TMS Protocol Options
Conventional TMS
The conventional, or standard TMS treatment protocol, usually involves 5 sessions per week for about 6-8 weeks, totaling 30–36 sessions. Each session is about 20-40 minutes long. This conventional protocol is supported by decades of research. The first session involves identifying a patient’s motor threshold (MT).
We recognize patients may not have the capability to commit to a protocol like this, so we are pleased to offer other options: accelerated TMS and one day TMS.
Example: Conventional TMS Protocol
| Weeks 1–5 | TMS Sessions daily, 5 days per week **Week 2–4 recheck & possibly re-do MT |
| Week 6 | TMS Sessions 3 days this week |
| Week 7 | TMS Sessions 2 days this week |
| Week 8 | TMS Session 1 day this week |
| Week 10–12 | Follow-up office visit between weeks 10–12 |
Accelerated TMS
At Mynd Thera, we offer accelerated TMS, which multiple peer-reviewed studies confirm is equally effective to conventional TMS. For some patients, we understand that attending treatment daily, for 5-6 weeks in a row, is not feasible.
An accelerated program allows for delivering multiple treatment sessions on a single day, over a shorter period of time.
Two examples of effective accelerated programs we offer:
A) at least four sessions of 2 hours per day and two days per week. This means a patient is treated over a period of 2 hours, on 2 different days in the first week, and again for 2 hours, on 2 different days, the second week.
B) up to ten sessions of five hours per day and five days per week. This means a patient is treated over a period of 5 hours per day, 5 days a week, and they can do this for a total of 10 days.
Both options reduce the total number of weeks required to come in-person to Mynd Thera.
Example A: Accelerated Protocol
| Week 1 | TMS Sessions on 2 days this week, for 2 hours each day |
| Week 2 | TMS Sessions on 2 days this week, for 2 hours each day |
| Week 3–5 | Follow-up office visit between weeks 3–5 |
Example B: Accelerated Protocol
| Week 1: Day 1 (Mon) | 5 hour treatment session |
| Week 1: Day 2 (Tues) | 5 hour treatment session |
| Week 1: Day 3 (Weds) | 5 hour treatment session |
| Week 1: Day 4 (Thurs) | 5 hour treatment session |
| Week 1: Day 5 (Fri) | 5 hour treatment session |
| Week 2: Day 6 (Mon) | 5 hour treatment session |
| Week 2: Day 7 (Tues) | 5 hour treatment session |
| Week 2: Day 8 (Weds) | 5 hour treatment session |
| Week 2: Day 9 (Thurs) | 5 hour treatment session |
| Week 2: Day 10 (Fri) | 5 hour treatment session |
| Week 4–6 | Follow-up office visit between weeks 4–6 |
Patients may also have the option to complete a one-day TMS protocol, which involves multiple treatment sessions over one full day between 9am-5pm, plus the addition of two prescription medications to enhance treatment efficacy: D-Cycloserine and Lisdexamfetamine.
With mental illness, brain circuits are often “turned off,” leading to difficult symptoms. D-Cycloserine and Lisdexamfetamine act on regions of the brain that help restore communication and “turn back on.”
The addition of these medications to a one-day treatment program promotes the brain’s ability to more quickly rewire and recover. Some patients with depression report feeling positive changes after a single day of this treatment protocol.
One Day TMS
Please be sure to speak with your provider about a TMS option recommended for you. We will work with your insurance company to discern coverage, and we welcome all questions. Transparency is at the forefront of our practice!