How Long Do TMS Results Last? A Minnesota Guide to Follow-Up Care

How Long Do TMS Results Last? A Minnesota Guide to Follow-Up Care

Transcranial magnetic stimulation (TMS) is a non-invasive treatment most often used for depression. It was cleared by the FDA for major depressive disorder in 2008, with clearance later extended to depression with comorbid anxiety in 2021.

A common question after treatment is: how long will the improvement last? There is no single answer. Some people continue to feel better for a long time after finishing a course, while others notice symptoms returning and may need further support. Follow-up care is therefore an important part of planning TMS, not an afterthought once sessions end.

For people in Minnesota, that plan may involve their TMS clinic, psychiatrist, GP or primary care clinician, therapist, and existing support network. The right approach depends on the person’s history of depression, other treatments, current medicines, and practical access to appointments.

What does a lasting TMS response mean?

TMS does not have one fixed outcome for everyone. A person may experience a meaningful reduction in symptoms, reach remission, or find that some symptoms improve more than others.

A lasting response generally means that improvements continue after the active treatment course has finished. This may include:

• More stable mood
• Better sleep, concentration or motivation
• Greater ability to work, study or manage daily tasks
• Less withdrawal from family, friends or usual activities
• Reduced severity or frequency of depressive symptoms

A standard TMS course is often around 36 weekday sessions delivered over roughly six to nine weeks. At the end of this course, the treating team will usually review symptom changes and discuss next steps.

Finishing the course does not necessarily mean ending all mental health care. TMS is often one part of a wider treatment plan, which may also include medication, talking therapy, physical health care and practical support.

Can depression return after TMS?

Depression can relapse after many types of treatment, including TMS. This does not mean TMS has failed or that earlier progress was not real. Depression is often a recurring condition, and symptoms may return during periods of stress, illness, major life change or changes to medication and routine.

The timing and pattern of relapse differ considerably. Some people remain well without further TMS for an extended period. Others may notice a gradual return of symptoms and benefit from early review. A smaller group may need more regular support.

It can help to distinguish between a difficult day or week and a sustained change in mood. Everyone has fluctuations. More concerning signs may include symptoms becoming more frequent, more intense, or harder to manage over time.

Possible early warning signs include:

• Sleep changing noticeably
• Loss of interest in usual activities
• Increasing fatigue or difficulty getting started
• Withdrawing from other people
• More negative or hopeless thoughts
• Reduced concentration or increased irritability
• Changes in appetite or daily routine
• Missing medication, therapy or medical appointments

If suicidal thoughts, plans or immediate safety concerns arise, seek urgent help through local emergency services or a crisis service rather than waiting for a routine follow-up appointment.

Follow-up after the active course

A useful follow-up plan is agreed before, or around the time, the final TMS sessions take place. It should set out who will monitor symptoms, how often reviews will occur, and what to do if depression starts to return.

The plan may include scheduled appointments with the TMS provider or prescribing clinician. Some people also continue regular therapy or check-ins with a primary care clinician. Where medicines are part of the treatment plan, any changes should be discussed with the clinician who manages them.

It is sensible to ask for clarity on practical details, such as:

• When the first post-treatment review will take place
• Who to contact if symptoms return between appointments
• Whether the clinic uses symptom questionnaires during follow-up
• How medication and therapy fit alongside TMS after treatment
• What signs should prompt an earlier review
• Whether the clinic offers maintenance TMS or re-treatment
• How insurance authorisation may work if further sessions are recommended

Keeping a simple record of mood, sleep, activity and medication can be useful in the weeks and months after treatment. This does not need to be complicated. The aim is to spot a meaningful pattern early, rather than waiting until symptoms become severe.

Maintenance TMS and re-treatment

Maintenance TMS refers to planned sessions given after an initial course, with the aim of helping to sustain improvement. There is no one maintenance schedule that suits everybody. Some people do not need it. For others, a clinician may recommend occasional sessions or a more structured plan based on previous symptoms and response.

Re-treatment, sometimes called a repeat or booster course, is different. It is usually considered when depressive symptoms return after a period of improvement. The clinician will review what has changed, assess safety and discuss whether another course of TMS is appropriate.

Neither maintenance sessions nor re-treatment should be assumed automatically. They are clinical decisions that should take account of:

• How well the first course worked
• How long benefits lasted
• Previous episodes of depression or relapse
• Current symptom severity
• Other treatments being used
• The person’s preferences and ability to attend sessions
• Insurance requirements and available coverage

TMS is generally well tolerated. Common side effects during treatment include scalp discomfort and headache. Seizure is rare. If a repeat course is being considered, the provider should review any relevant changes in health, medication or seizure risk since the first course.

Planning around work, travel and family life in Minnesota

Follow-up is easier when it is realistic. Minnesota has 136 clinics listed in the TMS Therapy Minnesota directory, with listings in communities including Edina, Saint Paul, Maple Grove, Duluth, Mankato, Burnsville, Stillwater, Maplewood, Rochester, Minnetonka, Baxter and Woodbury.

For someone who travelled for their active course, it is worth discussing whether follow-up can be shared with a local psychiatrist, therapist or primary care clinician. People should not assume that every clinic provides the same follow-up options, maintenance sessions or appointment formats. Ask directly before starting treatment and again before discharge from the active course.

Practical questions can include travel time, work arrangements, caring responsibilities, and whether a support person should be involved in recognising early warning signs. A written plan can make these conversations easier.

Insurance and further sessions

Coverage for maintenance TMS or a further course may differ from coverage for an initial course. Requirements can vary by plan, diagnosis, clinical history and prior authorisation rules.

In Minnesota, people may encounter plans from Blue Cross Blue Shield of Minnesota, HealthPartners, Medica, UCare, Aetna, Cigna, Minnesota Medical Assistance (Medicaid), Medicare, including Medicare Advantage plans, and others. It is important to confirm coverage directly with the insurer and the clinic rather than relying on a general assumption.

Ask whether follow-up appointments, maintenance sessions and re-treatment need separate approval. You may also want to ask what clinical documentation the insurer requires if symptoms return.

Questions to ask before finishing TMS

Before the final sessions, consider asking your care team:

• What improvement should I monitor over the next few months?
• Who is responsible for my follow-up care?
• When should I contact you rather than wait for my next appointment?
• Do you recommend maintenance sessions in my situation?
• What would make re-treatment appropriate?
• Should my medication or therapy plan change?
• How will insurance be checked if I need further TMS?
• Can I have my follow-up plan in writing?

Getting help in Minnesota

Use the TMS Therapy Minnesota directory to review clinic listings across the state, including the 136 published listings. The site’s insurance guide may help you prepare questions about coverage, and the contact page can help you find further directory support.

This is educational information, not medical advice.