This is like comparing apples to oranges. With only a few modest side effects and a long-lasting effect, TMS is a considerably more benign treatment for depression. Although intravenous ketamine can be quite beneficial in treating depression, the actual condition of remission is transient. Ketamine can cause sensations of unreality, visual and sensory distortions, a skewed perception of one’s body, momentary strange thoughts and beliefs, as well as a buzz or pleasure. There are no odd experiences during a TMS therapy session. Both are useful for treating moderate to severe depression. While TMS is used to provide longer-term relief for depressed symptoms, ketamine is particularly helpful for symptoms associated with suicidal ideation. Dissociation (a perceived separation of the mind from the emotional state or even the body), anxiety, nausea, spinning sensations, elevated blood pressure, sedation, feeling inebriated, and in some cases vomiting are some of the most frequent side effects of ketamine. The two adverse effects of TMS therapy that are most frequently reported are pain at the treatment site and headaches, both of which usually go away after the first few sessions and may be managed with over-the-counter drugs like Ibuprofen or Tylenol. Esketamine is a nasal spray that is given in a doctor’s office and is FDA-approved. Although not as effective as TMS, the drug may nevertheless be helpful for people who are experiencing severe depression symptoms, such as suicide thoughts. In addition, unlike TMS, the drug has a number of adverse effects, but it can be an excellent therapeutic option for some people who require relief right away.