

This is where the evidence for the use of TMS in teens is the strongest. 

Studies suggest that TMS therapy for depression can reduce depressive symptoms for some teens, particularly those who haven't gotten enough of a response from medication or therapy. It's the strength of this evidence that led the FDA to grant clearance for this treatment in teens. 

• Real-world studies indicate that between 60-70% of adolescent patients experience meaningful improvements in depression symptoms after TMS treatment.
• Another study examining deep TMS specifically concluded that 58% of adolescents showed improvement within 30 sessions and 75% within 36 sessions.

That said, not everyone responds the same. Some teens feel a noticeable improvement, others experience more modest changes, and some don't respond at all. TMS can be most effective when used as part of a treatment plan that includes therapy, medication, and lifestyle modifications. Long-term remission rates are still under analysis, so ongoing follow-up care is important.

OCD

Research on using TMS to treat obsessive-compulsive disorder (OCD) in teens is still limited. 

Almost 60% of OCD patients treated with TMS see some benefits. While some studies suggest it might also help teens, more research is needed. Treating OCD in teens with TMS is considered off-label, so it's important to talk about the risks and benefits with your child's doctor.

ADHD

Studies are also beginning to explore the use of TMS to treat ADHD in teens. 

Because TMS often targets the region of the brain involved in attention and impulse control, it could help people manage their ADHD characteristics. One study found that TMS led to significant reductions in inattention, hyperactivity, and impulsivity in people with ADHD. At this time, there is no FDA clearance for this use in teens, but it may be used off-label.

How do results in teens compare to adults?

While direct comparisons between teen and adult response rates are limited, the available evidence suggests that success rates in teens are similar to those of adults. There's also the potential that teens may experience better results because their brains are still developing and have greater plasticity, meaning they may be better able to change in response to treatment. 

Further investigation is also needed to understand how long-lasting the effects can be. Researchers are also still looking at which teens are most likely to benefit from TMS, how long improvements might last, and how TMS might interact with brain development over time.

That doesn't mean that TMS is unsafe or inappropriate for treating teen depression. It just means that research is still ongoing, so clinicians tend to be careful when using TMS for adolescents. They keep a close eye on progress while offering plenty of support.

Is TMS safe for teens? What are the side effects?

One of the biggest questions parents and teens have: Is TMS safe? While no treatment is completely free of risk, TMS is a safe and effective option. It has been shown to be safe in teens, with minimal, short-lasting side effects.

Side effects

TMS can have some side effects, but the most common ones are temporary and mild. They usually occur during or shortly after treatment and often improve as sessions continue. The most commonly reported side effects are:

• Scalp discomfort, itching, or tenderness at the treatment site
• Headaches during or after sessions
• Tingling sensations on the scalp or face
• Fatigue after treatment

Such effects are usually mild and can be minimized by taking a break, adjusting stimulation settings, and using over-the-counter pain relievers if appropriate. TMS does not require anesthesia, and most teens are able to return to school and other normal activities the same day.

Serious complications from TMS treatment are rare. There is a risk of seizures for a very small percentage (less than 1 in 1000) of patients. Because of this, providers carefully screen for factors that may increase seizure risk, including certain medications and neurological conditions.

It's also important to note that TMS has not been shown to cause memory loss or structural damage to the brain. While symptoms may not improve for everyone, there is no evidence that it worsens mental health conditions.

Safety considerations

To ensure safety:

• Teens participate in a detailed evaluation considering their medical history, mental health history, and medications before they begin treatment. 
• Effects are monitored during treatment to make adjustments as needed.
• Parents are asked to report changes they might notice at home.
• Teens are encouraged to speak up if they have concerns or experience discomfort.
• Stimulation may be increased slowly to help minimize common side effects.

TMS vs. medications

TMS can be a helpful option for teens who haven’t gotten adequate relief from antidepressants or who struggle with side effects like stomach issues, weight changes, sleep problems, headaches, or restlessness.

According to Dr. Eller, medications can provide significant relief for some people. "Unfortunately, every time you put something into your mouth, you open up the possibility for systemic side effects," she says.  

Specific side effects depend on how an antidepressant works in the body. Some can upset the stomach (like those that affect serotonin), some can increase blood pressure and heart rate (those that affect norepinephrine), and some can lead to emotional blunting or movement disorders (those that affect dopamine).

"While this may paint a grim picture, it's important to acknowledge that these medications have saved many lives. Mental illness, left untreated, kills people. And mental illness in teens leads to more suicide attempts than any other age group," Dr. Eller says.

Antidepressants also carry a black box warning about increased suicidal thoughts in young people, particularly early in treatment. TMS doesn’t have that same warning. That doesn't automatically make it a "better" or "safer" treatment in every situation, but it can be a valuable option for many teens who haven’t responded to medication or can’t tolerate it.

Talking to a mental health clinician can help you compare the risks and benefits of TMS and decide if TMS makes sense based on your teen's symptoms, history, and preferences.

What is TMS treatment like for teens?

Knowing what to expect can help you feel a lot more comfortable before your first TMS sessions. Here's what you can expect before you get started, during your sessions, and after treatment.

Before treatment

Before starting TMS, a teen will meet with a mental health provider who will assess their symptoms, past treatments, and medical history to determine if TMS is a good option.

Informed consent is a big part of this process. Parents or caregivers will provide formal consent, and teens will also be asked to consent to the treatment. The goal is to explain the process clearly, ensuring everyone understands the benefits and risks so that parents and teens feel comfortable making a voluntary, informed decision.

Most clinics also perform a step called mapping. “This is a process of identifying the specific part of your brain that we will stimulate using the magnetic coil,” Dr. Eller explains. “The mapping process takes about 5-10 minutes and involves the use of single magnetic pulses to find the specific area we will target during your treatment." 

Providers will also spend some time talking about expectations, including the fact that TMS typically doesn't work instantly and may not work the same for everyone.

During treatment

TMS sessions are structured and predictable. This can be reassuring, because it means you'll know what to expect. The specific structure will depend on the exact type of TMS you are receiving, but it typically looks like this:

• Each treatment lasts about 3 to 20 minutes
• Treatment is usually done five to seven days a week
• A full course includes between 36 to 50 sessions

Where traditional TMS usually takes 6 to 8 weeks, accelerated schedules can happen in as little as 5 days. Your treatment at Radial will be personalized to work with your symptoms and scheduling needs, with the doctors who pioneered the approach guiding your child’s care.

During a session, Dr. Eller says you will:

• Sit in a chair (similar to a barber chair) while a TMS technician positions the magnetic coil over the specific area of the brain
• You'll feel a series of "taps" on your scalp/head with periods of rest in between
• The cycle of taps and rests lasts about 10-15 seconds and continues throughout the treatment (3-20 minutes total)

The sensations may feel unusual or even slightly uncomfortable, especially when you first begin treatment. It's usually manageable and gets easier over time. Most teens can return to school the same day. You don't need sedation, and there is no recovery period needed after treatment. Oftentimes, the biggest challenge is scheduling sessions around school and activities, but planning ahead can help.

After treatment

“Once the treatment is done, you're done for the day. Most people don't experience any side effects or downtime,” Dr. Eller says. When side effects do happen, they are usually mild and resolve quickly. Mild headache is the most common side effect after treatment.

It may take some time to notice improvements in depression symptoms, although this may vary from one person to the next.

• Some evidence suggests that more than half of patients saw improvements in mood symptoms within one week of starting treatment. 
• Another study found that symptom improvement was greatest in the first 10 sessions, with continued steady progress after. 
• The best results were seen in longer treatments.

“When it comes to outcomes, consistency is key to treatment success,” Dr. Eller suggests.

After your initial course of treatment, your Radial clinician will reassess your progress and talk about the next steps. Some teens do well without additional treatment, but others may benefit from maintenance sessions or continued treatment alongside therapy or medication. Follow-up care is also important because depression symptoms can sometimes return.

How TMS can fit into a teen’s overall treatment plan

TMS can be used as a standalone treatment, but it is also often part of a comprehensive care plan. Thinking about how TMS might fit into this plan can help families set realistic expectations and see better results.

• Therapy can play a role before, during, or after TMS. There are several approaches that can improve symptoms, including cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and mentalization-based therapy (MBT). TMS can make depression symptoms gradually less severe so that teens are better able to engage in therapy and practice new skills between sessions.
• School support is also helpful. Depression symptoms can affect school performance, often affecting concentration and motivation. An IEP (Individualized Education Program, which provides special services) or a 504 plan (which provides accommodations) can be helpful for some teens, especially during treatment when their schedules and energy levels might vary. Working with the school can reduce stress levels and make the treatment process feel more manageable.
• Family involvement is also key, and better family dynamics are associated with lower levels of depression in teens. Family systems work can improve functioning, provide guidance, and support better communication. This can reduce conflict at home and help families better understand the role that TMS can play. That can help parents and family members support a teen through the ups and downs of treatment more effectively.
• Lifestyle factors also play a part, even with a brain-based treatment like TMS. Nutrition, sleep, physical activity, and social connection influence mood. TMS can help support recovery and make it easier for teens to establish and maintain healthy, balanced routines.
• Medications may still be a part of the treatment process for some teens. Decisions about starting, stopping, or adjusting medications should always be made with the prescribing physician based on factors such as side effects and symptom changes.

“TMS doesn't replace psychotherapy or medications,” Dr. Eller says. “It can help alongside these treatments and can be effective when medication side effects are intolerable. Most importantly, TMS offers hope to teens (and their families). It’s a tool that often works best when it is thoughtfully integrated into a plan to support a teen's mental health. This includes family involvement, school support, daily routines, and therapy.

What makes someone a good candidate for TMS?

While treatment for adolescent depression often begins with therapy and medication, there's a growing body of evidence that TMS can be an effective treatment. However, that doesn't mean that it's the right option for every teen. Providers usually look at symptoms, treatment history, readiness, and safety factors before recommending it. Understanding what makes a teen a good candidate for this treatment can help families decide if this is an option worth considering.

Teens who are good candidates for TMS often have:

• A clear diagnosis, most commonly major depressive disorder
• Persistent symptoms that have not improved much with other treatments
• Difficulty tolerating medications
• Ability to attend frequent treatment sessions
• Willingness to participate and communicate about concerns, side effects, or symptom changes

Given the time commitment, it's important for teens to be ready to try TMS and have family support to help them get to and from treatment and receive follow-up care. 

Who is not a good candidate for TMS?

While TMS can be helpful for many teens, there are situations where it may not be safe or appropriate. These are called contraindications, which providers carefully screen for before treatment begins.

TMS is usually not recommended for teens who have:

• A history of epilepsy or seizures, although some “off-label” approaches have shown promise.
• Certain neurological conditions that increase their risk of seizures
• Iron-containing implants or devices in or near the head, such as cochlear implants or metal plates
• Implanted medical devices that could be disrupted by magnetic fields, such as a pacemaker require additional steps to ensure safety.

TMS may also be reconsidered if a teen is unable to tolerate the sensations despite adjusting the stimulation level. It may also be off the table if a teen cannot commit to the treatment schedule or begins experiencing acute or severe depression symptoms that require a higher level of care.

Cost, insurance, and access considerations

Cost and insurance access often play a significant role in whether TMS is a realistic option for a family. Understanding your insurance coverage can help you answer any questions and determine what your policy will cover.

Age matters because insurance policies often follow FDA clearance closely. While deep TMS is cleared for depression in young people ages 15 to 21, not all insurers have updated their policies to apply the same coverage to teens as they do to adults.

Coverage may vary depending on:

• Age and diagnosis
• Whether the TMS protocol is FDA cleared for that age group
• Requirements to try therapy and medication first
• Differences between commercial plans, employer-based plans, and Medicaid

The best way to know more is to check with your policy provider to find out more about what your policy covers. Insurance providers may require prior authorization, along with evidence that a teen has not responded to prior treatments such as therapy and medication.

If TMS is not covered, families may need to pay out of pocket. Financial assistance and flexible payment options can help families cover the costs of TMS. It's also helpful to see if partial coverage is available for evaluations or visits.

The bottom line

“TMS is a game-changing treatment option for teens struggling with mental health challenges,”  Dr. Eller says. “It can work when medications have not.” It's non-invasive, generally well tolerated, and supported by a growing body of evidence, including recent clearance by the FDA as a treatment for depression in young people age 15 and up. 

At the same time, it's important to remember that research is ongoing, and access and costs can be barriers for some young people. This treatment often works best as part of an overall plan to help teens manage mood symptoms, so it's important to work with your provider and decide which options are right for a teen's specific needs.

Key takeaways

• TMS has been FDA cleared as a treatment for depression in teens aged 15 and up and may be particularly helpful in situations where medications are not a good fit.
• Evidence suggests that TMS for teens is generally safe and well-tolerated, but careful screening and treatment by experienced providers is still key.
• Practical considerations are also important, since TMS requires time commitment. Managing school schedules, having family support, and checking on insurance coverage are important to make sure it's a workable option for the teen and their family.

Frequently asked questions

What is the youngest age for TMS?

The FDA has cleared deep TMS to treat major depressive disorder in people as young as 15. It can also be a safe and effective treatment for other conditions, so clinicians may sometimes use TMS off-label. A qualified provider can determine whether TMS is an appropriate treatment option based on the patient's age, diagnosis, medical history, and prior treatment.

Does TMS hurt?

TMS typically doesn’t hurt, but the sensations of the magnetic pulses may feel a little uncomfortable at first. Many patients report sensations that feel like tapping on the scalp during treatment. It’s a feeling that tends to be stronger during the initial sessions, but often becomes less noticeable and easier to tolerate as treatment continues. Providers can usually adjust the stimulation settings as needed to help reduce discomfort.

Can a teen go to school during treatment?

Yes, most teens can continue to go to school during treatment–usually the same day. Treatment does not require anesthesia or require recovery time, so teens can return to their normal daily activities immediately afterward. Treatment can be time-consuming, often requiring sessions multiple days each week. Careful planning ahead and requesting temporary accommodations can help make sure that treatment works with a teen’s schedule.

Is TMS better than medication for teens?

It depends on the individual. TMS isn’t an inherently better choice, and both can be an important part of treatment depending on a person’s needs. Medications can be effective for some adolescents, but others don't respond well or experience side effects that are hard to tolerate. TMS offers a non-medication option, which can be appealing for many teens. The best way to know if it's right for you is to discuss it with a provider to decide which option makes the most sense based on a teen's symptoms, history, and preferences.

Deep dive recommendations

• Child and Adolescent Psychiatric Clinics of North America. Transcranial magnetic stimulation for adolescent depression.
• Psychiatric Research. Safety and efficacy of Deep TMS for adolescent depression based on large real-world data analysis.
• Brain Stimulation. Real-world effectiveness of TMS in adolescents and young adults with major depressive disorder.