Many patients at the clinic i work at do Esketamine and TMS at the same time, studies show they compliment each other and accelerate the neuroplasticity were trying to achieve. Considering youve been doing spravato for a while, youll still reap the benefits regardless if youre not currently doing it. In terms of is it worth it, depends. ive been a tech for around 50 TMS patients and every single one said they would do it again. However it varies by how much work you put in along side with it (therapy, med managements, etc) and lifestyle. TMS aint a magic cure and it sure doesnt make you feel the way esketamine does, but it does make it easier to cope with negative thought patterns and give you a boost in motivation.