Comparison
TMS vs. Ketamine for Depression
Medically reviewed · Updated 2026
These are the two interventional treatments people compare most after medication fails, and they're genuinely different tools. Here's an honest side-by-side — no marketing, just what matters when you're choosing.
Speed
Ketamine wins on speed. Many people notice a shift within hours to days of the first infusions. TMS is gradual — it's a course of sessions over roughly 6 weeks, with benefits building over that time. If rapid relief matters (severe symptoms, urgent distress), that difference is decisive.
Cost and insurance
TMS is more often covered. It's FDA-cleared for depression and frequently covered by insurance once you've failed an adequate number of medications. IV ketamine is usually out of pocket — commonly $400–$800 per infusion. The exception is esketamine (Spravato), the FDA-approved nasal form, which is often covered by insurance and can dramatically lower cost.
What it's actually like
- TMS: You sit in a chair, awake, while a magnetic coil stimulates a region of the brain. No sedation, no downtime — you drive yourself home and return to work. Sessions are short, but there are many of them.
- Ketamine: Administered under monitoring, often IV. You may experience dissociative effects during the session and need a ride home. Fewer sessions, but each is more involved.
Side effects
TMS side effects are usually mild — scalp discomfort or headache around sessions. Ketamine's are the dissociation and transient blood-pressure changes during treatment, which is why monitoring matters. Both have strong safety records when delivered properly.
How to decide with real numbers
Treatment Finder lays TMS and ketamine side by side with the details that actually drive the decision — mechanism, session structure, typical cost, and evidence — and includes both in the questionnaire so you can see which fits your severity, timeline, and coverage. Bring the exported summary to your psychiatrist to confirm eligibility.
Put this into practice
Treatment Finder maps all 38 options to your situation and exports a PDF for your appointment. $4.99 once, no subscription. Get it on the App Store →
Educational reference, not medical advice. This does not diagnose or treat any condition and is not a substitute for a licensed clinician. In crisis, call or text 988 (US Suicide & Crisis Lifeline).