When struggling with depression, finding the right treatment plan can sometimes feel overwhelming. For many, antidepressant medications bring relief. For others, medications alone aren’t enough.

In recent years, Transcranial Magnetic Stimulation (TMS) has emerged as a powerful therapy — especially when combined thoughtfully with medication management.

If you’re considering TMS and wondering whether you should continue antidepressants, you’re not alone. Many patients ask: Can TMS and antidepressants work together? Will one interfere with the other?
This article explores the answers, helping you understand how these treatments can complement each other for better outcomes.

Understanding TMS Therapy

Transcranial Magnetic Stimulation (TMS) is a non-invasive, FDA-approved treatment for major depressive disorder (MDD), especially when medications haven’t fully worked.

TMS uses pulsed magnetic fields to stimulate nerve cells in parts of the brain associated with mood regulation — particularly the dorsolateral prefrontal cortex.
Over time, TMS can help normalize brain activity, reduce symptoms of depression, and improve emotional resilience.

The TMS process is:

• Outpatient (no anesthesia or sedation)

• Painless (some patients feel a tapping sensation)

• Safe (minimal side effects, mainly scalp discomfort or mild headache)

• Delivered over several weeks (typically 5 sessions per week for 4–6 weeks)

Learn more about how TMS works here at Mayo Clinic.

How Antidepressant Medications Work

Antidepressants — such as SSRIs, SNRIs, atypical antidepressants, and others — aim to correct chemical imbalances in the brain, particularly involving neurotransmitters like serotonin, dopamine, and norepinephrine.

For some individuals, antidepressants dramatically improve mood and functioning.
However, about 30% to 40% of people with depression experience partial or no response to medication alone, according to the STAR*D study (source).

When depression remains stubborn despite medications, adding TMS can offer a new pathway to healing.

Can You Stay on Antidepressants During TMS?

Yes — in fact, most patients continue taking their antidepressants during TMS therapy.

TMS and medications work through different mechanisms:

• Medications alter chemical signaling across the entire brain

• TMS directly stimulates specific brain regions involved in mood and motivation

Because of this difference, combining both can be safe and often more effective than using either alone.

In clinical practice, it’s common to see patients:

• Continue their current medications without changes

• Adjust doses slightly if needed (for better symptom control)

• Sometimes reduce medications gradually after TMS, if remission is achieved

Every patient’s situation is unique. Medication management decisions should always be made collaboratively with your prescribing provider and TMS team.

Research on Combining TMS and Medications

Several studies have explored how TMS interacts with antidepressant medications.

A meta-analysis published in JAMA Psychiatry found that patients who received TMS in combination with antidepressants experienced significantly higher remission and response rates compared to those who received TMS alone or medications alone.

Specifically, patients who maintained antidepressant use during TMS:

• Had faster symptom improvement

• Were more likely to achieve full remission

• Reported higher levels of satisfaction with treatment

The combination approach may be especially helpful for individuals with treatment-resistant depression — those who have not responded to two or more prior antidepressant trials.

Potential Benefits of Combining TMS and Antidepressants

Pairing TMS with medication can offer several important advantages:

1. Higher Response Rates
   The synergistic effects of brain stimulation plus chemical modulation can boost your chances of improvement.

2. Shortened Time to Improvement
   Some patients notice symptom relief sooner when using both therapies together.

3. Greater Emotional Stability
   Combining treatments may help stabilize mood more evenly, reducing emotional “ups and downs.”

4. Flexibility for Future Adjustments
   Once TMS has improved your depression, your provider can reassess your medication needs — potentially adjusting or even reducing them safely over time.

When Might Medications Be Adjusted During TMS?

While most patients stay on their regular medications during TMS, there are some scenarios where adjustments might happen:

• Side Effects: If side effects from medications become problematic, doses might be lowered.

• Partial Response: If depression improves partially with TMS, providers may fine-tune medications to maximize results.

• Full Remission: Some patients who achieve full remission with TMS discuss tapering or simplifying their medication regimens after completing treatment.

Again, medication changes should only happen under careful medical supervision.

Common Questions About TMS and Medication

Will my antidepressant make TMS less effective?
No. Research shows that antidepressants do not block the effects of TMS. In fact, they may enhance outcomes.

Do I have to stop taking antidepressants before starting TMS?
No. You can begin TMS therapy while continuing your current medications, unless your provider advises otherwise for specific reasons.

Can I avoid medications altogether if I do TMS?
It depends. Some individuals may eventually reduce or stop medications after a successful TMS course, but others continue using both for long-term stability.

Who Might Benefit from Combining TMS and Antidepressants?

You might be a good candidate if you:

• Have depression that hasn’t fully responded to medications

• Experience ongoing side effects from your current medications

• Want to explore a more robust, comprehensive treatment plan

• Are seeking to reduce medication reliance long-term after stabilization

Before starting TMS, a thorough evaluation will help your care team create the safest, most effective strategy for you.

The future of depression care is personalized, multimodal treatment — combining different approaches to target symptoms from multiple angles.

TMS plus antidepressants is a strong example of how tailored treatment can help people reclaim their lives from depression.
With the right combination, many patients experience profound improvements in mood, energy, motivation, and hope.

If you’re considering TMS, don’t hesitate to discuss your full medication history and goals with your provider. Together, you can design a plan that maximizes your chance for lasting recovery.