TMS vs. Ketamine Therapy: Which Is Right for You?

When it comes to finding relief from depression—especially treatment-resistant depression—the options have expanded beyond traditional antidepressants and talk therapy. Two of the most innovative and evidence-backed approaches available today are Transcranial Magnetic Stimulation (TMS) and Ketamine Therapy. While both can be effective for the right patient, they differ significantly in how they work, the time required for treatment, and what your insurance may cover.

If you’re considering your next step toward recovery, here’s a simple yet comprehensive breakdown to help you understand the differences between TMS vs. Ketamine Therapy and determine which path might be right for you.

How They Work

TMS Therapy uses targeted magnetic pulses to stimulate specific areas of the brain involved in mood regulation. These pulses help “wake up” underactive regions that may contribute to depression symptoms. It’s completely non-invasive—no anesthesia, no needles—and patients remain fully awake during each session. Over time, TMS can help rewire brain activity patterns for lasting improvement.

Ketamine Therapy, on the other hand, involves using low doses of ketamine—a medication originally developed as an anesthetic—for its rapid antidepressant effects. In clinical mental health, ketamine can be administered in two main ways:

• Spravato (Esketamine): A nasal spray version approved by the FDA, administered in a medical setting under supervision.

• Intramuscular (IM) Ketamine: An injection form delivered in a clinic.

Ketamine is thought to work by encouraging the brain to form new connections between neurons, which can rapidly improve mood and reduce suicidal thoughts in some patients.

Treatment Style and Experience

TMS Therapy Sessions

• Typically last about 20–40 minutes

• No downtime—patients can drive themselves to and from appointments

• Usually performed 5 days a week for 6–8 weeks

• Painless for most patients, with minimal side effects (commonly mild scalp discomfort or headache)

Ketamine Therapy Sessions

• Spravato sessions often last about 2 hours to allow for observation after dosing

• IM ketamine sessions can be shorter but still require monitoring

• Usually begins with a series of treatments over 2–4 weeks, followed by maintenance sessions as needed

• Side effects can include dizziness, nausea, or temporary dissociation (a dream-like feeling), which typically fade within hours

Time Commitment

The time commitment between TMS vs. Ketamine Therapy can be an important deciding factor.

• TMS requires consistent, frequent sessions during the initial phase, making it a strong choice for those who can commit to a structured schedule.

• Ketamine involves fewer visits in the early stages, but maintenance sessions may be needed periodically, sometimes indefinitely, to sustain benefits.

Your lifestyle, availability, and ability to commit to a treatment schedule may help you decide which option fits best.

Insurance Coverage TMS Vs. Ketamine Therapy

One of the biggest differences between TMS vs. Ketamine Therapy is insurance coverage.

• TMS Therapy is FDA-approved for depression and is widely covered by most insurance plans, provided certain criteria are met (such as trying a set number of antidepressants without success).

• Spravato (Esketamine) is also FDA-approved and increasingly covered by insurance, though prior authorization is usually required.

• IM Ketamine is not FDA-approved for depression (off-label use) and is generally not covered by insurance, meaning it is often an out-of-pocket expense.

Before starting any treatment, it’s important to verify coverage with your provider and discuss potential out-of-pocket costs with your clinic.

Which Is Right for You?

Choosing between TMS vs. Ketamine Therapy depends on several factors:

• How quickly you need relief: Ketamine can work within hours or days, whereas TMS may take a few weeks to show benefits.

• Insurance coverage: TMS and Spravato may be more affordable if covered by your plan.

• Treatment preference: If you prefer a non-invasive, medication-free approach, TMS might be the better option. If you want rapid relief and are open to medication, ketamine could be worth considering.

• Long-term goals: TMS often provides lasting results after the treatment course, while ketamine may require ongoing sessions for maintenance.

Final Thoughts

Both TMS and Ketamine Therapy offer new hope for people struggling with depression that hasn’t responded to traditional treatments. Neither is “better” in every case—it’s about finding the right fit for your needs, preferences, and medical history. The best way to decide is to consult with a mental health provider experienced in both options, so they can guide you toward the treatment that aligns with your goals and lifestyle.

At Goodwin Health Café, we’re here to help you navigate your options with compassion, expertise, and a personalized approach. Our team can walk you through what to expect with TMS Therapy, discuss whether ketamine might be appropriate, and coordinate care so you can take confident steps toward recovery.

Learn more about our services or schedule a consultation:Goodwin Health Cafe | Treatment-Resistant Depression | 5625 N Wall St suite 100, Spokane, WA 99205, USALocated at 5625 N. Wall St. Suite 100 Spokane, WA 99205