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Psychiatry · UK

Transcranial magnetic stimulation - a NICE-approved option after two failed antidepressants.

A focused magnetic pulse delivered through the scalp to stimulate a specific area of the brain - usually the left dorsolateral prefrontal cortex for depression. No sedation, no medication, delivered as an outpatient course. Consultant psychiatry-led, with a proper diagnostic workup first.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a private TMS course costs in the UK.

Indicative ranges across our partner units.

In short

£4,500–£7,500 across 4–6 weeks.

Procedure Indicative range
Consultant psychiatry TMS assessment £350–£550
Standard rTMS session £150–£250
iTBS (accelerated protocol) session £120–£220
Full TMS course (20–36 sessions) £4,500–£7,500
iTBS course (accelerated) £3,500–£5,500
Maintenance session (single) £120–£200
TMS for OCD (deep or standard) £7,500–£12,000

Prices vary by service, coil type, and whether the course is standard rTMS or accelerated iTBS. Consultant psychiatry assessment, rating scales and end-of-course review are usually included.

The problem

A NICE-approved option, delivered like a NICE-approved service.

TMS is where private psychiatry can shine or slip. A psychiatry-led service, NICE-aligned protocols and a real relapse plan - or it isn’t worth doing.

  • Is it psychiatry-led?

    A CQC-registered psychiatry service means a consultant assessing, prescribing and reviewing - not a stand-alone clinic with a technician only.

  • Are the protocols the ones with evidence?

    10 Hz DLPFC rTMS and standard iTBS are what NICE and the trials back. Off-piste protocols without evidence are red flags.

  • Is there a plan after the last session?

    Rating-scale response, medication continuation, therapy referral and maintenance sessions - all agreed before you finish, not after you relapse.

When it helps

When TMS is the right step.

The situations we see most, plus the safety flag - seizure risk - that always deserves a specialist judgement rather than a template.

  • Treatment-resistant depression

    Two or more adequate antidepressant trials without adequate response - NICE-approved indication for rTMS.

  • Depression with medication intolerance

    Side effects that stopped adequate trials of medication - TMS avoids systemic drug effects.

  • Postpartum depression

    A drug-free option for women who cannot or would rather not take antidepressants while breastfeeding.

  • OCD not responding to first-line

    Deep or standard TMS at approved coil positions for OCD refractory to SSRIs and cognitive behavioural therapy.

  • Bipolar depression, cautiously

    Selected bipolar depression under specialist care, with mood monitoring and continued mood stabilisation.

  • Relapse after previous TMS response

    A repeat course for patients who did well before and have relapsed - often faster and equally effective.

  • Depression in older adults

    An option where anticholinergic side effects of medication are a problem, with dose adjusted for coil-to-cortex distance.

  • Red flag: seizure risk

    Personal history of seizure, current alcohol or benzodiazepine withdrawal, or metallic implants near the coil raise TMS risk - a specialist call, not a template.

Procedure options

Coil, frequency, and how long the course runs.

What each option involves - standard rTMS, low-frequency right-sided, iTBS, accelerated, deep TMS and OCD-specific protocols.

  • Standard high-frequency rTMS

    10 Hz over the left dorsolateral prefrontal cortex, 20–40 minutes a session, 20–36 sessions over 4–6 weeks. The best-evidenced NICE-approved protocol for depression.

  • Low-frequency rTMS

    1 Hz over the right DLPFC. Better tolerated in some patients and used as monotherapy or alongside high-frequency left-sided stimulation.

  • iTBS (intermittent theta burst)

    A 3-minute protocol delivering theta-burst bursts. Non-inferior to standard rTMS in major trials - lets a full daily treatment fit into a lunchbreak.

  • Accelerated TMS

    Multiple sessions per day over one to two weeks. Faster response for some patients - but not yet standard NHS practice.

  • Deep TMS (H-coil)

    A different coil design reaching deeper cortex. Licensed in the UK for depression and OCD with condition-specific coil orientation.

  • TMS for OCD

    Coil placed over the supplementary motor area or medial prefrontal cortex, with symptom-provocation before each session. Longer courses than depression.

  • Maintenance TMS

    Single sessions weekly or monthly for responders, to hold response and prevent relapse.

  • When TMS is not the answer

    Severe suicidal risk, psychotic depression, bipolar mania and catatonia often need ECT rather than TMS - a psychiatric decision, not a marketing one.

Safety and recovery

What to expect afterwards - honestly.

TMS is a well-tolerated outpatient treatment - but the safety screening, the coil position and the relapse plan all deserve a proper conversation, not a form.

  • No sedation, no drug interaction

    You sit in a chair, awake. You can drive yourself home, work between sessions, and stay on your usual medication.

  • Scalp discomfort and headache

    The commonest side effect - a tapping feeling on the scalp during pulses, and mild headache afterwards. Usually settles within the first week.

  • Rare seizure risk

    Around 1 in 30,000 sessions in modern practice. Screening for seizure risk, alcohol use, benzodiazepines and medication interactions is standard.

  • Jaw and dental sensation

    Pulses close to jaw muscles can cause twitching or an odd tooth sensation - harmless, and adjustable by moving the coil slightly.

  • Metal and implants

    Cochlear implants, deep brain stimulators and some medication pumps are contraindications. Standard dental fillings are fine.

  • Response, remission and time-course

    Around 50–60% of treatment-resistant patients respond and 30–40% remit. Effects build over the course; give the treatment its full time to work.

  • Relapse prevention matters

    Without a plan, relapse rates in the first year are meaningful. Maintenance TMS, continued medication and therapy each cut relapse.

  • Interaction with medication and therapy

    TMS is usually added on - not swapped in for - existing medication and therapy. Changes to those are made deliberately, in writing.

  • Red flags during a course

    New severe headache, an unusual sensation or focal weakness, or a marked worsening of mood or thoughts of self-harm need same-day psychiatry review.

Reading your notes

Your notes in four parts. Read the last one first.

Whichever protocol was used, the psychiatry team’s note keeps to the same shape.

  1. 01 Header

    Diagnosis and treatment history

    The formal diagnosis, previous medications and therapies, and why TMS was chosen now.

  2. 02 Technique

    Protocol, coil and dose

    Type of TMS (rTMS or iTBS), coil position, motor threshold, intensity and total number of sessions.

  3. 03 Findings

    Rating scale trajectory

    PHQ-9, MADRS or Y-BOCS at baseline, mid-course and end - the numbers, not the impressions.

  4. 04 Impression

    Relapse prevention and next step

    Read this first: whether medication continues, whether therapy is next, whether maintenance TMS is offered, and how to re-refer if things slip.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

TMS is covered by some UK private insurers when NICE criteria are met and pre-authorisation is obtained.

Frequently asked

Everything we get asked about TMS.

Quick answers on approach, recovery, cost and long-term outcome.

  • Does TMS actually work?

    For treatment-resistant depression, around 50–60% of patients respond meaningfully and 30–40% reach remission during the course. Response builds over weeks, and durability depends heavily on continued medication, therapy and, where needed, maintenance sessions. NICE and NHS practice recognise it as an evidence-based option after two failed antidepressants.

  • Is TMS the same as ECT?

    No. ECT uses a brief electric current under general anaesthetic to induce a controlled seizure and is a different, more powerful treatment reserved for severe depression, psychotic depression, catatonia and mania. TMS uses a focused magnetic pulse, needs no sedation, does not induce a seizure, and has no cognitive side effects.

  • Will I need to stop my antidepressant?

    Almost always no. TMS is usually added on to your existing medication, and doses are usually held stable during the course to give the treatment a fair chance to work. Medication changes are made deliberately, with your psychiatrist, at planned points.

  • How much does a private TMS course cost in the UK?

    A full standard rTMS course (20–36 sessions) is roughly £4,500–£7,500 all-inclusive of the consultant assessment and rating scales. An accelerated iTBS course is £3,500–£5,500. TMS for OCD is longer and costs £7,500–£12,000. Maintenance sessions run £120–£200 each.

  • Can I have TMS on the NHS?

    Yes, in a small but growing number of NHS services with NICE approval since 2015. Access varies widely by area. Private TMS gives faster access to assessment and a scheduled start date, with the same protocols and rating scales.

  • What if TMS does not work?

    Around a third to a half of patients do not respond adequately. The options then are ECT, ketamine (for selected patients under specialist care), a fresh look at diagnosis and medication, and psychological therapy at the right dose and modality. We talk about all of these before you start, not just at the end.

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