A Full Course of TMS in 48 Hours
For years, TMS meant daily visits for six to nine weeks. That schedule works for some people, but for many, it is the reason they never start. Between work, family, and everything else life demands, finding time every weekday for two months can be unrealistic.
ONE-D changes that. ONE-D (Optimized, Neuroplasticity-Enhanced Depression treatment) can deliver a complete course of TMS in a single treatment day. It is one of the most significant advances in interventional psychiatry in years, and Breakthru is proud to offer it to patients in the Atlanta area.
If you have read about ONE-D and wondered what the day actually looks like, this guide walks you through it, from your first evaluation to the weeks after treatment.
Who ONE-D Is Designed For
ONE-D is designed for adults living with major depressive disorder, including those who also experience anxiety. It is often a strong fit for people who:
- Have tried multiple antidepressants without the relief they hoped for
- Cannot commit to weeks of daily appointments
- Want to start feeling better sooner rather than later
- Responded to TMS in the past and want a faster way to get back on track
Whether ONE-D is right for you is determined during your initial evaluation with one of our doctors.
Before Your Treatment Day: The Evaluation
Every ONE-D patient starts with a comprehensive evaluation. Initial appointments at Breakthru are 90 minutes to 2 hours, which gives our doctors time to review your full history, including past treatments and how you responded to them.
Because ONE-D includes two medications that are given in our office as part of the protocol, our doctors also review your health history to confirm the treatment is a safe fit for you. You do not need a referral to schedule an evaluation.
What Happens on Treatment Day
Preparing for Your First Session
The two medications are taken one time, before coming into our office,: a low dose of lisdexamfetamine (Vyvanse) and D-cycloserine. Both are used to help the brain respond to stimulation, and they are taken one time, on treatment day only. They are part of the ONE-D protocol, not an ongoing prescription. For some patients, Vyvanse may be skipped; this will not affect the efficacy of the protocol.
Locating Your Treatment Target
Before treatment begins, your TMS team measures your motor threshold, which is the amount of stimulation your brain needs, and locates the treatment area. ONE-D targets the left dorsolateral prefrontal cortex; a region of the brain closely tied to mood regulation.
20 Short Sessions Throughout the Day
ONE-D uses intermittent theta burst stimulation (iTBS). Each session lasts about three minutes, and sessions are spaced roughly 30 minutes apart, for a total of 20 sessions. Most of the day is spent resting between sessions, so bring a book, a laptop, headphones, or anything else that helps you relax.
You are awake and alert the entire time. There is no anesthesia or sedation.
How It Feels
During each session, you will feel a tapping sensation on your scalp and hear a clicking sound. Earplugs are provided. The most commonly reported side effects are scalp discomfort and mild headache, which are typically temporary. In the first published study of ONE-D, no serious adverse events were reported.
Plan for a Full Day
Plan on spending a full day in our office. Our team will go over what to expect before you arrive, including travel and getting home at the end of the day.
After ONE-D: What the Weeks Ahead Look Like
There is no recovery period, and you can return to your normal routine. Some patients notice changes within the first week, while for others, improvement builds gradually over the following weeks. Our team follows up with you to track your progress along the way.
What the Research Shows
The first published study of ONE-D followed 32 adults with depression who completed the single-day protocol. At 12 weeks, 84.4% of patients responded to treatment and 71.2% reached remission, based on a standard clinician-rated depression scale. At six months, half of the patients remained in remission. All 32 patients completed treatment, and no serious adverse events were reported. Read the study here.
ONE-D is an advanced, off-label protocol, and research is still evolving. Larger studies are underway, but these early results are among the strongest seen for any TMS protocol.
Standard once-daily TMS for depression has a 50-60% response rate and 30-40% remission rate, according to real-world data.
ONE-D vs. Accelerated TMS vs. Standard TMS
Breakthru offers several TMS protocols, so our doctors can match the schedule to your needs.
| Standard TMS | Accelerated TMS | ONE-D | |
|---|---|---|---|
| Treatment length | About 9 weeks | 2 weeks | 48 hours |
| Schedule | 1 session per weekday for 6 weeks, then tapered | 4 sessions per day, 5 days per week | 20 sessions in one day |
| Session length | About 19 minutes | About 3 minutes | About 3 minutes |
| Insurance | Often covered | Self-pay | Self-pay |
For a deeper look at each option, see our guide to comparing TMS treatment protocols.
Living with OCD? Meet AMPLIFI
AMPLIFI applies the same condensed approach to anxiety with rumination and obsessive-compulsive disorder. Treatment takes place over two consecutive days, with 10 sessions each day, and targets two areas of the brain involved in OCD. As with ONE-D, a one-time dose of the same two medications is given before treatment each day. Patients typically experience the full benefit over the six weeks following treatment.
Research supports this approach: a randomized clinical trial published in the American Journal of Psychiatry found that pairing theta burst TMS with D-cycloserine produced greater improvement in OCD symptoms than TMS alone. Learn more about AMPLIFI TMS for OCD.
Is ONE-D Right for You?
If you have been living with depression that has not improved after multiple medications, and weeks of daily appointments have kept you from trying TMS, ONE-D may be the option you have been waiting for. The best next step is an evaluation with one of our doctors, who can review your history and recommend the protocol most likely to work for you.
Frequently Asked Questions
Is ONE-D FDA-approved?
TMS is FDA-approved for the treatment of major depressive disorder. ONE-D is an advanced, off-label TMS protocol based on evolving clinical research.
Is ONE-D covered by insurance?
ONE-D is not currently covered by insurance and is offered on a self-pay basis. Standard TMS is often covered by insurance, and our team can help you compare options.
How long is the ONE-D treatment day?
Plan for a full day in our office. Our team will give you an exact schedule before your appointment.
Will I need to keep taking the medications?
No. The two medications are taken one time, before coming into our office, on your treatment day.
Will I need maintenance sessions?
ONE-D is designed as a complete course of treatment, with no ongoing daily sessions. If symptoms return, our doctors can discuss additional options with you.
Do I need a referral?
No. You can schedule an evaluation directly with Breakthru.
Take the Next Step
You do not have to spend another two months waiting to feel better. If you are ready to find out whether ONE-D is right for you, schedule a consultation, refer a patient, or call us at 470-231-2235.