rTMS for depression that has not improved with standard treatment
Repetitive transcranial magnetic stimulation (rTMS) uses magnetic pulses, delivered through a coil placed on the head, to stimulate brain areas involved in mood regulation. You stay awake throughout, no anaesthesia is needed, and you can usually go back to normal activities straight after.
rTMS is an established treatment for major depression that has not responded well to antidepressants, and international guidelines support its use. A course usually involves sessions on most weekdays for several weeks. At Headspace Mind Clinic, rTMS is available at our Paschim Vihar clinic after an assessment by our psychiatrist.
For education only. This page explains a treatment in general terms. It is not medical advice and cannot replace a consultation with a qualified doctor who knows your history. Whether a treatment suits you can only be decided after an assessment. If you are in danger or think you may harm yourself, call 112 or Tele-MANAS 14416 now.
How rTMS works for depression
In depression, activity in certain brain networks that regulate mood is often reduced. rTMS targets one of these areas, usually the left dorsolateral prefrontal cortex, with repeated magnetic pulses. Over a course of sessions this is thought to change activity in the wider mood network. Key points:
- A magnetic coil is placed against the head; nothing is implanted
- You are awake and can talk during the session
- No anaesthesia and no memory loss
- Sessions usually last from a few minutes to around 40 minutes, depending on the protocol
- You can usually travel and work straight after
- Often used alongside medicines and therapy
rTMS for depression: key facts. Tap the image to enlarge.
I consider rTMS for depression in selected individuals, particularly when symptoms have not improved adequately with conventional treatment or when medication-related concerns need to be considered. One of the most common questions I hear is whether rTMS involves electric shocks or causes memory problems. I explain that it uses focused magnetic pulses to stimulate specific brain regions and is a non-invasive treatment performed while the person remains awake.
Dr. Deepak Verma, MBBS, MD (Psychiatry), Consultant Psychiatrist, Headspace Mind Clinic
Who rTMS for depression may suit
rTMS is mainly considered for adults with major depression who:
- have not improved enough with one or more antidepressants taken at a proper dose for long enough
- cannot tolerate the side effects of antidepressants
- prefer a non-medication option alongside therapy, after discussion with their psychiatrist
It may also be considered in some people with depression in bipolar disorder, with careful monitoring. rTMS is not an emergency treatment: for severe depression with suicidal thoughts, psychosis or not eating and drinking, other urgent treatment comes first. Read more about depression treatment in Delhi.
What the evidence says
rTMS for depression has been studied for over two decades in many controlled trials. Evidence-based guidelines rate high-frequency rTMS over the left prefrontal cortex as effective for major depression, and national guidelines in several countries recommend it for depression that has not responded to medicines. Not everyone responds, and some people need maintenance sessions later to stay well. Related treatments and conditions:
Our neuromodulation service
Full treatment options for depression
How antidepressants work
Brain stimulation for OCD
When low mood will not lift
Talking therapy alongside rTMS
What a course of rTMS involves
Your psychiatrist will explain the exact plan for you.
A course of rTMS. Tap the image to enlarge.
Assessment. A psychiatric consultation to confirm the diagnosis, review previous treatment and check safety.
Mapping. At the first session, the team finds the right spot and strength of stimulation for you, using your motor threshold (the strength that makes your thumb twitch).
Treatment sessions. A course commonly involves sessions on five days a week for about four to six weeks. Some protocols use shorter sessions.
Monitoring. Mood and side effects are checked regularly with rating scales.
After the course. Improvement often builds gradually over the course and the weeks after. Medicines and therapy usually continue, and some people benefit from occasional maintenance sessions.
Side effects and safety
rTMS is generally well tolerated. The most common side effects are scalp discomfort at the site of stimulation and headache, usually mild and easing over the first week. The clicking sound is loud, so earplugs are used.
A seizure is a very rare but serious risk. Everyone is screened before treatment, and rTMS may not be suitable if you have:
- metal in or near the head (other than dental fillings), cochlear implants or brain stimulators
- a history of epilepsy or seizures, or certain brain conditions
- a heart pacemaker or other implanted electronic device (discussed case by case)
Tell the team about all your medicines, alcohol use and sleep, as these can affect seizure risk.
Is rTMS for depression right for me?
rTMS may be worth discussing if your depression has not improved enough with antidepressants, or if side effects have made medicines hard to continue. The decision is made with your psychiatrist after a full assessment, taking into account your history, safety screening and preferences.
If you are having thoughts of ending your life, please seek help today: Tele-MANAS 14416 or 112.
rTMS at Headspace Mind Clinic
rTMS is provided at our Paschim Vihar clinic under the supervision of our consultant psychiatrist, Dr. Deepak Verma (MD Psychiatry). tDCS, a gentler form of brain stimulation, is available at Paschim Vihar and Narela for selected patients.
डिप्रेशन के लिए rTMS (rTMS for depression in Hindi)
rTMS में सिर पर रखी एक कॉइल से चुंबकीय तरंगें दी जाती हैं, जो मूड से जुड़े दिमाग़ के हिस्से को सक्रिय करती हैं। इसमें बेहोशी की ज़रूरत नहीं होती और आप सत्र के बाद सामान्य काम कर सकते हैं। यह उन मरीज़ों के लिए उपयोगी है जिनका डिप्रेशन दवाइयों से पूरी तरह ठीक नहीं हुआ। हेडस्पेस माइंड क्लिनिक में rTMS पश्चिम विहार क्लिनिक में उपलब्ध है। यह जानकारी केवल शिक्षा के लिए है। अपॉइंटमेंट के लिए कॉल करें: +91 99711 66040
Founder of Headspace Mind Clinic. Dr. Verma sees patients at our Paschim Vihar, Rohini and Narela clinics. About our psychiatry service →
Three clinics in West and North Delhi
Psychiatrist consultation fee: ₹1,800 at Paschim Vihar and Rohini, ₹500 at Narela. All appointments are scheduled; please call or book online.
Frequently asked questions
A typical course involves sessions on most weekdays for about four to six weeks, but this varies with the protocol and your response. Your psychiatrist will explain the plan.
Some people notice changes within two to three weeks; for others improvement comes towards the end of the course or in the weeks after.
Usually yes. rTMS is often given alongside medicines. Do not change any medicine without speaking to your psychiatrist.
Most people feel a tapping sensation on the scalp and hear clicking sounds. Some have mild scalp discomfort or a headache during the first few sessions, which usually settles. No anaesthesia is needed.
No. ECT uses an electric current under general anaesthesia to cause a brief seizure. rTMS uses magnetic pulses over a small area of the head, you stay awake, and you can usually go back to normal activities straight after a session.
rTMS is generally well tolerated. The most common side effects are scalp discomfort and headache. A seizure is a very rare but serious risk, which is why everyone is screened before starting. People with metal implants in or near the head, cochlear implants or certain other devices may not be suitable.
rTMS is available at our Paschim Vihar clinic. tDCS is available at Paschim Vihar and Narela. An assessment with our psychiatrist comes first.
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References
- Lefaucheur JP, Aleman A, Baeken C, et al. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): an update (2014–2018). Clinical Neurophysiology. 2020;131(2):474–528.
- Milev RV, Giacobbe P, Kennedy SH, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder: Section 4. Neurostimulation treatments. Canadian Journal of Psychiatry. 2016;61(9):561–575.
- National Institute for Health and Care Excellence (NICE). Repetitive transcranial magnetic stimulation for depression (IPG542). nice.org.uk
- Rossi S, Antal A, Bestmann S, et al. Safety and recommendations for TMS use in healthy subjects and patient populations, with updates on training, ethical and regulatory issues: expert guidelines. Clinical Neurophysiology. 2021;132(1):269–306.
- Tele-MANAS, National Tele Mental Health Programme, Ministry of Health and Family Welfare, Government of India. Helpline 14416.
Medically reviewed by Dr. Deepak Verma (MBBS, MD Psychiatry; DMC Reg. No. 37616). Last reviewed: 15 November 2026.
Medical disclaimer. The information on this page is provided for general educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure or prevent any condition. Reading this page or using the self-check does not create a doctor–patient relationship with Dr. Deepak Verma or Headspace Mind Clinic. Please consult a qualified doctor about any symptom, diagnosis or treatment, and do not start, stop or change any medicine without talking to the doctor who prescribed it. Do not ignore professional advice, or delay seeking it, because of something you have read here. Symptoms, causes and responses to treatment differ from person to person, and no particular result is promised. Links to other websites are given for reference only, and we are not responsible for their content. If you think you or someone else may be facing a medical or mental health emergency, call 112, call Tele-MANAS on 14416 (free, 24×7) or go to the nearest hospital emergency department.