Beat depression in FIVE days 

What is Accelerated TMS Therapy? 

Accelerated rTMS (repetitive Transcranial Magnetic Stimulation) is exactly what the name implies, an accelerated or more rapid TMS therapy that reduces the conventional six weeks needed for standard TMS treatment to as little as one week. Accelerated TMS packages fifty TMS sessions over one to two weeks. Five to ten treatments are administered each day over the course of one to two weeks. For comparison, a standard TMS course of treatment would involve only around thirty-six treatments and take six weeks to complete.

Read more: How does TMS therapy work? →

In addition, treatments involve ten minutes of a newer type of magnetic stimulation called iTBS (intermittent Theta Burst Stimulation).

Learn more about intermittent Theta Burst Stimulation →

Accelerated TMS Therapy is different from iTBS, but both treatments are used together to reduce the time needed for treatment and to increase the total amount of pulses received.

What Should I Expect During Accelerated TMS Therapy?

Accelerated TMS therapy is administered over the working week, Monday-Friday. Therefore, it is beneficial for patients traveling from out of town, to arrive on the weekend before their first session and leave on the weekend after their last session. Prior to the first session of accelerated TMS is the “mapping” where we will determine your unique neural requirements, the dosage required to excite neurons (also known as the motor threshold) and the individualized target location. This ensures that you do not receive too low, or an unnecessarily high amount, of magnetic stimulation. The process is akin to a session of regular TMS therapy, with the patient sitting comfortably in a chair while the magnetic device is placed on the side of their head. Many patients describe the feeling as a light tapping sensation, and it is typically well tolerated and often pain-free. Should you have any questions during your treatment, a medical professional will be available and willing to assist with any of your worries.

Your accelerated TMS therapy protocol will consist of sessions that are 9 minutes in length, with a break of 50 minutes in between. You will have 10 sessions per day. Your breaks are free to spend as you please - be that relaxing in our comfortable waiting rooms, or going for a walk to get some fresh air. These are intended to provide a necessary break in treatment throughout your day and to maximize cortical excitability and the effectiveness of the treatments.

Accelerated relief from depression

Major Depression, Anxiety, and other Mood Disorders have never been easy for the medical community to treat quickly, and symptomatic relief or full recovery usually entails long-term medication use in addition to talk therapy.

Accelerated TMS therapy potentially provides response in a much shorter time frame. This is a win-win for patients and providers alike. No one wants to wait months to experience relief from severe depression and providers want to help their patients find relief as quickly and successfully as possible.

Do all TMS clinics provide Accelerated TMS Therapy and iTBS?

Not all TMS providers have systems with the capability of providing iTBS nor the cooling capacity required to run Accelerated TMS Therapy. Inspire TMS Denver uses the latest TMS technology and a Magventure system fully capable of delivering both treatments. Magventure was the first TMS device manufacturer to obtain FDA approval for use of iTBS and a Magventure system was used in the groundbreaking study that showed the potential of Accelerated TMS, the SAINT trial.

Stanford Accelerated Intelligent Neuromodulation Therapy-SAINT Protocol

Stanford School of Medicine pioneered Accelerated TMS and has published its evidence in the American Journal of Psychiatry. ¹

Stanford Accelerated Intelligent Neuromodulation Therapy utilized Accelerated TMS in a study of depressed patients with Treatment-Resistant Depression (SAINT-TRD). 

What were the key findings? 

This study was open-label and involved a smaller number of patients. It also used fcMRI (functional connectivity MRIs that were patient-specific). Time will tell how important this part of the study was to the results. There have been additional studies on Accelerated TMS (including randomized and controlled trials that are the benchmark for research) that have shown positive results and were similarly safe and well-tolerated.² They have also shown at least equivalent remission and response rates between Accelerated TMS and Standard TMS.³

The SAINT study likewise had a follow-up RCT trial called SNT that was supportive of the initial research.⁴ In this paper, they found a mean reduction in the depression scale utilized to measure response - the MADRS - of 52.5%. Our clinic has now treated over 50 accelerated patients with a similar protocol without the use of fcMRI and have achieved similar results with a 56% reduction on the MADRS on average. In the SNT study, they also measured remission (score of 10 or less on the MADRS) and response (greater than 50% reduction on the MADRS) weekly for one month post-treatment. The average remission rate was 57% and the average response rate was 74%. For patients we have treated to date, within one-month post-treatment, we have achieved a similar 53% remission rate and 75% response rate.

Pros & Cons of Accelerated TMS Therapy

We have composed this pros and cons list as guidance to help you decide if the process will suit you.

Accelerated TMS at Inspire TMS Denver

As a patient of Inspire TMS Denver, all TMS treatment options will be discussed with you before embarking on a course of treatment. As Accelerated TMS therapy is so new, it is not currently standard of care or covered under insurance. Breakthrough FDA approval has been granted as of September 2022, but this is only with the use of a functional connectivity MRI. This is costly and proprietary at this time. We have been seeing excellent results for accelerated treatment in our clinic without the use of fcMRI. We use a combination of a measurement system called Beam F3 and heart rate monitoring during treatments to select our target locations. There is some preliminary evidence that heart rate drops slightly during each set of pulses for a significant portion of patients that respond to TMS. We hence look at this to guide target location. Our current response rate at 4 weeks post accelerated treatment hovers around 75% and remission rate hovers around 45%. This is actually higher than that seen at 4 weeks post treatment in the SNT randomized control trial - Response rate: 64.3% and Remission rate: 42.9%.⁴ 

Accelerated TMS Cost

Inspire TMS Denver offers Accelerated TMS as we want to provide the latest treatment options to our patients. Our all inclusive rate for accelerated TMS is $6500 - this includes evaluation, all follow up visits, and 50 sessions the week of treatment. We also offer additional treatments free of charge in the first 6 months post treatment if touch up treatment is needed. Our clinic is spacious and has comfortable treatment rooms for watching TV or listening to music. We offer free coffee, tea, or water to enjoy during your visits. There are restaurants and walking trails close by as well. These amenities and our team ensure a relaxing and accommodating treatment experience so that our patients can get back to living their lives free from depression and associated anxiety and other mental health symptoms. 

Whatever TMS treatment you choose, rest assured that Inspire TMS Denver will tailor treatment protocols to your unique symptoms and situation. We promise to keep you informed and comfortable with your individual care plan. More questions about Accelerated TMS Therapy, intermittent Theta Burst Stimulation, or other information on this page? Please contact us here to see about a free consultation.