If you have serious depression that has not responded to other treatments, you may be a candidate for a new type of therapy. Accelerated transcranial magnetic stimulation (TMS) therapy is a noninvasive treatment that uses brain stimulation for people with severe depression.
In 2022, the Food and Drug Administration (FDA) cleared the Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT®), or accelerated TMS, for use in people with treatment-resistant depression.
At the Center for Interventional Psychiatry at UPMC Western Psychiatric Hospital, our clinicians offer this treatment as an option for people with severe depression.
Contact Us
For more information about accelerated TMS therapy or to schedule an appointment with the Center for Interventional Psychiatry at UPMC Western Psychiatric Hospital, please call 412-246-5063.
What Is Accelerated TMS?
Accelerated TMS is a treatment for people with severe major depression. It relies on brain stimulation to activate specific brain circuits. A magnetic paddle on the scalp delivers magnetic pulses to targeted areas of the brain.
It is a newer form of TMS, a noninvasive brain stimulation technology that providers have been using to treat depression and other mental health disorders for decades.
Depression is one of the most common forms of mental illness in the U.S. According to the National Institute of Mental Health, more than 8% of U.S. adults had a depressive episode in the last year.
For many people, medication, lifestyle changes, and psychotherapy help with depression.
Accelerated TMS is specifically indicated for people who have severe depression that does not respond to other treatments. Mental health providers call this form of mental illness treatment-resistant depression.
How Does Accelerated TMS Work?
Accelerated TMS is used to treat major depression. It doesn’t involve surgery, drugs, or any invasive procedures. Rather, it uses repetitive magnetic pulses to stimulate specific areas of the brain.
When you have depression, there may be abnormal connections in your brain. Doctors identify these areas with sophisticated brain imaging before you receive treatment.
Accelerated TMS modulates these connections by stimulating brain activity in the left frontal regions. It specifically targets the prefrontal cortex, a part of the brain that along with other areas controls emotional regulation.
The magnetic pulses (called intermittent theta-burst stimulation or iTBS) activate specific networks in your brain. This stimulation can help relieve symptoms of depression and help regulate your mood.
Targeting approach
Accelerated TMS is customized to your specific symptoms. Structural and functional MRIs of the brain are obtained before treatments are started. Providers use the images to guide your treatment and deliver electrical pulses to the parts of the brain involved with your depression symptoms.
Time commitment
Accelerated TMS treatments are administered 10 times a day over a five-day period.
Am I a Candidate for Accelerated TMS Therapy?
Accelerated TMS may be an option if you have major depression that hasn’t responded to other treatments. You can talk to your mental health provider about whether your depression symptoms might be treatable with this therapy.
Accelerated TMS is currently approved for adults only.
To qualify for accelerated TMS therapy, you must be able to have the specialized MRI required for treatment. If you have contraindications for an MRI, you will not be a candidate for this type of treatment.
Accelerated TMS may not be an appropriate treatment option for individuals with any of the following conditions:
- Acute psychosis.
- Bipolar disorder.
- An implanted pacemaker.
- Metallic devices or implants that cannot be removed or are specifically contraindicated for MRI or TMS.
- Cochlear implants.
- Pregnancy.
What to Expect During Accelerated TMS Therapy
Here's what you should expect before, during, and after accelerated TMS therapy.
Before accelerated TMS therapy
The first step is figuring out if accelerated TMS is the right treatment for you.
Our expert clinicians at the Center for Interventional Psychiatry at UPMC Western Psychiatric Hospital will review your medical history. You will need a referral from your current psychiatrist or mental health care provider.
You should tell your care team about any medications you take, including antidepressants or other psychiatric medications. They will let you know which medications are safe to take during accelerated TMS treatment.
Before treatments are started an MRI of the brain will be obtained. This is a detailed picture of your brain. Your health care team will use the images to find out what part of your brain to target with the treatment.
During accelerated TMS therapy
Accelerated TMS therapy takes place over five consecutive days, generally Monday through Friday. You will be at the clinic for 10 hours each day, so you will need time off from work or other responsibilities.
Because accelerated TMS therapy doesn’t require anesthesia or sedation, you can drive yourself to and from the appointments.
The week before treatment begins, you will be asked to come into the clinic to identify the brain region that will be stimulated and intensity of the stimulation based on the MRIs obtained. During the initial session and on the treatment days a member from your care team will tape a small tracker to your forehead. This tracker assures the device is kept in the right place while the treatments are being delivered.
For treatment, you will sit in a comfortable chair while a member of the team places a paddle-like device on your head. The device connects to a machine that generates the magnetic pulses.
The MRI-generated images will be used to make sure the magnetic pulses are being delivered to the area associated with your symptoms. The pulses move through your scalp into your brain to activate this region.
You will feel a tapping sensation on your head. This sensation can be uncomfortable for some patients. Your care team will work with you to adjust intensity of the treatments gradually in order to help you adjust as the intensity is increased. You’ll be fully awake and able to communicate with your care team throughout the treatment.
Each hour, you’ll receive one 10-minute session. Between sessions, you can relax, work, read, listen to music, or get a snack or meal, such as breakfast or lunch.
When your last session is complete, you go home for the day. The next morning, you will return for another round of treatment sessions. This schedule will continue for five consecutive days.
After accelerated TMS therapy
You may notice your depression symptoms improving after just a few sessions. Or, it may take a week or so after you finish the treatment to notice a difference. In some cases, it may take up to four weeks to see the full response.
You should continue seeing your regular mental health care provider after accelerated TMS therapy is completed. Even if you are feeling better, you should continue seeing your provider on a regular basis. You should not make any changes to your treatment plan unless indicated by your mental health care provider.
Your care team will check in with you following treatment. They will ask how you are doing and discuss any follow-up care recommended.
Safety, Side Effects, and Risks
There are usually very few side effects from accelerated TMS therapy. Most side effects happen during the week of treatment and improve on their own following treatment.
They may include:
- Fatigue.
- Low risk of seizure.
- Mild headaches.
- Scalp pain.
Your care team will monitor you closely during the treatment. You should tell them if you notice any side effects or experience any issues.
What Does the Research Say About Accelerated TMS Therapy?
Early studies show a high response rate. Response rate is the percentage of people who see a significant improvement in symptoms after treatment.
With standard TMS, there is usually a 50% to 60% response rate. In a recent clinical trial for accelerated TMS, participants receiving the accelerated treatment demonstrated a response rate between 70% and 79%.
Accelerated TMS therapy is still a relatively new treatment. Research is ongoing, and doctors do not yet know long-term outcomes.
Life After Accelerated TMS Therapy and Follow-Up Care
It is important to have ongoing care after your treatment. Your mental health provider will continue to monitor your symptoms over time.
It is also important to keep in mind that accelerated TMS is not a one-time solution for severe depression. Monitoring your depressive symptoms over time is essential, and you should continue with individual therapy and any medications recommended by your mental health care providers to support sustained improvement.
Does Insurance Cover Accelerated TMS Therapy?
Accelerated TMS therapy is currently covered by some Medicare plans and some private insurance plans. Coverage continues to expand. Self-pay options are also available.
Hotel Accommodations Near UPMC Western Psychiatric Hospital for Traveling Patients
If you are traveling for care, discounted hotel rates are available near UPMC Western Psychiatric Hospital to make your stay more convenient. View hotel options and rates.
Why Choose UPMC Western Psychiatric Hospital for Difficult-to-Treat Depression?
UPMC Western Psychiatric Hospital UPMC offers the latest treatments in mental health care. Our experts treat different types of depression and can tailor treatment to your needs.
Here are some reasons to choose us for your mental health care:
- Our specialists are board-certified and licensed — Our multidisciplinary team of experts provides leading-edge behavioral health care for people with depression.
- We look at the big picture — We see you as a whole person, not just a set of symptoms. We may recommend a combination of therapies to treat your depression symptoms. These may include medication, psychotherapy, and lifestyle changes.
- We offer cutting edge care, close to home —We are among the first centers in the U.S. to offer accelerated TMS therapy.If you have treatment-resistant depression, this accelerated form of magnetic brain stimulation may be an option.
- You’ll receive expert diagnosis and personalized care —If accelerated TMS therapy is not right for you, you have other options. Your care team can develop a customized treatment plan to reduce your depression symptoms and improve your quality of life.
- Research-driven care — Through our partnership with the Department of Psychiatry at the University of Pittsburgh School of Medicine, we support research that advances the understanding of mental illness and improves patient care. The department consistently ranks first in the nation in psychiatric research funding from the National Institutes of Health.
By UPMC Editorial Staff. Last reviewed on 2026-06-24.
