Can Accelerated TMS Treat Depression in Just Five Days?
Yes. A UCLA study of 175 patients found that five TMS sessions per day over five days produced comparable depression relief to the standard six-week course of daily sessions. Even patients who did not respond right away saw a 36% drop in depression scores two to four weeks later.
Transcranial magnetic stimulation, or TMS, uses magnetic pulses to stimulate specific areas of the brain involved in mood. It is one of the few treatments that works for people whose depression has not improved with medication. The problem is that standard TMS requires daily clinic visits for six weeks, which is a major barrier for many patients. This new study tested whether compressing all that treatment into just five days could work just as well.
Dr. Kumar’s Take
This study adds strong real-world evidence to the growing case for accelerated TMS. What stands out to me is the delayed response pattern. Some patients who did not feel better right after the five-day protocol showed a 36% improvement in depression scores weeks later. That tells us the brain keeps responding and rewiring even after treatment stops. For patients who struggle with the time commitment of traditional TMS, this compressed format could be a game-changer. I want to see more long-term follow-up data, but the trajectory here is very promising.
Study Design and Participants
Researchers at UCLA enrolled 175 patients with treatment-resistant depression, meaning their symptoms had not improved with at least one antidepressant medication. This is a meaningful sample size for a TMS study, and it reflects the real-world population that needs this treatment most. Participants received the accelerated protocol of five sessions per day over five consecutive days, and their outcomes were compared to those of patients who completed the conventional six-week course of daily sessions.
Results and the Delayed Response Effect
The headline finding is that the accelerated five-day protocol produced symptom relief comparable to the standard six-week treatment. That alone is significant, but the delayed response effect makes these results even more compelling. Among patients who did not show an immediate response to the accelerated protocol, depression scores dropped by 36% when they were reassessed two to four weeks after treatment ended. This suggests the magnetic stimulation triggers changes in brain circuits that continue to develop over time, even without additional sessions. The conventional protocol has long been the gold standard, but these findings challenge the assumption that more sessions spread over more weeks necessarily means better outcomes.
Who Could Benefit Most
The people who stand to gain the most from accelerated TMS are those whose lives make a six-week daily commitment nearly impossible. That includes working parents, people without reliable transportation, patients who live far from a TMS clinic, and anyone whose depression makes it hard to follow through with weeks of appointments. Compressing treatment into a single work week removes many of those barriers. It also opens the door for patients who may have dismissed TMS entirely because of the time commitment.
Practical Takeaways
- Ask your psychiatrist or neurologist whether accelerated TMS protocols are available at clinics near you, as not all TMS providers currently offer the five-day format.
- If you tried standard TMS and dropped out because of scheduling, the accelerated protocol may be worth revisiting since the compressed timeline addresses the most common barrier to completion.
- Do not be discouraged if you do not feel better immediately after an accelerated TMS course, because the study found significant improvement can develop over the following two to four weeks.
- Continue working with your treatment team during and after TMS, as the best outcomes typically come from combining brain stimulation with ongoing psychiatric care.
Related Studies and Research
If you are interested in learning more about TMS for depression, these articles explore related research and protocols:
- Daily TMS Therapy: The Depression Treatment That Works in Just 6 Weeks
- Accelerated TMS: From 6 Weeks to 5 Days, the Future of Depression Treatment
- Accelerated rTMS for Treatment-Resistant Depression
- TMS Consensus Review for Depression: Comprehensive Update
FAQs
What is the difference between accelerated and standard TMS?
Standard TMS involves one session per day, five days a week, for about six weeks. That adds up to roughly 30 sessions spread over more than a month. Accelerated TMS delivers the same total number of sessions but compresses them into five sessions per day over five consecutive days. The total amount of brain stimulation is similar, but the time commitment drops from six weeks to a single week. This study found both approaches produced comparable relief from depression symptoms.
Does accelerated TMS have more side effects than standard TMS?
TMS in general is well tolerated compared to many depression treatments. The most common side effects are mild scalp discomfort and headaches during or shortly after sessions. Because accelerated TMS delivers multiple sessions in one day, patients may experience more fatigue on treatment days. However, the overall side effect profile has been similar to standard TMS in studies to date. Always discuss potential risks with your doctor before starting any TMS protocol.
Why would depression improve weeks after TMS treatment ends?
The magnetic pulses used in TMS stimulate nerve cells in brain regions that control mood. These pulses do not just create a temporary effect during treatment. They appear to trigger lasting changes in how brain circuits communicate with each other. Think of it like exercise: your muscles do not get stronger during the workout itself, but in the days and weeks of recovery afterward. Similarly, the brain continues to strengthen and reorganize the neural pathways affected by TMS long after the last session, which is why some patients in this study saw a 36% improvement weeks later.
Bottom Line
This UCLA study of 175 patients shows that accelerated TMS, five sessions per day over five days, can match the depression relief of standard six-week treatment. The finding that non-responders still improved by 36% weeks later suggests the brain continues to heal after treatment ends. For the millions of people with treatment-resistant depression, this compressed protocol could make an effective treatment far more practical and accessible.
