TMS vs. Ketamine in San Diego

 

Understanding the differences and which treatment may be right for you

For patients struggling with depression or persistent anxiety symptoms, choosing between Transcranial Magnetic Stimulation (TMS) and ketamine therapy can feel overwhelming. Both treatments are evidence‑based options for individuals who haven’t improved with traditional medications — but they work in very different ways.

At Silverlining Psychiatry in San Diego, we offer both TMS and ketamine/Spravato® under the supervision of a board‑certified psychiatrist. This allows us to help you understand the strengths of each treatment and determine which one aligns best with your symptoms, history, and goals.

 

How TMS Works

TMS uses gentle magnetic pulses to stimulate the brain circuits involved in mood regulation.

Key features of TMS:

• Non‑invasive

• Medication‑free

• No anesthesia or sedation

• No systemic side effects

• FDA‑cleared for depression and OCD

• Delivered in daily sessions over 6–8 weeks

TMS gradually strengthens underactive neural pathways, helping improve mood, motivation, and emotional regulation.

 

How Ketamine Works

Ketamine and Spravato® (esketamine) work through a different mechanism, targeting the brain’s glutamate system to rapidly increase neuroplasticity.

Key features of ketamine/Spravato:

• Fast‑acting (hours to days)

• Administered in a monitored medical setting

• FDA‑approved for treatment‑resistant depression (Spravato)

• Often used alongside an oral antidepressant

• Typically involves 1–2 sessions per week

Ketamine can provide rapid relief for severe symptoms, especially when patients are in crisis or experiencing profound functional impairment.

 

TMS vs. Ketamine: Key Differences

1. Speed of Relief

• Ketamine: Often rapid (hours to days)

• TMS: Gradual improvement (2–4 weeks)

2. Treatment Frequency

• TMS: Daily sessions, 5 days per week

• Ketamine: 1–2 sessions per week

3. Side Effects

• TMS: Mild scalp discomfort or headache

• Ketamine: Dissociation, dizziness, nausea, temporary blood pressure changes

4. Medication Requirements

• TMS: No medication required

• Spravato: Must be taken with an oral antidepressant even though, recently, the FDA removed this requirement 

5. Long‑Term Effects

• TMS: Often provides durable, long‑lasting improvement

• Ketamine: Booster sessions may be needed

6. FDA Indications

• TMS: Depression, OCD

• Spravato: Treatment‑resistant depression

 

Who May Benefit More From TMS

TMS may be a better fit if you:

• Prefer a non‑medication treatment

• Have not tolerated antidepressants

• Want a therapy with minimal systemic side effects

• Have OCD symptoms

• Prefer a gradual, structured treatment course

• Want a long‑lasting, durable response

TMS is also ideal for patients who want to avoid dissociation or sedation.

 

Who May Benefit More From Ketamine

Ketamine or Spravato may be a better fit if you:

• Need rapid relief

• Are experiencing severe or acute symptoms

• Have not responded to multiple antidepressants

• Prefer a medication‑based approach

• Are comfortable with monitored in‑clinic sessions

Ketamine can be especially helpful for patients with profound functional impairment or severe depressive episodes.

 

Can TMS and Ketamine Be Combined?

Yes. For some patients, a combined or sequential approach can be effective:

• Ketamine for rapid symptom relief

• TMS for long‑term stabilization

This approach is considered on a case‑by‑case basis after a full psychiatric evaluation.

 

How We Help You Decide

During your consultation, we will:

• Review your symptoms and treatment history

• Discuss your goals and preferences

• Evaluate medical and psychiatric factors

• Explain the benefits and limitations of each treatment

• Recommend the option most likely to help you

Our goal is to provide clear, evidence‑based guidance — not push one treatment over another.

 

Schedule a Consultation

If you’re deciding between TMS and ketamine in San Diego, we’re here to help you understand your options and choose the treatment that aligns best with your needs.

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