Patients researching TMS therapy often want to know one thing first: what is the success rate? There is no single percentage that predicts how an individual patient will respond, but we can give patients useful numbers from the research. In a 2023 meta-analysis of adults with major depressive disorder who had not achieved adequate improvement after two prior antidepressant trials, about 40% responded to active adjunctive rTMS and about 36% achieved remission (Vida et al., 2023). We use those figures as clinical context, not as a guarantee of an individual outcome.
What the Research Supports
A 2023 meta-analysis included 19 randomized, sham-controlled trials of adjunctive rTMS in adults with major depressive disorder who had not achieved adequate improvement after two prior antidepressant trials. Across the 19 studies reporting response, 39.68% of patients receiving active rTMS responded compared with 13.71% receiving sham treatment. Among the nine studies reporting remission, 35.71% of patients receiving active rTMS achieved remission compared with 8.37% receiving sham treatment (Vida et al., 2023).
Of note, this meta-analysis included studies with variable treatment protocols, including studies that used treatment parameters associated with a lower treatment response (Oostra L, et al). One way to interpret this is that treatment response and remission rates could be higher using current protocols than this meta-analysis suggests. Nevertheless, the Vida et al. study supports TMS as a viable treatment option for individuals with MDD who have not responded adequately to antidepressants.
The broader evidence base also supports TMS for treatment-resistant depression. A 2025 network meta-analysis evaluated 69 randomized controlled trials involving 10,285 adults and found both rTMS and theta-burst stimulation among the treatments associated with significantly higher response rates than placebo or sham treatment (Saelens et al., 2025).
Naturalistic studies reporting real-world outcomes in outpatient TMS clinics in the U.S. show that treatment response in their hands are closer to 58-65%, and remission rates are closer to 32-37%. It is important to keep in mind that these naturalistic studies include a mixture of treatment-resistant and treatment naive individuals, and that they are not placebo or sham-controlled. However, they do demonstrate that in a real world setting, where patients are likely engaged in psychotherapy and taking medications for depression, individual outcomes may be better than controlled studies suggest.
These studies give us useful evidence, but they do not give us one universal TMS success rate. Outcomes depend on the population studied, treatment protocol, definition of response or remission, and other clinical factors. We use published results to frame expectations while evaluating each patient individually.
What Affects Individual Response
Not every patient responds to TMS in the same way, and research has not identified one factor that reliably predicts an individual outcome. The evidence is strongest for major depressive disorder, including treatment-resistant presentations. We consider the research alongside each patient’s diagnosis, treatment history, current medications, symptoms, safety considerations, and current care plan.
TMS is prescribed as a course of repeated treatment sessions, and we monitor both symptoms and tolerability throughout that course. Patients should follow the treatment plan Dr. Bowers recommends unless there is a clinical reason to adjust or stop treatment. We do not treat course completion, neuroplasticity, or any other single factor as a simple predictor of whether an individual patient will respond.
Prior treatment history is one part of the clinical picture, but research on predictors of TMS response remains mixed. Dr. Bowers reviews prior medication and psychotherapy treatment, current symptoms, medications, diagnosis, and other clinical factors rather than using the number of previous treatments to predict an individual patient’s outcome.
How We Think About Success at The Mind Grove TMS Center
Research distinguishes between response and remission rather than using one definition of “success.” In the Vida et al. meta-analysis, response meant at least a 50% reduction on a standardized depression rating scale. Remission meant symptoms fell below a defined threshold on one of those scales, although the exact cutoff varied among studies. A patient can improve without meeting remission criteria, so we look at changes in symptoms and functioning rather than reducing treatment to a simple success-or-failure label.
Before treatment begins, Dr. Bowers evaluates each patient to determine whether TMS is appropriate and which protocol to recommend. She reviews diagnosis, prior treatment, current medications, symptoms, safety considerations, and the current care plan. We offer standard rTMS, iTBS, and Accelerated TMS using MagVenture technology. TMS is central to our practice, and medication management can remain part of care when clinically appropriate.
What Happens If TMS Does Not Produce the Expected Response
Not every patient achieves the response they hoped for. If improvement is partial or symptoms do not change meaningfully, Dr. Bowers reassesses the patient’s response and overall treatment plan. Medication management may remain part of care when clinically appropriate, and we can coordinate with other members of the patient’s care team when needed.
If symptoms return after a patient previously benefited from TMS, another course may be considered. Retreatment is not automatic, and the evidence continues to develop. Dr. Bowers considers the prior response, current symptoms, treatment history, safety considerations, and the patient’s current care plan before recommending another course.
FAQ
What percentage of patients respond to TMS therapy?
One useful benchmark comes from a 2023 meta-analysis of adults with MDD who had not achieved adequate improvement after two prior antidepressant trials. Across 19 randomized, sham-controlled studies, 39.68% of patients receiving active adjunctive rTMS met criteria for response compared with 13.71% receiving sham treatment. In the nine studies that also reported remission, 35.71% of patients receiving active rTMS achieved remission compared with 8.37% receiving sham treatment (Vida et al., 2023). Those figures describe the populations and protocols included in that research; they are not a prediction of any one patient’s outcome.
Does TMS work better for some types of depression than others?
The strongest evidence and clearest success-rate data are for major depressive disorder, including treatment-resistant presentations. MagVenture also has an FDA-cleared indication for adults with MDD and co-occurring anxiety symptoms (U.S. Food and Drug Administration, 2025). We do not apply success rates from depression studies to other diagnoses because the evidence, protocols, devices, and regulatory status can differ.
How many sessions before TMS starts working?
There is no single session number at which every patient should expect improvement. Response timing varies by patient and treatment protocol. We monitor symptoms throughout treatment using standardized measures and clinical follow-up rather than assuming that improvement should appear at the same point for everyone.
If TMS works for me, how long do the effects last?
The duration of benefit varies by individual. Some patients maintain improvement after an acute course, while others experience a return of symptoms and need additional treatment. We do not promise a specific duration of response. Follow-up planning depends on your symptoms, prior response, current treatment plan, and clinical needs.
Can I repeat TMS if symptoms return?
Possibly. If symptoms return after a prior course of TMS, Dr. Bowers can evaluate whether another course is appropriate. Prior response is one factor in that decision, along with your current symptoms, treatment history, medications, safety considerations, and overall care plan.
Key Takeaways
In a 2023 meta-analysis, 39.68% of patients receiving active adjunctive rTMS met criteria for response compared with 13.71% receiving sham treatment; remission rates were 35.71% and 8.37%, respectively.
Those results came from adults with MDD who had not achieved adequate improvement after two prior antidepressant trials and should not be treated as an individual patient’s predicted outcome.
In that research, response meant at least a 50% reduction on a standardized depression rating scale, while remission meant symptoms fell below a defined threshold.
Dr. Bowers reviews diagnosis, prior treatment, current medications, symptoms, safety considerations, and the current care plan to determine whether TMS is appropriate.
We offer standard rTMS, iTBS, and Accelerated TMS using MagVenture technology, and medication management can remain part of care when clinically appropriate.
Research can tell us how groups of patients responded to TMS, but it cannot predict exactly how one patient will respond. At The Mind Grove TMS Center in Colorado Springs, Dr. Bowers reviews your diagnosis, treatment history, current medications, symptoms, safety considerations, and current care plan before recommending TMS. We use the available evidence to set realistic expectations and monitor your response throughout treatment. Contact us to schedule a consultation.
References
Oostra L, et al. More rTMS pulses or more sessions? The impact on treatment outcome for treatment resistant depression. Acta Psychiatrica Scandinavica. 2025;151(4):485–505. doi:10.1111/acps.13768.https://pmc.ncbi.nlm.nih.gov/articles/PMC11884915/
Saelens, J., Gramser, A., Watzal, V., Zarate, C. A., Jr., Lanzenberger, R., & Kraus, C. (2025). Relative effectiveness of antidepressant treatments in treatment-resistant depression: A systematic review and network meta-analysis of randomized controlled trials. Neuropsychopharmacology, 50(6), 913–919.https://pubmed.ncbi.nlm.nih.gov/39739012/
Trapp, N. T., Purgianto, A., Taylor, J. J., Singh, M. K., Oberman, L. M., Mickey, B. J., Youssef, N. A., Solzbacher, D., Zebley, B., Cabrera, L. Y., Conroy, S., Cristancho, M., Richards, J. R., Flood, M. J., Barbour, T., Blumberger, D. M., Taylor, S. F., Feifel, D., Reti, I. M., McClintock, S. M., Lisanby, S. H., & Husain, M. M. (2025). Consensus review and considerations on TMS to treat depression: A comprehensive update endorsed by the National Network of Depression Centers, the Clinical TMS Society, and the International Federation of Clinical Neurophysiology. Clinical Neurophysiology, 170, 206–233.https://pubmed.ncbi.nlm.nih.gov/39756350/
U.S. Food and Drug Administration. (2025). MagVenture TMS Therapy System (K251119).https://www.accessdata.fda.gov/cdrh_docs/pdf25/K251119.pdf
Vida, R. G., Sághy, E., Bella, R., Kovács, S., Erdősi, D., Józwiak-Hagymásy, J., Zemplényi, A., Tényi, T., Osváth, P., & Voros, V. (2023). Efficacy of repetitive transcranial magnetic stimulation (rTMS) adjunctive therapy for major depressive disorder (MDD) after two antidepressant treatment failures: Meta-analysis of randomized sham-controlled trials. BMC Psychiatry, 23, 545.https://pubmed.ncbi.nlm.nih.gov/37501135/
Medical Disclaimer
The information in this blog is provided for educational purposes only and does not constitute medical advice. TMS therapy should only be pursued under the supervision of a licensed medical or psychiatric provider familiar with your full medical and psychiatric history. Individual results vary. If you are experiencing a mental health crisis or thoughts of self-harm, please call or text 988 to reach the Suicide and Crisis Lifeline or go to your nearest emergency room.
Disclaimer
This article is for educational purposes only and is not a substitute for individualized evaluation, diagnosis, or treatment from a qualified healthcare professional.