The drug-free depression treatment Washington should be talking about

ABOUT THE AUTHOR: Dr. Ruchir P. Patel, M.D., FACP, is the founder of TMS Institute of Arizona in Scottsdale, Ariz., and is triple board-certified in internal medicine, sleep medicine and obesity medicine. He completed his fellowship training and certification in TMS therapy at Duke University and received advanced TMS training at Harvard Medical School and Maastricht University in the Netherlands.

This year, the federal government took two important steps to address the mental health needs of our veterans. First, President Donald Trump signed an executive order directing federal agencies to fast-track psychedelic therapies for veterans living with post-traumatic stress disorder and depression. Then, Health and Human Services Secretary Robert F. Kennedy Jr. announced a new initiative to reduce what he called America’s “dependency crisis” — a push to wean millions of patients off antidepressants, particularly SSRIs like Prozac and Zoloft.

While these are two distinct policy actions, they share a common recognition: the treatments we have relied on for so long are not meeting the needs of many Americans, especially our veterans. We owe it to them — and to all those struggling — to seek better solutions.

One established option is missing from this conversation: transcranial magnetic stimulation, or TMS, an FDA-approved, non-medication treatment that is already covered by Tricare and most major insurers.

According to the VA’s 2025 National Veteran Suicide Prevention Annual Report, 6,398 veterans died by suicide in 2023 — a heartbreaking number that’s exceeded 6,000 every year for more than two decades. The recent executive order recognizes what many already know: for veterans living with PTSD, depression and substance use disorders, standard antidepressants and talk therapy often fall short.

But this challenge isn’t limited to veterans. First responders, emergency room nurses, active duty military, and survivors of trauma, violence or disaster — all are part of a much larger community. Tens of millions of Americans live with treatment-resistant depression, facing struggles often invisible to others.

Large-scale clinical research shows that only about one in three patients achieves remission on the first antidepressant; response rates drop sharply with each subsequent medication tried, falling to roughly 25% on the second and as low as 17% on the third. For the millions living with both depression and PTSD, full remission on medication alone is the exception, not the rule.

Kennedy isn’t wrong that millions of Americans have stayed on these medications for years. However, encouraging people to reduce or stop medication without expanding access to proven, effective alternatives leaves patients in a dangerous position.

The recent executive order supporting psychedelic therapies marks encouraging change in federal policy. Therapies such as ibogaine, psilocybin, and MDMA-assisted treatment have shown promise in clinical studies, especially for veterans who haven’t responded to other treatments.

However, these therapies are not yet available. They are not FDA-approved, nor are they covered by Tricare or private insurance. The clinical systems needed to deliver them safely and effectively are still being developed. For a veteran or service member in crisis today, waiting for future treatment is not an option. Transcranial magnetic stimulation is a non-invasive treatment that uses gentle, targeted magnetic pulses to stimulate areas of the brain involved in depression. It is FDA-approved for major depressive disorder and is performed in an outpatient setting. There is no need for anesthesia or recovery time. Patients typically spend about 20 minutes in a session and can return to their activities immediately afterward.

The evidence for TMS is substantial and growing. A 2025 consensus statement confirms TMS is safe and effective, including for patients whose depression hasn’t responded to medication. In real-world clinical settings, up to 75% of patients who complete a full course of TMS experience a meaningful treatment response, defined as at least a 50% improvement in symptoms. That compares favorably to the roughly 40% of patients who respond to the first antidepressant prescribed; unlike medication, those odds don’t decline the more times a patient has tried a prior treatment.

For patients who haven’t found relief with one or more antidepressants, the very people these new policies and trials aim to help, TMS consistently outperforms the alternative of trying yet another medication, with remission rates of 30-42% in patients for whom drugs have already failed.

As TMS isn’t medication, there’s no risk of becoming dependent on it and no tapering process. For people hoping to find a safe, evidence-based alternative to long-term medication, TMS offers a non-pharmaceutical option.

Our leaders have correctly identified the challenges we face with depression and PTSD treatments. Our veterans, first responders, and trauma survivors deserve access to solutions that are available now. They shouldn’t have to wait.