Transcranial Magnetic Stimulation (TMS) is a mild form of brain stimulation that is a painless, non-invasive procedure, shown to be a safe and effective treatment for treatment-resistant depression. TMS can offer hope for people with depression that have not responded to first-line treatment.
Transcranial Magnetic Stimulation (TMS) was invented in the UK with public funding and is an outpatient brain stimulation treatment that uses focused magnetic pulses to restore balance in brain networks associated with depression. It works by stimulating electrical activity in nerve cells in the front parts of the brain close to the where the coil has been placed. Over repeated pulses of energy in one session of stimulation, the stimulation wakes up brain pathways that have been dampened down by depression. These changes embed across 20 to 30 treatment sessions, gradually restoring balance between brain networks that previously were not working in harmony. Sessions last from 3 to 40 minutes and a full course runs 2 to 4 weeks. No anaesthesia is required, and there is no systemic side-effects, and no need for specialist aftercare.
TMS works across age groups, in suicidal patients, and alongside any other treatment.
However, TMS is currently only available at a small number of NHS treatment sites, creating inequity of access.
1 in 7 people will experience depression during their lifetime and depression is estimated to cause of 70% of suicides and substantially increases the risk of death from physical health problems. About 1 in 3 people with depression may have "difficult to treat depression" or DTD as they do not respond to the first or second treatments they try.
Over 50% of young people who are not in work and education might have depression, as do 20% of carers for others and 20% of people with other physical health problems.
Demand for NHS depression treatment has doubled over the past 10 years, which includes; first-line GP-initiated treatments include sick leave, antidepressants and self-referral to NHS Talking Therapies (IAPT) for courses of psychological treatment such as cognitive behaviour therapy (CBT).
People at risk of serious complications, including suicide, should be directed promptly to NHS111 or mental health crisis services.
For those not at immediate risk, the rise in demand has created significant pressure on services.
This British technology, invented using taxpayers' money, can transform lives. It is cost-effective, approved by NICE and widely used around the world. Our aim is to increase access for UK patients affected by this hugely debilitating condition, and save money for the NHS at the same time.
Listen to people with lived experience of depression and TMS, leading researchers and clinicians to find out how we can shift the dial.
1 in 3 people in the UK with depression have 'difficult to treat depression'.
Approximately 2.5 million adults.
Outpatient, no need for anaesthesia, no systemic side-effects.
Sessions take 3 to 40 minutes, over a 2 to 4 week period.
odds of responding VS placebo/sham (Saelens et al, 2025)
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Cost per quality-adjusted life year gained (intermittent theta burst stimulation, NHS UK).
Below NICE threshold.
The National Institute for Health and Care Excellence have approved repetitive transcranial magnetic stimulation (rTMS) for depression.
Ref: HTG396 (formally IPG542).
In this short video, we hear the experiences of people who endured many years of severe depression before accessing TMS. It doesn’t work for everyone, but for many, it resulted in dramatic improvements, enabling them to get their lives back.
This short video gives a brief overview of what we know about TMS from systematic clinical research, and what patients think about.
These documents provide a 10-minute read on the clinical evidence and service development considerations in developing a business case for TMS service.
Evidence summary
This document provides an overview of the clinical evidence for TMS in difficult-to-treat depression. It includes a plain language summary.
TMS Evidence Summary
Clinical Briefings
This document is for clinicians and commissioners who want to develop TMS services locally.
TMS Clinical Briefing
Tim Nicholls has developed resources to support the writing of a business case for TMS, including an guidance notes and an example business case.
NIHR Translational Research Collaboration: TMS Resources
Authors: Cox E, Ma J, Roadevin C, Morriss R, James M.
Year of publication: 2026
Journal: BMJ Mental Health. 2026 ;29:e302237
Digital Object Identifier: doi: 10.1136/bmjment-2025-302237
Authors: Morriss R, Briley PM, Webster L, Abdelghani M, Barber S, Bates P et al
Year of publication: 2024
Journal: Nature Medicine.30(2):403-413
Digital Object Identifier: doi: 10.1038/s41591-023-02764-z