When medication and therapy aren’t enough, it can feel like you’ve run out of options. But for people living with depression or similar mental health conditions, two treatments are changing what recovery looks like: ketamine therapy and transcranial magnetic stimulation (TMS).
These treatments target the brain at a neurological level to produce results that many patients haven’t been able to achieve through conventional care. Let’s explore how each treatment works, who they’re right for and what it looks like to pursue them as part of a modern neuro rehab plan.
What Is Ketamine Therapy?
Ketamine has a complicated reputation. Most people know it as a club drug or a veterinary anesthetic, and that association has made some patients doubt its effectiveness as a depression treatment. But when administered intravenously in controlled clinical settings, ketamine therapy has proven results.
It works by increasing the availability of glutamate, a neurotransmitter that plays a key role in mood regulation, thought patterns and pain perception. This surge in glutamate activity can promote synaptic growth and help restore neural connections that depression has weakened over time.
One of ketamine’s most clinically significant qualities is its speed. Most antidepressants take six to eight weeks to produce noticeable effects. Selective serotonin reuptake inhibitors (SSRIs), for example, slowly adjust serotonin levels over time, targeting mood through chemical rebalancing.
Ketamine, however, can begin relieving depressive symptoms within hours of administration. This makes it a critical option for patients experiencing severe or treatment-resistant depression, including those with active suicidal ideation. Beyond depression, ketamine therapy has shown promise for:
- Anxiety and PTSD
- Obsessive-compulsive disorder (OCD)
- Chronic pain conditions
Each infusion session typically lasts around 30 minutes and is administered on an outpatient basis under medical supervision.
What Is TMS Therapy?
While ketamine works through neurochemistry, transcranial magnetic stimulation takes a different approach — one that doesn’t involve medication at all. TMS is a non-invasive, FDA-cleared treatment that uses focused magnetic pulses to stimulate areas of the brain involved in mood regulation. In people with depression, certain neural pathways become underactive over time. TMS targets those pathways directly, working to restore healthier brain function without introducing anything into the body.
One technology leading the way in TMS treatment is BrainsWay Deep TMS, which uses a proprietary H-Coil design to reach deeper and broader brain structures than standard TMS devices. Based on preliminary studies, the outcomes are promising:
- 81.6% response rate
- 65.3% remission rate
- ~60% return to normal functioning (patient-reported)
Sessions, which occur throughout the week, last approximately 30 minutes and produce none of the systemic side effects commonly associated with antidepressants. Patients remain awake and alert throughout and can return to normal activities immediately after each session. For many patients, symptom improvement continues to build even after the treatment course ends, with some experiencing sustained relief or full remission in the weeks that follow.
What Makes Ketamine and TMS Stand Out (And Why They Work Well Together)
For decades, antidepressants have been the first line of defense against depression — and for many people, they work. That being said, the limitations are real. Research shows that symptoms return for 33% of people taking antidepressants, and some patients experience side effects significant enough to discontinue treatment altogether.
Ketamine and TMS therapies can help address those gaps. Here’s how they differ from conventional care:
- Mechanism: Rather than adjusting neurotransmitter levels over time, these therapies intervene directly at the neurological level, targeting the brain structures and pathways most closely tied to mood regulation.
- Speed: Ketamine can produce relief within hours. TMS benefits build progressively and often continue after the treatment concludes.
- Side effects: Neither treatment carries the systemic side effects commonly associated with long-term antidepressant use.
- Goal: The aim isn’t ongoing symptom management; it’s restoring the brain’s capacity to function and heal.
What makes these therapies particularly compelling is how well they work together. Ketamine temporarily increases neuroplasticity, or the brain’s ability to form and strengthen new connections. When TMS is delivered alongside or shortly after ketamine, the brain is in a more receptive state, allowing the magnetic stimulation to reach those newly activated pathways more effectively.
This sequencing can deepen the antidepressant effect of TMS and extend the relief produced by ketamine, resulting in outcomes that neither therapy reliably achieves on its own. For patients with long-standing treatment resistance, that coordinated approach can be a meaningful turning point.
Ketamine and TMS Therapy: Common Questions
What conditions can ketamine and TMS treat?
Both therapies are primarily used for major depressive disorder, particularly in cases where standard treatments haven’t worked. Beyond depression, ketamine has shown clinical effectiveness for anxiety, PTSD, OCD and certain chronic pain conditions.
TMS holds FDA clearance for major depressive disorder, OCD and smoking cessation, and it’s also used for patients with comorbid anxiety symptoms alongside depression. The two therapies can be coordinated as part of the same treatment plan, which may produce stronger and more sustained results than either therapy alone.
How many sessions are typically needed?
Ketamine therapy is usually administered as a series of infusions over several weeks, with each session lasting around 30 minutes. TMS follows a similar timeframe, with sessions held several days per week over the course of several weeks. The exact number of sessions varies depending on the patient’s condition, history and clinical response.
Are ketamine and TMS safe?
Both treatments are considered safe when administered under proper medical supervision. Ketamine is given in controlled doses that are far below those associated with misuse. TMS is non-invasive and well-tolerated, with side effects often minimal. As with any treatment, a psychiatric evaluation should be conducted beforehand to confirm that the therapy is appropriate.
Is ketamine or TMS right for me?
The right treatment depends on your diagnosis, treatment history and personal needs. Both therapies are generally considered for adults who haven’t achieved adequate relief from at least two antidepressant medications. If you’re ready to explore your options, Sun Health Center’s clinical team can help you find a path forward.
Begin Your Neuro Rehab Journey at SHC
If you’ve tried conventional treatments and are still searching for relief, you don’t have to keep looking alone. Sun Health Center’s clinical team specializes in advanced neuro rehab therapies, including IV ketamine and TMS. We’ll work with you to determine the right approach for your specific needs. Contact us today to schedule a consultation and take the first step toward lasting recovery.
