Transcranial Magnetic Stimulation (TMS) is a non-invasive treatment that uses magnetic pulses to stimulate nerve cells in the brain located in specific areas associated with mood and behavior regulation.
TMS was first FDA-approved for Major Depressive Disorder in 20081, then expanded for use in other conditions, including pain associated with certain migraine headaches, Obsessive Compulsive Disorder, and Smoking Cessation. These approvals underscore the growing recognition of TMS as an effective intervention for a range of mental health conditions.
During a TMS session, patients wear a specially designed helmet that delivers the magnetic pulses. While the experience may feel strange at first, most people find it comfortable. A physician typically sets the initial settings in your first session, then a trained technician is present in your following sessions to adjust the targeting of the device, ensuring the right areas of the brain are stimulated.
The standard dTMS protocol involves 36 sessions over 8-10 weeks, each lasting about 20 minutes. dTMS is often covered by insurance for patients with Depression who haven’t responded to antidepressants in the past in particular.
Accelerated TMS protocols are faster - involving 10 sessions a day, each about 10 minutes long with a 40 minute break, over the course of 5 days. It’s a condensed alternative to dTMS, though requires more time in each day. While a type of Accelerated TMS, SAINT TMS, is FDA approved, it’s not covered by insurance yet.
Many individuals battling addiction also struggle with co-occurring conditions like Depression. TMS offers a valuable way to target these challenges simultaneously within addiction treatment programming. In addition, there are protocols that focus specifically on addiction, including the FDA-approved Smoking Cessation protocol.
By addressing both the addiction and underlying mental health issues, TMS is a tool that can help accelerate the path to recovery and provide a more comprehensive approach to healing.
As noted earlier, an emerging advancement in TMS is SAINT TMS, developed by researchers at Stanford University. This accelerated version of the traditional TMS protocol significantly condenses the treatment schedule. While standard dTMS involves 36 sessions over weeks, SAINT TMS delivers 50 sessions over just 5 consecutive days. It also integrates MRI-guided brain imaging to improve precision.
SAINT TMS received FDA approval in 2021, but it is just starting to be put into real-world use in late 2024 and not yet covered by insurance.
At Pharia, we offer TMS at our partnered centers, as an add-on treatment to one of our centers’ baseline programming. We believe pairing powerful tools like TMS with programming that includes individual and group therapy will lead to the strongest outcomes.
We are also actively researching how to expand access to both Accelerated TMS and SAINT TMS, ensuring that patients have a range of clinically effective options available to them.
