Nearly half of people with major depressive disorder don’t achieve full remission with their first antidepressant. Partial response—feeling somewhat better but still not yourself—is one of the most common and least-discussed experiences in depression treatment. If your medication has taken the edge off but significant symptoms remain, that gap has a name, and there are evidence-based options for addressing it.
What Partial Antidepressant Response Actually Means
Partial response means your antidepressant is doing something (your depression has improved from where it was) but you’re still experiencing symptoms that interfere with your daily functioning. You might sleep better than before but still struggle to find motivation. You might feel less hopeless but still can’t engage fully in your relationships or your work. The medication moved the needle without moving it far enough.
This is not a treatment failure. It’s clinical information. Partial response tells your psychiatrist that the neurochemical pathways your antidepressant targets are involved in your depression. But they’re not the whole picture. Depression is not a single-pathway condition. Antidepressants primarily work by modulating serotonin, norepinephrine, or dopamine—neurotransmitter systems that play real roles in mood regulation. But for many people, other brain systems and circuits contribute to persistent symptoms in ways that medication alone doesn’t fully address.
At Catalyst Psychiatry, our board-certified psychiatrists approach partial response as a signal rather than a dead end. With over 20 years of combined experience treating difficult-to-treat depression, we look at what your treatment history tells us about where your depression is and isn’t responding, and what that suggests about where to go next.
How Deep TMS Works Differently Than Antidepressants
Deep TMS (Deep Transcranial Magnetic Stimulation) doesn’t work through your bloodstream or your neurotransmitter system. It uses magnetic pulses to directly stimulate specific brain regions involved in mood regulation, working through a mechanism distinct from any oral antidepressant.
For depression, Deep TMS targets the left dorsolateral prefrontal cortex, a region consistently shown to have reduced activity in people with depression. By delivering high-frequency magnetic pulses to this area, Deep TMS aims to increase cortical excitability, strengthen neural connections, and promote neuroplasticity—the brain’s ability to form and reorganize neural pathways (National Network of Depression Centers, 2024). This process works alongside whatever your antidepressant is doing through neurochemical pathways, addressing depression from a different biological angle at the same time.
Because the two treatments work through separate mechanisms, they don’t interfere with each other. You continue taking your antidepressant throughout Deep TMS treatment exactly as prescribed. The goal isn’t to replace what’s working; it’s to add a complementary approach that addresses what the medication hasn’t fully reached. Results vary by individual, and not everyone achieves the same degree of improvement. For a step-by-step look at what Deep TMS sessions actually involve, see our post on the Deep TMS therapy process explained.
What the Evidence Shows
Deep TMS received FDA clearance for major depressive disorder in patients who have not achieved satisfactory improvement from prior antidepressant medication (FDA, 2013). The clinical evidence supporting its use in this population is substantial. Across randomized controlled trials, Deep TMS has demonstrated response rates of 40–50% and remission rates of 25–30% in patients with major depressive disorder. Post-marketing data from real-world clinical settings have shown variable outcomes across different patient populations and study designs, with some analyses reporting higher rates (National Network of Depression Centers, 2024). These are outcomes in patients much like those we see at our practice: people who have tried antidepressants and needed more.
Research also shows that Deep TMS promotes neuroplasticity in mood-regulating brain circuits, which may help explain why improvements can extend beyond the treatment course itself (National Network of Depression Centers, 2024). Deep TMS uses specialized H-coil technology to reach deeper and broader brain tissue than standard TMS, making it effective for a wider range of patients and presentations (Past, Present, and Future of Deep TMS, 2023).
Adding Deep TMS to Your Current Treatment
One of the most important things to understand about Deep TMS for depression is that it’s designed to work alongside existing treatment, not replace it. You continue your antidepressant throughout the treatment course if you are having some benefit. If you’re also working with a therapist, those appointments continue as well. Deep TMS adds a layer of direct brain stimulation to what’s already in place.
Before starting, your psychiatrist at Catalyst Psychiatry will conduct a comprehensive evaluation: reviewing your diagnosis, your complete medication history, your current symptoms, and any medical factors that affect candidacy. Some people are not appropriate candidates for TMS due to metallic implants in the head or neck, a history of seizures, or certain neurological conditions. That evaluation is where we determine whether Deep TMS makes sense for your specific situation.
If you’re a candidate, your first session includes determining your motor threshold—the individualized stimulation intensity used to guide your treatment. This process takes about 20 to 30 minutes and is generally well tolerated. After that, treatment sessions run approximately 20 minutes each, five days a week for six weeks, followed by a taper period of three additional weeks. Most people drive themselves to and from appointments and return to their normal routine immediately after each session.
Many people notice some improvement within the first two to three weeks, though the full benefit often becomes clearer after completing the course. If you achieve improvement or remission, the benefit may last from three months to a year or longer. If your depression returns after a successful course, another full treatment series is an option. Your psychiatrist will monitor your symptoms over time and discuss next steps if symptoms begin to resurface.
As the only Deep TMS provider in the Willamette Valley, Catalyst Psychiatry offers this treatment to patients throughout Corvallis and the surrounding region. Geographic access matters: Deep TMS requires a commitment to daily appointments, and having a local provider makes that feasible in a way that traveling to Portland or Eugene would not be for most people.
Who Is a Good Candidate
The strongest candidates for Deep TMS augmentation are people with major depressive disorder who have tried at least one antidepressant without achieving full remission. This includes people currently on a medication that’s helping somewhat, as well as people who have tried multiple medications without adequate benefit.
You may also be a good candidate if medication side effects have prevented you from reaching a fully therapeutic dose. Rather than pushing your current medication higher at the cost of tolerability, adding Deep TMS allows you to pursue greater symptom improvement without increasing medication burden.
Deep TMS is not appropriate for everyone, and the evaluation process is designed to identify who is and isn’t a good fit. Your psychiatrist will discuss your complete history, including any conditions or factors that affect safety, before making any recommendations. You can also complete our online self-assessment as a helpful first step.
Insurance Coverage and Cost
Many insurance plans cover Deep TMS for major depressive disorder, but prior authorization is required and the criteria are specific. Most insurers want to see failure to respond to two to three antidepressants during the current episode, with at least one from a different medication class, as well as failure to respond to an augmentation medication and failure to respond to weekly evidence-based talk therapy such as CBT, DBT, ACT, or psychodynamic psychotherapy. Your symptom severity also typically needs to fall in the moderate to severe range. Our team handles the prior authorization process and verifies your coverage before treatment begins so you understand your financial commitment in advance.
Catalyst Psychiatry accepts most major insurance plans and works with patients to address coverage questions before starting treatment. If you pay out of pocket, a cash discount is available. Please call our office for details.
FAQ
Q: Do I have to stop my antidepressant to do Deep TMS?
A: No. Deep TMS is designed to work alongside your current medication, not replace it. You continue taking your antidepressant exactly as prescribed throughout the treatment course. Your psychiatrist may adjust medications over time based on your response, but that happens collaboratively and gradually, not as a precondition for starting TMS.
Q: How do I know if my response to antidepressants qualifies as “partial”?
A: If your depression has improved since starting medication but you’re still experiencing symptoms that interfere with your functioning—sleep, motivation, concentration, relationships, work—that’s worth discussing with your psychiatrist. There’s no single threshold that defines partial response, which is why a thorough evaluation matters. Our team can help you assess where you are and what your options look like.
Q: How long before I notice results from Deep TMS?
A: Many people notice some improvement within two to three weeks, though maximum benefit typically emerges after completing the full treatment course. Results vary by individual, and your psychiatrist will monitor your progress throughout.
Q: Can I do Deep TMS if I’ve already tried multiple antidepressants?
A: Yes. The FDA clearance for Deep TMS specifically covers patients who have not achieved satisfactory improvement from prior antidepressant medication, including people who have tried several. Your treatment history is part of the evaluation, not a disqualifier.
Q: What if Deep TMS doesn’t produce the results I’m hoping for?
A: Not everyone responds to Deep TMS, and results vary by individual. If your symptoms don’t improve meaningfully during the treatment course, your psychiatrist will discuss next steps with you. At Catalyst Psychiatry, a course of treatment is the beginning of an ongoing conversation about your care, not an endpoint.
Key Takeaways
- Partial antidepressant response—feeling somewhat better but not well—is common and treatable, not a sign that recovery isn’t possible.
- Deep TMS works through direct brain stimulation targeting the left dorsolateral prefrontal cortex, using a mechanism distinct from any oral antidepressant.
- Deep TMS is designed to work alongside existing antidepressant treatment, not replace it. You continue your medication throughout the treatment course.
- The standard treatment course involves daily sessions Monday through Friday for six weeks, followed by a taper period; most people drive themselves and return to normal activity immediately after each session.
- Catalyst Psychiatry is the only Deep TMS provider in the Willamette Valley, offering patients in Corvallis and the surrounding region local access to this FDA-cleared treatment.
Conclusion
Partial antidepressant response is not the end of the road. It’s a signal that your depression may involve systems that medication alone hasn’t fully addressed. Deep TMS offers a way to target those systems directly, working alongside your antidepressant rather than replacing it. If you’ve been on medication that helps but not enough, that’s a conversation worth having with a psychiatrist who has experience with the full range of treatment options available today.
At Catalyst Psychiatry, our board-certified psychiatrists serve patients throughout Corvallis and the mid-Willamette Valley who need more than what standard antidepressant treatment has provided. To find out whether Deep TMS might be an appropriate next step for your situation, call 541-730-4400 or contact us online to schedule a consultation.
Medical Disclaimer: The information in this blog is for educational purposes only and does not constitute medical advice. Deep TMS and antidepressant treatment should only be pursued under the supervision of a licensed psychiatric provider familiar with your full medical and psychiatric history. Individual results vary. If you are experiencing a mental health crisis or thoughts of self-harm, please call or text 988 to reach the Suicide and Crisis Lifeline or go to your nearest emergency room.
References
- FDA 510(k) Clearance. (2013). BrainsWay Deep TMS System K122288. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?ID=K122288
- National Network of Depression Centers, Clinical TMS Society, and International Federation of Clinical Neurophysiology. (2024). Consensus review and considerations on TMS to treat depression. Clinical Neurophysiology. https://www.sciencedirect.com/science/article/pii/S1388245724003766
- Past, Present, and Future of Deep TMS. (2023). World Journal of Psychiatry. https://pmc.ncbi.nlm.nih.gov/articles/PMC10523198/