You are reading this with a work calendar open in another tab.
You have read enough about TMS to think it might help, and then you picture six weeks of daily appointments against a job that does not pause. The thought underneath is usually: I can’t take six weeks off.
Whether you can do TMS while working full time is mostly a scheduling question, and the schedule most people picture comes from older protocols, not the ones cleared today.
So this is a calendar article, not a clinical one; whether TMS fits you is covered in our other TMS articles. One thing comes first: metal or implanted devices in or near the head, and a history of seizures, can rule TMS out. Screening comes before scheduling.
Can you do TMS while working full time? The honest short answer
Usually, yes. Many people keep working through a course.
The reason is structural rather than lucky. There is no anesthesia, no sedation, and no recovery period built into the visit. The National Institute of Mental Health notes that repetitive TMS, or rTMS, “does not require anesthesia and can be performed in a clinical or office setting.” Cleveland Clinic puts the aftermath plainly: “After your session, you can go back to your normal day.”
What TMS asks of you is not recovery time but a run of weekday appointments, and the willingness to protect them.
How long is a TMS session, and how many weeks is a TMS course?
We use the BrainsWay Deep TMS system, which reached patients for depression through FDA clearance rather than drug-style approval, as TMS devices generally do.
Here is what FDA 510(k) summary K251449, cleared September 13, 2025, lists for the three protocols:
| Protocol | Stimulation per session | Schedule as cleared | Stated duration |
| Conventional (18 Hz) | about 20 minutes | 5 daily sessions for 4 weeks, then optional maintenance for 12 weeks | 4-week acute phase |
| Theta burst (iTBS) | about 3 minutes | Same schedule, same optional maintenance | 4-week acute phase |
| Accelerated iTBS | about 10 minutes | 5 sessions a day for 6 days across 14 days, then 2 a day weekly for 4 weeks | 6 weeks |
Two things surprise everyone.
The first is the four. BrainsWay’s cleared acute schedule is five days a week for four weeks, not six, which works out to roughly 20 acute sessions (our arithmetic, not an FDA figure). The 2013 clearance, K122288, listed that same schedule at 20.2 minutes per session.
The second is where the famous six weeks lives. In that same 2013 document, the older predicate device BrainsWay was measured against is listed at 37.5 minutes per session on “5 daily sessions for 6 weeks.” That is a different system, not the protocols we use today. Six weeks is still real: it turns up in general guidance and in the accelerated protocol below.
Broader guidance runs longer. The 2018 consensus recommendations from McClintock and colleagues say “a standard acute course of 20 to 30 treatment sessions over 6 weeks will very likely be needed.”
Every duration above is stimulation time, not appointment time. Check-in, positioning in the helmet, and a settings check push your calendar block past the table’s number.
Does an accelerated theta-burst TMS schedule mean less time off work?
It cuts the number of visit-days, not the number of weeks.
Theta burst compresses the stimulation itself: about 3 minutes in the helmet against about 20. MagVenture’s own 510(k) summary for its theta-burst system, cleared in 2018 as K173620, says iTBS “has similar effectiveness and side effect profile compared to standard-of-care 10 Hz rTMS.” That is the manufacturer’s sentence, not the agency’s: clearance means FDA found the device substantially equivalent to something already sold, not that FDA endorsed the comparison.
The accelerated protocol stacks sessions into single days. By our arithmetic that is roughly 10 visit-days instead of 20, and about 38 sessions. But the clearance states the treatment duration as 6 weeks, so it is not a one-week course. The five-day version circulating online is another manufacturer’s: FDA clearance K220177, granted in 2022, lists Magnus Medical’s SAINT system at 10 sessions a day for 5 consecutive days with functional MRI-guided targeting. We offer the conventional and accelerated Deep TMS protocols, and we do not present accelerated as the better one.
The trial behind the BrainsWay clearance was multicenter, blinded, controlled, and randomized 104 adults. It tested whether the compressed schedule is not meaningfully worse than the standard one, not whether it is better. On the HDRS-21, a standard depression rating scale, the two differed by 0.77 points, small enough to be chance (p=0.7783). Response rates were essentially identical, 87.8 percent accelerated against 87.5 percent standard. Remission was 78.0 against 87.5 percent, numerically lower with accelerated treatment, though the confidence intervals overlap heavily and the trial was not built to detect a remission difference. Those are results in the 89 people who finished, all with major depressive disorder and at least moderate symptoms. They describe that trial, not a prediction for you: response to TMS varies, and some people do not respond.
Compressing the calendar also concentrated side effects. Headaches were reported by 41.18 percent of the accelerated group against 15.09 percent of the standard group, none severe, and application site pain by 7.84 percent against none. BrainsWay’s own submission calls that gap “logical given the increased number and frequency of treatments,” the manufacturer’s explanation, not an independent finding. Two participants stopped treatment because of adverse events, one for anxiety and one for hypomania. A shift toward hypomania is uncommon, but it is one reason we screen carefully for bipolar disorder before starting TMS, and one reason to tell us promptly about unusually little sleep, racing thoughts, or unfamiliar energy during a course. The clearance also never says how much time separates the five sessions of an intensive day.
All of this sits inside the K251449 indication: depressive episodes, and decreasing comorbid anxiety symptoms, in adults with major depressive disorder who did not improve enough on a previous antidepressant. When several antidepressants have already fallen short, that is the picture our treatment-refractory depression page describes. Deep TMS also holds a separate FDA authorization for OCD in adults, granted in 2018 through the De Novo pathway (DEN170078) rather than by clearance. Using TMS for PTSD, bipolar depression, or chronic pain is off-label.
The details that decide whether it fits your week
Most people drive themselves to and from sessions. One caveat: Cleveland Clinic calls seizures “the most severe side effect, but they’re very rare,” and adds that the risk “is higher if you already have a seizure disorder or take medications that increase seizure risk.” That is why we screen before a course, and why the same page notes that “for safety, your provider may recommend that someone drives you to and from your first appointment.” Tell us about any seizure history and every medication you take, including anything started mid-course.
Every session is in the office, so your commute is part of the treatment. Our TMS page states that “sessions take place in-office at the Institute for Advanced Psychiatry”; virtual visits are available for other appointments but never for TMS. If you work downtown or east toward Arlington, door-to-door time from our southwest Fort Worth office can exceed the stimulation time, several days a week, for weeks. Map that drive at the hour you would make it.
The tradeoffs, said plainly
You will miss some work. The honest ledger:
- A conventional or iTBS course means an appointment nearly every weekday for about a month. Even a short one interrupts a workday, and each accelerated day asks for a much larger block.
- Headache and scalp discomfort are the common complaints. McClintock and colleagues note that “headaches tend to occur early in treatment and decrease with successive treatments.”
- What missed sessions cost you has not been well studied, so we will not put a number on it. Tell us early about any week you know is a problem.
- If you respond well, the calendar may not stop there. The conventional and iTBS schedules each offer optional maintenance for another 12 weeks, printed as “bi-weekly”; in the trial behind the 2013 clearance, that meant twice a week.
We are a self-pay practice, and TMS is charged per session, so the protocol you choose changes your total as well as your calendar. See our current Price List.
Frequently asked questions
How many weeks is a TMS course?
BrainsWay’s cleared schedule for conventional and iTBS protocols is 5 daily sessions for 4 weeks, plus optional maintenance for 12 weeks; the accelerated protocol states 6 weeks. Broader guidance runs longer, with Cleveland Clinic describing a common course as five days a week for four to six weeks. Plan for the longer end.
Can I drive back to work right after a session?
Generally yes. No anesthesia or sedation is used, so no recovery period is built into the appointment. TMS does carry a rare risk of seizure, which is part of why clinicians screen before a course and why Cleveland Clinic notes a provider may recommend someone drive you to and from a first appointment.
Can I schedule TMS appointments around work?
Often, yes, but it depends on which slots are open when you start. Our TMS page notes that session frequency depends partly on your availability, so the schedule gets built around what you can protect. Bring your real constraints, including commute time and the impossible days, and we will tell you whether a workable run exists before you commit.
Does an accelerated schedule get me back to work faster?
It reduces visit-days rather than weeks, and it was studied as not meaningfully worse, not as better. In that trial, response rates were nearly identical, remission at six weeks was numerically lower in the accelerated arm, and headaches were reported more than twice as often. Response varies, and some people do not respond.
What happens if I miss a day?
Usually the calendar stretches rather than the course shrinking. The cleared schedule is a set number of sessions over a treatment period, so a missed day generally moves the end date rather than coming out of the total. How much a gap costs you is not something anyone can quantify from the evidence, which is exactly why we would rather rearrange a week in advance than lose it.
The bottom line
Doing TMS while working full time is usually possible, because the appointment carries no sedation and no recovery period. What it costs you is a run of weekday interruptions: about 20 minutes of stimulation for a conventional session or about 3 for theta burst, five days a week across the cleared four-week acute course, plus check-in and your drive. Plan for the longer end, though: four weeks is a floor, not a forecast, and general guidance points to 20 to 30 sessions over about six weeks. Disruptive but survivable is the honest verdict for many working adults. Bring your real calendar and we will do the arithmetic with you.
Talk with us
If you are in Fort Worth or the surrounding North Texas area and what you have read here sounds familiar, we would be glad to talk it through with you. The Institute for Advanced Psychiatry is an outpatient practice at 6800 Harris Parkway, Suite 100, treating adults 18 and older. You can request an appointment or call 817-659-7344.
If you are in crisis or thinking about harming yourself, please do not wait for an appointment. Call or text 988 to reach the Suicide & Crisis Lifeline, available 24/7, or go to your nearest emergency room.
Sources
- U.S. Food and Drug Administration. “510(k) Summary: BrainsWay Deep TMS System, K251449.” 2025. https://www.accessdata.fda.gov/cdrh_docs/pdf25/K251449.pdf
- U.S. Food and Drug Administration. “510(k) Summary: Brainsway Deep TMS System, K122288.” 2013. https://www.accessdata.fda.gov/cdrh_docs/pdf12/k122288.pdf
- U.S. Food and Drug Administration. “510(k) Summary: MagVita TMS Therapy System w/Theta Burst Stimulation, K173620.” 2018. https://www.accessdata.fda.gov/cdrh_docs/pdf17/K173620.pdf
- U.S. Food and Drug Administration. “510(k) Summary: Magnus Neuromodulation System (MNS) with SAINT Technology, K220177.” 2022. https://www.accessdata.fda.gov/cdrh_docs/pdf22/K220177.pdf
- U.S. Food and Drug Administration. “De Novo Classification Request: Brainsway Deep Transcranial Magnetic Stimulation (DTMS) System, DEN170078.” 2018. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/denovo.cfm?id=DEN170078
- National Institute of Mental Health. “Brain Stimulation Therapies.” Accessed 2026. https://www.nimh.nih.gov/health/topics/brain-stimulation-therapies/brain-stimulation-therapies
- Cleveland Clinic. “TMS (Transcranial Magnetic Stimulation): What It Is.” Accessed 2026. https://my.clevelandclinic.org/health/treatments/17827-transcranial-magnetic-stimulation-tms
- McClintock SM, Reti IM, Carpenter LL, et al. “Consensus Recommendations for the Clinical Application of Repetitive Transcranial Magnetic Stimulation (rTMS) in the Treatment of Depression.” Journal of Clinical Psychiatry. 2018. https://pmc.ncbi.nlm.nih.gov/articles/PMC5846193/
- Institute for Advanced Psychiatry. “TMS (Transcranial Magnetic Stimulation).” Accessed 2026. https://www.psychiatryfortworth.com/services/tms-transcranial-magnetic-stimulation/
- Institute for Advanced Psychiatry. “Price List.” Accessed 2026. https://www.psychiatryfortworth.com/price-list/
Medical disclaimer
This article is for general education and is not medical advice, a diagnosis, or a treatment recommendation for any individual. Reading it does not create a physician-patient relationship. Treatment decisions, including whether any medication or procedure is appropriate for you, should be made with a qualified clinician who knows your history. Do not start, stop, or change a psychiatric medication without talking to your prescriber. If you are experiencing a medical or mental health emergency, call 911 or 988.