photo credit: Baburov / Wikimedia Commons / CC BY-SA 4.0

Key Takeaways

• Psychiatrists introduce TMS only after first-line treatments like therapy and medication have not produced sufficient improvement.
• Treatment-resistant depression must typically be documented before TMS becomes a clinical and insurance-approved option.
• Psychiatrists evaluate full treatment histories, symptom patterns, and prior therapy tolerance to determine TMS eligibility.
• Insurance requirements, including prior authorization and proof of failed treatments, often shape the timing of TMS access.
• TMS is usually added to – not substituted for – existing treatments, forming a layered approach monitored throughout the process.