Beyond depression and OCD, TMS is being studied
for generalised anxiety disorder (GAD) and
post-traumatic stress disorder (PTSD). The early
evidence is encouraging, but considerably thinner
than for depression.
PTSD
A foundational double-blind, placebo-controlled trial found that high-frequency TMS over the right dorsolateral prefrontal cortex improved core PTSD symptoms, such as re-experiencing and avoidance,
more than slow-frequency or sham stimulation. Guideline reviews rate this as probable efficacy: supportive,
but not yet definitive.
Generalised anxiety
For GAD, meta-analytic data suggest a real symptom-reducing effect, but it rests on a small number of varied trials using different targets and frequencies. Protocols are not yet standardised, and authors consistently call for larger, more rigorous studies.
A note on approvals
TMS is not cleared as a stand-alone treatment for primary GAD. It does carry a clearance for anxious depression, meaning anxiety symptoms occurring within a depressive episode, which is a different thing. For a primary anxiety disorder, TMS should be understood as emerging and off-label.
TMS shows genuine promise for PTSD and GAD, but the evidence base is small and mixed. It is best framed as emerging and off-label for primary anxiety disorders, not settled science.
References
- Cohen H, et al. (2004). Repetitive TMS of the right dorsolateral prefrontal cortex in PTSD: a double-blind, placebo-controlled study. American Journal of Psychiatry.
- Lefaucheur JP, et al. Evidence-based guidelines on the therapeutic use of rTMS.
This article is for general information and is not medical advice. TMS suitability is decided by a psychiatrist on an individual basis. Speak to our team about your own situation.