Comparing TMS Treatment Protocols

Transcranial magnetic stimulation (TMS) has become a highly effective, noninvasive treatment for patients with depression and other neuropsychiatric conditions — particularly when medication and talk therapy haven’t provided sufficient relief. Although TMS itself is a proven therapy, the way it’s delivered varies significantly depending on the protocol used.

At Breakthru Psychiatric Solutions, serving the greater Atlanta, Georgia area, we’re proud to offer three different treatment options: traditional TMS, accelerated TMS, and ONE-D TMS. 

All these options are backed by solid evidence, and tailored to meet various patient needs, schedules, and treatment goals. Knowing the differences can help you choose the right care.

Traditional TMS: The standard of care

Traditional TMS is the most thoroughly researched TMS approach, and it’s approved by the FDA. It’s a structured, daily treatment routine that spans nine weeks, and for many people, this tried-and-true method provides a reliable route to lasting symptom relief with only minimal side effects.

Key features of traditional TMS:

Session frequency: Once daily, five days per week

Duration of treatment: Six weeks of acute treatment, followed by a tapering phase. 36 treatments total over the course of nine weeks

Session length: Approximately 19 minutes per session

Ideal for: Patients who prefer a well-established, steady approach with widespread insurance coverage

Considerations: Requires a longer time commitment; symptom improvement may emerge gradually starting around week 3 or 4

This protocol is ideal if you want a reliable, methodical option backed by years of clinical use. It’s also widely covered by insurance, so it’s more accessible.

Accelerated TMS: Compressed schedule, rapid relief

Accelerated TMS condenses the benefits of traditional TMS into a much shorter time frame using intermittent theta burst stimulation (iTBS) — a faster stimulation pattern. This means you can complete multiple sessions per day and receive the full course of treatment in just two weeks.

Key features of accelerated TMS:

Session frequency: 4 sessions per day, five days a week for two e weeks

Duration of treatment: Typically 10 days, with flexibility based on patient response

Session length: 3-10 minutes per session, due to the use of iTBS technology

Ideal for: Patients seeking rapid improvement or those with limited availability for long-term daily appointments

Considerations: Accelerated TMS is not covered by insurance. The condensed format can be more physically and mentally demanding; side effects, such as headache or fatigue, are more common but typically mild and temporary. Symptom improvement may emerge starting around day 3 - 4

Accelerated TMS is particularly appealing for those who need fast symptom relief, such as students, professionals, or those traveling from out of town. It also shows promise for reducing depressive symptoms more quickly than traditional protocols in appropriate candidates. Accelerated TMS is not covered by insurance.

ONE-D TMS: The Latest, Scientific Advancement 

ONE-D TMS (Optimized, Neuroplasticity-Enhanced Depression Treatment Regimen is the newest treatment protocol available. Although not yet cleared by the FDA, this protocol has been rigorously studied and is evidence-based.

ONE-D TMS is an advanced, high-dose TMS protocol that delivers 20 intermittent Theta Burst (iTBS) sessions over the course of a single treatment day, combined with two supportive medications: Vyvanse (lisdexamfetamine, a mild stimulant) and D-cycloserine (a cognitive enhancer).

This protocol can be personalized to treat depression, anxiety, OCD, or all three. 

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Key features of ONE-D TMS include:

Session frequency: 20 treatments over a single day. Patients can expect to spend 12 hours in the clinic.

Duration of treatment: Variable, based on treatment needs. Typically 3 - 5 minutes/treatment 

Session length: 12 - 13 hours

Ideal for: Patients with complex psychiatric histories, failed prior TMS, or treatment-resistant conditions

Considerations: ONE-D TMS is not covered by insurance.  The condensed format can be more physically and mentally demanding; side effects, such as headache or fatigue, are more common but typically mild and temporary. Symptom improvement may emerge within 3 days of treatment and will steadily improve for the next six weeks.

ONE-D TMS is an exciting advancement in TMS therapy, blending the latest in real-time brain data with the proven safety and effectiveness of magnetic stimulation. It’s especially great for patients looking for a personalized, precision-medicine approach to support their mental health treatment.

Choosing the right protocol

All three TMS protocols available at Breakthru Psychiatric Solutions start with a solid foundation of safety, effectiveness, and scientific research. Choosing the right option for you depends on various factors — such as your personal clinical history, what you hope to achieve from treatment, your lifestyle, and how your brain reacts to stimulation.

Dr. Karen Giles or Dr. Cecilia Kwong conducts a thorough evaluation and helps you select the protocol that best aligns with your needs, whether you’re seeking long-term stability, rapid relief, or a data-driven, personalized plan.

Call Breakthru Psychiatric Solutions in Sandy Springs or Alpharetta, Georgia, to schedule your consultation today or request an appointment online.