TMS Key Findings

Safety Profile

Low Risk of Serious Adverse Events

Studies indicate that the risk of serious adverse events in children and adolescents is similar to that observed in adults, which is very low.

Out of 639 healthy children, 482 children with CNS disorders, and 84 epileptic children who underwent single pulse or paired pulse TMS, adverse events occurred at rates of 3.42%, 5.97%, and 4.55% respectively.

Mild and Transient Side Effects

The most common side effects reported in children and adolescents undergoing TMS are mild and short-lived (typically no longer than 1-2 weeks), including:

  • Headache (11.5%)
  • Scalp discomfort (2.5%)
  • Mood changes (1.2%)
  • Fatigue (0.9%)
  • Tinnitus (0.6%)

These side effects typically resolve without intervention or with over-the-counter pain medication.

Seizure Risk

The risk of seizures during TMS treatment in children appears to be very low. In a review of repetitive TMS (rTMS) studies involving 230 children with CNS disorders, only 3 seizures were reported, representing a risk of 0.14% per session. 

Long-term Safety

While long-term safety data in children is limited, preliminary research suggests that TMS does not negatively affect cognition, brain maturation, motor development, or brain activity in adolescents

Comparative Safety

Multiple studies indicate that the safety profile of TMS in children is comparable to that in adults.

A 2017 review of TMS studies from 1985 to 2016 concluded that the risk of TMS in children is similar to that in adults.

Comparing TMS and medications:

Briefly comparing the current available evidence regarding the safety and side effect profiles of psychiatric medications and Transcranial Magnetic Stimulation (TMS) in children and adolescents:

Psychiatric Medications

Safety Profile

  • Serious adverse drug reactions (ADRs) occur in approximately 8.3% of pediatric patients treated with antidepressants and/or antipsychotics.
  • The most common serious ADRs are psychiatric in nature, predominantly suicidal ideation and behavior.
  • Children treated with antipsychotics may have a greater risk of cardio-metabolic and endocrine disturbances compared to adults.

Common Side Effects

  • Antidepressants: headache, nausea, sedation, weight gain, insomnia
  • Antipsychotics: weight gain, sedation, extrapyramidal symptoms
  • ADHD medications: decreased appetite, sleep problems, irritability

Suicidality Risk

  • Antidepressants may increase the risk of suicidal thinking and behavior in children and adolescents, particularly in the first few months of treatment

Transcranial Magnetic Stimulation (TMS)

Safety Profile

Generally considered safe and well-tolerated in children and adolescents.

  • The risk of serious adverse events is very low, similar to that observed in adults
  • No evidence of negative effects on cognition, brain maturation, or motor development

Mild and transient Side Effects

  • Headache (11.5%)
  • Scalp discomfort (2.5%)
  • Mood changes (1.2%)
  • Fatigue (0.9%)
  • Tinnitus (0.6%)

Seizure Risk

  • The risk of seizures during TMS treatment is very low (0.14% per session).

Comparison

  1. Side Effect Severity: Psychiatric medications tend to have more severe and potentially long-lasting side effects compared to TMS, which generally causes mild and transient side effects
  2. Systemic Effects: Medications can have systemic effects on the body, such as weight gain or metabolic changes, while TMS effects are primarily localized to the brain and scalp
  3. Suicidality Risk: Some psychiatric medications, particularly antidepressants, carry a risk of increased suicidal ideation in youth, which has not been reported with TMS
  4. Reversibility: TMS effects are generally more reversible, as the treatment can be stopped immediately if side effects occur, while medication effects may persist for some time after discontinuation.

TMS therapy offers a non-invasive, clinically effective treatment for various conditions, with evidence supporting its safety and efficacy for children and teens. 

This overview, informed by current available evidence and Brain Health Hawaii’s clinical experience, highlights its potential as a potential treatment option for you or a loved one. 

Contact us to schedule a consultation and brain map to determine whether TMS treatment is the right choice for your child.

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