Which Type of TMS Is Best? (Comparing Protocols)

Who might be a candidate for ONE-D? ONE-D is typically considered for people who: Have treatment-resistant depression or severe depressive symptoms that warrant intensive approaches Want a very time-condensed option (travelers, people with limited availability) Are medically appropriate after careful screening (no contraindicated implants, controlled seizure risk, no untreated substance issues, etc.) Understand that ONE-D may be experimental and require informed consent about augmentation medications and devices. A skilled clinician must determine candidacy after reviewing history, prior TMS (if any), medications, and a psychiatric evaluation. Inspire’s approach emphasizes physician supervision and a personalized plan. Read More: Is TMS right for me? Safety, side effects & monitoring Common short-term effects: Scalp discomfort, brief headache, transient fatigue -similar to standard TMS. Seizure risk: Extremely rare with properly screened patients; clinics follow strict screening protocols (medication review, seizure history). ONE-D’s increased session density requires vigilance; clinical teams are trained and prepared to manage rare events. Medication interaction/augmentation risks: If medications such as D-cycloserine or stimulants (e.g., lisdexamfetamine) are used to augment, the psychiatrist will monitor for side effects and interactions. Augmentation increases potential benefit but also adds clinical considerations. Always discuss risks and alternatives in detail with your provider. ONE-D should only be delivered in a setting with physician oversight, individualized mapping, and appropriate follow-up. It is not a DIY or consumer treatment. How ONE-D compares to other TMS options Standard TMS: 1 session/day for 4–8+ weeks. Best-studied and commonly covered by insurance. 5-day Accelerated TMS (50 sessions in 5 days): Intensive week-long program showing strong outcomes for many patients. Often self-pay but sometimes covered for semi-accelerated variants. ONE-D (20 sessions in 1–2 days): More condensed; attractive for time-limited patients and those seeking an intensive “reset.” Emerging evidence: may use medication augmentation and AMPA equipment; typically self-pay initially (Inspire’s planned price: $3,000). Read More: TMS Pricing Guide What to expect if you choose ONE-D at Inspire Pre-visit consult & screening - psychiatric evaluation, medication review, seizure risk screening. Mapping & motor-threshold determination - before or at the visit to personalize the dose. ONE-D visit (1–2 days) - repeated iTBS sessions with short breaks; staff monitor comfort and vitals. Immediate follow-up & outcome tracking - PHQ-9 or similar scales, and follow-up calls/visits; touch-ups or maintenance discussed if needed. Patient story: why someone might pick ONE-D Some patients travel specifically for accelerated care because it lets them complete a therapeutic course in days rather than weeks. For people balancing work, family, or long travel, ONE-D’s compressed schedule is appealing - especially when paired with physician oversight and clear aftercare. Inspire’s approach highlights convenience while retaining safety and personalization.

Quick Summary Most psychiatric meds can be continued through TMS , but certain drugs affect seizure risk or response and require review. Careful pre-treatment medication review, mapping, and collaboration with a psychiatrist are essential for safe and effective TMS. Augmentation strategies (e.g., ONE-D with D-cycloserine or a stimulant) may be used under strict psychiatric supervision and add monitoring requirements. General principles Safety first. Screen for medications and medical conditions that increase seizure risk or interact with planned augmentation strategies. If seizure risk is elevated, weigh alternatives or modify the plan. Efficacy considerations. Some sedating medications (high-dose benzodiazepines) can blunt TMS response; consider minimizing sedative load when clinically safe. Individualize. Decisions to continue, taper, hold, or change medications should be individualized and documented in the psychiatry visit. Shared decision-making and informed consent are essential. Collaboration. The treating psychiatrist (or a TMS-trained prescriber ) should make medication decisions in close communication with the TMS team; TMS clinics should require medication lists and med reconciliation at intake. Medication Guidance Generally continue SSRIs / SNRIs (e.g., sertraline, escitalopram, venlafaxine) - usually safe to keep during TMS; no routine stop required. Mood stabilizers (e.g., lithium) - generally continue; coordinate for bipolar cases. Use with caution / consider adjustment Benzodiazepines (e.g., clonazepam, lorazepam) - may dampen response; consider minimizing dose if clinically safe. Antipsychotics (e.g., risperidone, olanzapine) - usually continue; clozapine needs special attention because of seizure risk. Review & adjust if needed (seizure-risk meds) Bupropion - dose-related seizure risk; discuss taper/hold if other risk factors present. Opioids, tramadol, certain stimulants at high doses - evaluate case-by-case; may increase seizure or sympathetic risk. Action: Flag these at intake and discuss with the psychiatrist before treatment. (Clinics should screen for seizure risk and have protocols.) Augmentation / experimental agents (ONE-D) D-cycloserine, short-acting stimulants (e.g., lisdexamfetamine) - used in some ONE-D protocols as augmentation only under psychiatrist supervision, with informed consent and monitoring. Document timing and monitoring plan. Read More - TMS Vs Medication Medications that most commonly affect seizure risk Higher seizure risk: bupropion, clozapine, tramadol, theophylline (rare). Agents that lower seizure threshold modestly or via interactions: some antipsychotics, certain antibiotics (quinolones — discuss if relevant), stimulants in high doses. Agents that raise seizure threshold (often protective): many anticonvulsants (valproate, carbamazepine, lamotrigine) - however, these can affect TMS response. Action: Flag any high-risk meds during screening and consult psychiatry to mitigate risk. ONE-D and augmentation - special considerations Augmentation meds (e.g., D-cycloserine 125 mg, short-acting stimulants) have been used experimentally to enhance ONE-D effects; they require psychiatric oversight, informed consent, and monitoring for side effects and interactions. Document augmentation rationale and monitoring plan. If using stimulants : evaluate cardiovascular status, anxiety history, and seizure risk. Consider holding stimulant dose or using a lower dose on treatment day, depending on risk/benefit. Medication log: Track timing of augmentation relative to stimulation in the chart (useful for outcome interpretation).

Short Answer  If you’ve been living with depression for a long time - trying medication after medication, attending therapy, sometimes even pursuing intensive programs - it’s completely understandable to feel exhausted. Treatment fatigue is real: the disappointment after another treatment that doesn’t “stick,” the side effects , the energy it takes to keep trying. That fatigue matters, and it deserves to be acknowledge d. This page is for people who are tired of trying the same things and want a different kind of option: a scientifically supported, non-drug treatment that works by directly engaging the brain’s circuits. Transcranial Magnetic Stimulation (TMS) is an option for many people with long-term, treatment-resistant depression. Below, we explain what TMS does, why it can help when other approaches haven’t, what the evidence says, and how clinics like Inspire TMS Denver approach long-term care with compassion and real outcome tracking.

How the FDA views affects teen treatment Device- and label-specific: The FDA clears devices and their indications, and those clearances may include age ranges. Because clearance is device- and indication-specific, whether a teenager is “on-label” depends on the device used by the clinic and the diagnosis being treated.  Practical result: Some systems have adolescent labeling, which allows clinics to treat teens consistent with labeling; where devices do not include a teen label, treatment would be off-label and requires extra care and documentation. Inspire explicitly offers TMS to individuals as young as 15 when clinically appropriate and in line with device/label guidance.

Quick summary (the short answers) Medicare: Often covers TMS for treatment-resistant major depressive disorder when the plan’s clinical criteria (such as prior medication trials) are met and prior authorization is approved. Inspire routinely helps patients with Medicare benefits checks and authorizations. Medicaid: Coverage varies by state . Some state Medicaid plans cover TMS with strict medical necessity criteria; others do not. Inspire collects your insurance details and runs a state-specific benefits check. Pre-authorization: Nearly always required. Insurers want documented prior treatment attempts, objective symptom measures (PHQ-9), and a psychiatrist’s letter of medical necessity. Inspire will run the authorization for you once you approve.

What Inspire TMS Denver accepts and what that means In-network / insurer relationships: Inspire states it accepts major commercial insurers and works with patients to obtain coverage - including Medicare and Tricare, where criteria are met - and the clinic routinely runs benefits checks and prior authorizations on a patient’s behalf. That means you don’t need to guess whether a policy will pay - Inspire will verify for you. Common Medicare / commercial rules (examples): Different payers have specific clinical criteria. For example (from the clinic’s pricing documents): Anthem - typically requires failure of two different antidepressants from different classes (or intolerance). Medicare -may require failure of one previous antidepressant (or intolerance) Tricare - covers TMS when it is medically necessary and prior less-intensive interventions have failed or are inappropriate. These examples illustrate typical insurer frameworks, but your plan may differ. What’s often covered vs not covered: Commonly covered: FDA-cleared TMS for treatment-resistant major depressive disorder when prior treatment criteria are met and prior authorization is approved. Often not covered (or considered “off-label”): accelerated TMS protocols , certain indications (some anxiety/insomnia/experimental uses), and some PTSD/anxiety uses; these may require self-pay or sliding-scale payment. Inspire notes it offers sliding-scale/self-pay for off-label care and for financial hardship.

How TMS is different: a quick, plain-language explanation TMS uses a magnetic coil to stimulate specific areas of the brain associated with mood and emotional control. It’s non-invasive, does not require anesthesia, and is performed in an outpatient setting. Instead of changing chemistry like antidepressants or providing a rapid but medication-based reset like ketamine , TMS aims to retrain brain circuits by repeatedly activating under-performing regions so they function more normally over time. Inspire’s patient materials stress this neuroplastic, circuit-based approach and describe mapping, stimulation and physician oversight used to personalize treatment.

What is “treatment-resistant depression” (TRD)? Clinically, TRD is commonly defined as depression that has not sufficiently responded to an adequate trial of two different antidepressants (from at least two different classes) given at therapeutic doses and durations. Some insurers and clinical guidelines use this “two-trial” rule when deciding whether to cover advanced treatments like TMS. Medicare and commercial payers may have slightly different wording (for example, Medicare sometimes requires one failed antidepressant; Anthem often requires two). The key idea is consistent: TRD means standard medication strategies haven’t produced an acceptable response.

Your main options while you’re in Colorado Short/accelerated courses If you have very limited time, accelerated TMS (iTBS or compressed protocols) lets clinics deliver many sessions over a few days rather than weeks. Inspire offers accelerated regimens (MagVenture-capable) and lists accelerated TMS as an option for patients who need a fast course, but note: accelerated courses are often not covered by insurance and usually require self-pay or sliding-scale arrangements. Maintenance or “rescue” sessions Maintenance or “rescue” sessions If you’ve completed a full course and need occasional boosters to maintain gains while away, maintenance TMS (weekly, biweekly, or monthly sessions) is common. Clinics also provide rescue or extension courses when symptoms re-emerge. Maintenance often requires a clinician discussion to set frequency, and many insurers do not routinely cover maintenance so clinics may offer packages or discounted session bundles. Full course continuation If your original acute course was interrupted, many clinics will pick up or adjust your plan; this typically requires review of previous mapping and progress measures and coordination with your home TMS provider. Inspire performs mapping and tailors plans to each patient’s needs.