Treating PTSD with TMS - the evidence

The 2018, NICE Guidelines for the management of PTSD recommend 8 to 12 trauma focused Cognitive Behaviour Therapy sessions. Other psychological treatment such as EMDR or exposure therapy may also be beneficial. Medication can alleviate some of the symptoms of PTSD and drugs which are licensed in the UK for PTSD include Sertraline and Paroxetine, although the NICE Guidelines also recommend Venlafaxine and Risperidone. It appears from research that about two thirds of patients with PTSD will recover either spontaneously or with treatment over a 6-year period and a third will go on to develop a more chronic long-term illness.

TMS stimulates the brain through magnetic fields over the scalp. The passage of the electric current in the coil induces a transient, high-intensity magnetic pulse that penetrates the scalp and painlessly reaches the neurons of the targeted cortical area. TMS changes the amount of electrical activity in the surface of the brain. This change in cortical activity is able to produce both physiological and behavioural effects. NICE considers that TMS is safe and effective in the treatment of depression.

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Research by Xu et al. (2023) reviewed studies involving over 300 people with PTSD. The study found that TMS led to a significant reduction in PTSD symptoms, including re-experiencing, avoidance, and hypervigilance. The review concluded that TMS is safe, well-tolerated, with very few side effects, and improvements were long-lasting. A meta-analysis by Wang et al. (2025) including 15 studies with a total of 760 patients found rTMS to be an effective treatment for PTSD, with more rTMS sessions leading to greater reductions in PTSD symptoms (P = < 0.05). Additionally, this meta-analysis concluded that TMS is safe and well tolerated, with minimal adverse effects reported.  

 At Smart TMS, we analysed outcomes from 21 patients who received TMS treatment for PTSD. Symptom severity measured using the Impact of Event Scale–Revised (IES-R), decreased by an average of 35% following treatment. Nearly half of patients (10 out of 21) achieved clinical remission, meaning their symptoms fell below the threshold typically used to indicate PTSD. Many patients also experienced improvements in mood. Almost two-thirds (62%) showed a clinically significant reduction in depression symptoms, with an average 43% reduction in scores on the Patient Health Questionnaire-9 (PHQ-9). These results suggest that TMS may provide meaningful benefits for people living with PTSD, particularly for those whose symptoms have persisted despite other treatments.

PTSD can be distressing and isolating, but recovery is possible. TMS offers a new, evidence-based way to help the brain heal after trauma — safely, effectively, and without medication side effects. If you’ve tried therapy or medication and still struggle with PTSD symptoms, talk to your healthcare provider or contact Smart TMS to find out if TMS could support your recovery. 

Dr Leigh A Neal MB BCh FRCPsych MRCGP MD
Consultant in Psychiatry and Neuromodulation
Medical Director: Smart TMS