When Does TMS Start Working?

Answering the question “when does TMS start working?” can be tricky due to variations in individual responses to TMS, the protocol selected by your clinician, and the type of TMS being used. For accelerated TMS (the fastest working type), results often appear within a week, though the full effect can take longer to peak.

Quick answers

• Many patients first notice changes around session 18-20, which is about five days after starting accelerated TMS.
• However, TMS symptom improvement can take weeks to come to fruition, even if there are early signs TMS is working. 

What does the TMS timeline typically look like?

The TMS timeline varies depending on the type. With accelerated TMS, all the TMS sessions are packed into five to seven days, while traditional TMS consists of one to two daily sessions for up to six weeks. True to its name, accelerated TMS, which is what Radial specializes in, typically works faster.

Accelerated TMS

• Week one through two: With accelerated TMS, the first two weeks are when someone receives treatment, but not when the full effect is felt. “This big infusion of change to your brain takes time for your brain time to catch up with that change,” says Owen Muir, MD, DFAACAP, chief medical officer at Radial.
• Week three through four: By now, someone is done with all sessions, and the benefits continue to appear. In one study that compared traditional and accelerated TMS, the average time to remission was 21 days on average, about one month in another.
• Week five and six: While treatment is over, symptom improvement and remission usually remain. By week six, 87.8% of participants continued to experience symptom reduction, with 78% reaching full remission in one study. 

Once-daily TMS

• Week one through two: During this time, people receive their first sessions. Dr. Muir mentions that for many people, very little happens in these first few weeks. 
• Week three through four: The average remission time for once daily TMS was 28 days in one study, meaning it’s possible to feel better within four weeks.
• Week five and six: Remission may also happen after week five, and people usually go to daily TMS sessions until the six week mark. In one study, over 70% of patients had a response (aka reduction of symptoms) after 18–20 dTMS sessions over 31 or 32 days. Plus, over 50% had a sustained response. In a 2026 study, 87.5% of participants treated with once daily, went into remission by the six-week mark. 

What these timelines don’t capture is that the progress isn’t linear. You may feel highs and lows before improving. “It's rarely a linear improvement,” says Dr. Muir, “You can have days or even hours where you feel intensely.” These are sometimes referred to as feeling bubbles, or overwhelming rushes of emotion, and they can be positive or negative.

Why response time varies, and what affects your timeline

There are a few other predictors of a faster TMS response time:

• Condition treated: “The patients who tend to respond the quickest are patients who end up having bipolar disorder,” says Dr. Muir. Comparatively, people with OCD or treatment-resistant depression may respond at a slower rate.
• Neuroplasticity: Dr. Muir describes neuroplasticity as the brain’s ability to change—and this isn’t something mental health providers can measure in advance, though it does affect how fast TMS works.
• TMS type: “What we do know is that patients who have accelerated treatment tend to remit faster,” says Dr. Muir, “The speed of remission varies based on the speed of the delivery of the treatment.”‍
• Attendance consistency: TMS treatment is not the time to play hooky. Consistent attendance at TMS sessions can support earlier symptom relief.