Accelerated TMS (or aTMS) is a non-invasive and non-pharmacological interventional modality for Treatment – Resistant Major Depressive Disorder. This treatment utilizes magnetic impulses to modify underactive/overactive areas of the brain. The impulses target the dorsal lateral prefrontal cortex to enhance the ability to release and regulate the proper brain activity for mood regulation. It is designed to reduce the total number of days that the treatment will be delivered, while maintaining or superseding the efficacy of traditional TMS protocols. While a typical course of rTMS includes once a day sessions for 30-36 (about 6 weeks), a typical course of Accelerated TMS is 5 days. Each day consists of 10 sessions of treatment (once per hour), with each session lasting about 9 minutes. Although this results in long treatment days, the results can be achieved at a much faster rate.

As a relatively new treatment, there are an increasing number of Accelerated TMS protocols used in research and clinical settings. The seminal study and protocol done by a team at Stanford, originally named The Stanford protocol and later changed to SAINT protocol, included five days of treatment each consisting of 10 sessions. Subsequently, other protocols have been suggested with differing number of treatment dates (e.g. 15 days) and total number of sessions.

Unfortunately most insurance providers do not currently cover Accelerated TMS. While this may change in the future, the majority of insurance providers who do cover TMS, limit coverage to rTMS and iTBS protocols at this time, with some only covering rTMS protocol.

At your first TMS appointment our highly specialized team will locate the treatment site utilizing landmarks, neuro-navigation, and imaging studies (if applicable). Then the team will determine the appropriate intensity to achieve therapeutic results. After finding both the location and the proper amount of power, the first session will be administered. Treatment sessions are completed once per hour, and for a typical Accelerated TMS treatment, you will receive 10 sessions each day. During each session you will sit comfortably on a recliner in the private TMS treatment suite while a team member places the coil in the correct location using the neuro-navigation system before initiating treatment. The treatment may feel like a light tap on your scalp. The TMS machine is loud – ear plugs will be provided. Each session of aTMS lasts for about 9 minutes. A team-member will be in the treatment suite during the entire session, to ensure safety and comfort. Between sessions, you will have access to an assigned private room, where you can relax, eat or drink (we will inform you about any limitations). You can read books, use electronic devices to work or to watch or listen to your favorite series, audiobook, etc. while waiting for your next sessions.

Although TMS treatment in general is well-tolerated, there are mild side effects that can occur. Side effects are significantly minimal compared to pharmacological treatments. By its nature, Accelerated TMS has a higher chance of inducing the common side effects as the treatments are closer to each other, but the studies of various accelerated protocols did not detect a significant difference in significant adverse events compared to traditional protocols. Some of the common side effects are: headache, dizziness, fatigue, and soreness at the treatment location. Adverse events are rare with TMS and include seizures and complications from presence of metallic objects in the head and neck area.