One of the most common questions before starting rTMS is: “How many times do I need to come and how long does it take?” Unlike a pill that you can take on the first day, rTMS requires a specific time commitment. To familiarize yourself with the basics of this method, also see the article What is rTMS?.

Overall Structure of a Treatment Course

The standard protocol usually includes daily or near-daily sessions, five days a week, for several consecutive weeks. The exact number of sessions varies depending on the diagnosis and the psychiatrist's chosen protocol.

Why are so many sessions necessary?

The effect of rTMS is cumulative; each session alone creates a small change, but it is the total of consecutive sessions that can lead to a lasting change in the activity pattern of the targeted neural circuit.

Weekly rTMS session schedule on the clinic calendar

General Stages of a Course

  1. Assessment session and target site determination (precisely locating the stimulation point on the head using standard methods)
  2. Main treatment phase — frequent sessions according to the established schedule
  3. Assessment of treatment response in the middle and at the end of the course
  4. Maintenance sessions (if needed) — spaced out more, to maintain the results
Assessment session and target site determination before starting the rTMS course

What if I miss a session?

Missing one or two sessions is usually not a major crisis, but the overall consistency of the schedule plays a role in effectiveness — it is better to coordinate absences with the treatment team.

To see an example of a specific application with a different protocol, see the article rTMS and Obsessive-Compulsive Disorder; if you are still unsure whether rTMS is the right path or medication, the article rTMS or Medication? will also help in decision-making.

Patient in the middle of the rTMS treatment course with an optimistic spirit

Summary for the Patient

rTMS is a regular multi-week commitment, not a one-time session. Patience and adherence to the schedule play an important role in the final outcome.

Sources

  • Clinical TMS Society — Standard Treatment Protocols for TMS Therapy
  • American Psychiatric Association — Practice Guideline for Neuromodulation Therapies
  • Mayo Clinic — Transcranial Magnetic Stimulation, What You Can Expect
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