Quick facts
- What it is
- Non-invasive magnetic stimulation, studied for generalized anxiety and panic.
- FDA status
- Cleared for depression; some systems are cleared for anxious depression. Anxiety alone is off-label.
- Our approach
- Standard left-sided TMS first; progress is re-evaluated after 10 sessions.
- If anxiety persists
- We may add right-sided, low-frequency TMS.
- Insurance
- Coverage is typically based on a depression diagnosis.
- Locations
- Wesley Chapel and Tampa, Florida.
TMS and anxiety
TMS therapy is a non-invasive, FDA-cleared treatment that is effective for depression, OCD, and other psychiatric disorders. Unlike medications, it has none of the systemic side effects caused by SSRIs, SNRIs, TCAs, and other antidepressants. Using TMS for generalized anxiety disorder and panic disorder is of particular interest to researchers.
Read the transcript
Does transcranial magnetic stimulation work for anxiety? The answer is yes. There is enough clinical evidence to support the use of low-frequency, right-sided transcranial magnetic stimulation for anxiety and PTSD.
Anxiety lives on the other side of the brain, and we need a different treatment protocol for that reason. It is not really covered by insurance, but the good news is that at Florida TMS Clinic, we do not charge extra for anxiety treatment.
If a patient comes into our clinic and has comorbid anxiety or PTSD and needs right-sided treatment, we do not charge extra for that. They receive their left-sided treatment for depression, and then they receive their right-sided treatment for anxiety.
Anxiety disorders
According to the Anxiety and Depression Association of America, 18% of the adult population suffers from anxiety annually, and COVID-19 increased the prevalence of anxiety in 2020 and 2021. That makes anxiety more common than depression. The overlap between depression and anxiety is about 50%, meaning that half of patients with depression have comorbid anxiety.
How does TMS therapy work for anxiety?
Because depression and anxiety overlap so much in prevalence and mechanism, antidepressants and psychotherapy are usually first-line treatment for both. That also explains why anxiety often responds when depressed patients are treated with left-sided brain stimulation using TMS.
TMS protocol for anxiety
Some patients don't respond to the classical TMS protocol. In those cases we perform right-sided, low-frequency TMS, aiming to reduce hyperactivity of the electrochemical signal originating from the right prefrontal cortex.
A frequency of 1 Hz for 15 minutes, for a total of 900 pulses, has shown good response in a few trials. One study treated patients twice a week for three weeks, while others did five days a week for six weeks. The theory is that 1 Hz stimulation is inhibitory thanks to the release of GABA, a neurotransmitter that causes a calming effect.
TMS for anxiety at Florida TMS Clinic
We tailor the treatment for each patient to optimize their response. After 10 sessions of standard TMS therapy, we re-evaluate progress and consider a different stimulation location if there is no response. If your depression improved with left-sided stimulation but your anxiety did not, we add right-sided TMS therapy.
More TMS research is published every day, and in the next few years many psychiatric disorders may be treated with TMS. We just need to find where to stimulate for each disorder and optimize protocols accordingly.
Next steps
Start with a psychiatric evaluation with Dr. Bowarshi. Call (813) 867-2378 to schedule in Wesley Chapel or Tampa.
Frequently asked questions
Sources and further reading
- Generalized Anxiety Disorder: What You Need to Know. National Institute of Mental Health
- Trapp NT, et al. Consensus review and considerations on TMS to treat depression. Clin Neurophysiol. 2025;170:206–233. Clinical TMS Society / NNDC / IFCN
- Brain Stimulation Therapies. National Institute of Mental Health
Medical information on this page is educational and not a substitute for professional advice. Individual results vary.