What is transcranial magnetic stimulation (TMS)?

Transcranial magnetic stimulation delivers focused magnetic pulses to specific regions of the brain through a coil placed against the scalp. The magnetic field induces electrical currents in neural tissue, stimulating neurons involved in mood regulation and emotional processing. The procedure is painless, performed in outpatient settings, and does not require anesthesia or sedation.

TMS is most widely used for treatment-resistant depression (TRD), defined as depression that has not improved after trials of at least two antidepressant medications at adequate doses. It has FDA approval for this indication in the United States and is increasingly available in Italian psychiatric centers. The procedure typically involves multiple sessions over several weeks, with patients remaining awake and alert throughout.

Unlike medications, TMS works through direct stimulation of brain circuits rather than biochemical adjustment. This makes it valuable for patients who cannot tolerate antidepressant side effects, are pregnant, or have complex medical histories. Efficacy varies by individual, and response rates for TRD typically range from 30 to 40 percent. Some psychiatrists recommend TMS earlier in treatment protocols, before medication trials are exhausted, depending on clinical presentation and patient preference.

Psychiatrists in Milan offering TMS can be found through adult psychiatry services in your area. Referral usually comes from your treating physician after initial medication trials have been attempted.