Accelerated TMS Effective for Treatment-Resistant Depression


Depression is one of the most pervasive mental health conditions worldwide, affecting millions of individuals. While traditional treatments such as medication and psychotherapy work for many, there is a significant group of patients who experience treatment-resistant depression (TRD). These individuals struggle to find relief even after multiple trials of antidepressants.

A groundbreaking study has recently explored the effectiveness of accelerated theta burst stimulation (aTBS), a condensed and high-intensity form of transcranial magnetic stimulation (TMS). The results indicate that this new approach could be a game-changer for those who have not responded to conventional treatments.

What is Transcranial Magnetic Stimulation (TMS)?

TMS is a non-invasive brain stimulation technique that has been used for years to treat depression. By using magnetic pulses to stimulate nerve cells in the brain, TMS can help regulate mood, reduce anxiety and alleviate symptoms of depression.

How Does TMS Work?

TMS works by delivering repetitive magnetic pulses to specific brain areas, particularly the left dorsolateral prefrontal cortex, which is responsible for mood regulation. This stimulation encourages neuronal activity in underactive regions of the brain, ultimately helping to reduce symptoms of depression.

Traditional vs. Accelerated TMS (aTBS)

Traditional TMS requires daily sessions over a period of four to six weeks, making it a slow and time-consuming process for patients. However, aTBS condenses this timeline, delivering short bursts of magnetic stimulation that is thought to be in sync with the brain's natural wave pattern. This means patients can see significant improvement in their symptoms within three weeks instead of several months.

Understanding Treatment-Resistant Depression

A third of individuals diagnosed with depression do not experience relief from traditional treatments, leading to treatment-resistant depression (TRD). This can be a frustrating and discouraging experience, but alternative treatment options like TMS and TBS provide new hope.

Why Some Patients Don’t Respond to Antidepressants

There are several reasons why some individuals do not respond to antidepressants:

  • Genetic Factors – Some people metabolize medications differently, making them less effective.
  • Neurobiological Differences – Certain brain structures and functions may contribute to depression resistance.
  • Chronic Stress and Trauma – Long-term stress can alter brain chemistry, making standard treatments ineffective.

Alternative Treatments for Depression

For those with TRD, there are several alternatives beyond medication, including:

  • Electroconvulsive Therapy (ECT) – A procedure using electrical pulses, requires anesthesia.
  • Ketamine Treatment– Shown to provide rapid relief for some patients.
  • Transcranial Magnetic Stimulation (TMS) – A non-invasive and effective outpatient option.

The Study on Accelerated Theta Burst Stimulation (aTBS)

A recent study published in JAMA Psychiatry examined the effectiveness of aTBS in treating treatment-resistant depression. The study aimed to determine whether aTBS could provide faster and more effective relief than traditional TMS.

Research Overview

The research focused on comparing aTBS with a sham procedure to evaluate its impact on depression symptoms. Participants underwent treatment in an outpatient setting, making it accessible and practical for real-world use.

Study Participants and Methodology

The research focused on comparing aTBS with a sham procedure to evaluate its impact on depression symptoms. Participants underwent treatment in an outpatient setting, making it accessible and practical for real-world use.

The study took place between July 2022 and June 2024 and included 89 outpatients with TRD. The participants were randomly assigned to either:



  • Active aTBS Group – Received actual TMS treatment.
  • Sham Procedure Group – Received a placebo treatment that mimicked TMS but did not deliver magnetic pulses.


All participants had a Hamilton Depression Rating Scale (HDRS) score above 16 and had failed to respond to at least one antidepressant trial.

Treatment Duration and Procedure

Patients in the active aTBS group underwent:

  • Three daily TMS sessions, each lasting six minutes and 18 seconds.
  • Two 30-minute breaks between sessions.
  • Total daily treatment time of 78 minutes.
  • 15 weekdays of treatment, totaling 45 sessions.

Results and Effectiveness

The study found that aTBS led to a significant reduction in depression symptoms:

  • Patients who received active aTBS experienced a 55% reduction in their depression scores.
  • 34% of the active treatment group achieved full remission (HDRS score ≤ 8), compared to only 16% in the sham group.
  • The treatment was well tolerated, with only mild side effects reported.

Advantages of aTBS Over Traditional TMS

Shorter Treatment Duration

One of the biggest benefits of aTBS is its efficiency. Traditional TMS requires six weeks of daily treatments, whereas aTBS condenses this into just three weeks.

No Need for Neuroimaging Equipment

Unlike some TMS protocols, aTBS does not require neuroimaging equipment to target the treatment area, making it more accessible for outpatient clinics.

High Success Rate in Remission

The remission rate for aTBS (34%) was more than double that of the sham group (16%), demonstrating that this condensed treatment is highly effective.

Potential Side Effects and Considerations

Common Side Effects

The study reported that aTBS was well tolerated, with only mild side effects, including:

  • Scalp discomfort or pain during treatment.
  • Mild headaches after sessions.
  • Temporary discomfort in the treated area.

Who is an Ideal Candidate for aTBS?

Individuals who may benefit most from aTBS include:

  • Patients diagnosed with treatment-resistant depression.
  • Those who have tried at least two antidepressants with no success.
  • Individuals seeking a non-invasive treatment alternative.

Future of TMS and aTBS in Mental Health Treatment

Expanding Accessibility to Patients

Given its shorter treatment time and high success rate, aTBS has the potential to become a leading treatment for TRD. More clinics worldwide are adopting this protocol, making it accessible to a larger population.

Ongoing Research and Potential Improvements

The study suggests further clinical trials are needed to optimize aTBS parameters and compare its effectiveness to traditional TMS. Future advancements may refine pulse frequencies, treatment durations, and individualized protocols.

Conclusion

The results of this study confirm that accelerated theta burst stimulation (aTBS) is a promising treatment for individuals with treatment-resistant depression. With its short treatment time, high remission rates, and minimal side effects, aTBS is paving the way for more accessible and effective depression treatments. As research in TMS and aTBS continues to evolve, the future of mental health treatment looks increasingly bright for those struggling with TRD.

SHARE pOST:

RECENT POST:

September 5, 2026
Chronic pain and mental health are deeply connected, and treating one without considering the other often leads to incomplete care. When pain lingers for months or years, it can affect mood, sleep, energy, motivation, and the ability to enjoy daily life. At the same time, anxiety, depression, and stress can make pain feel more intense and harder to manage. For many patients, chronic pain is not only a physical experience. It becomes emotional, cognitive, and social too. That is why a whole-person approach matters so much in psychiatry. How pain affects mental health Living with chronic pain can be exhausting. Even when pain is “just there” in the background, it can wear people down over time and make everyday activities feel overwhelming. Common ways chronic pain affects mental health include: Increased depression and hopelessness. Higher anxiety and fear about movement or worsening symptoms. Sleep disruption, which makes both pain and mood worse. Social withdrawal, because pain can limit work, travel, and relationships. Irritability and frustration from feeling misunderstood or dismissed. When pain is constant, it can also change how the brain processes stress. Over time, the nervous system can become more sensitive, making the body more reactive to discomfort and emotional strain. The effort it takes to manage baseline pain on a daily basis reduces our capacity to handle other issues that may come up. This will lower our threshold for managing emotions and reactions in day to day situations. How mental health affects pain The relationship goes both ways. Depression and anxiety do not just happen because of pain; they can also intensify it. When someone is depressed, they may notice: Lower pain tolerance. More focus on discomfort and body sensations. Less motivation to move, exercise, or follow treatment plans. More negative thinking, such as not believing pain can improve. Increased muscle tension, which can worsen physical symptoms. Anxiety can also keep the body in a state of alertness. That stress response may make pain feel sharper, more frequent, or harder to ignore. In this way, the brain and body can get stuck in a cycle that keeps both pain and emotional distress going. Why chronic pain and depression often overlap Chronic pain and depression are often seen together because they share many of the same risk factors. Sleep problems, inflammation, trauma, isolation, and long-term stress can all contribute to both conditions. When pain limits a person’s ability to function, it may also affect self-esteem, identity, and hope for the future. Some people begin with pain and later develop depression. Others start with depression or anxiety and then notice body symptoms becoming more intense. In either case, the conditions can feed into each other and become harder to separate over time. That is why it is important to ask not only, “Where does it hurt?” but also, “How is this affecting your life, mood, and sense of control?” A whole-person treatment approach At Irvine Psychiatry and TMS, we believe chronic pain and mental health should be considered together whenever present. A coordinated approach can improve both emotional well-being and day-to-day functioning. Treatment may include: Psychiatric evaluation to assess depression, anxiety, trauma, sleep, and stress. Medication management when appropriate, especially if mood symptoms are making pain harder to manage. Psychotherapy to help patients cope with pain, reduce distress, and change unhelpful thought patterns. Lifestyle support, including sleep, movement, and routine-building. Coordination with primary care, pain specialists, physical therapy, or other providers when needed. The goal is not to suggest pain is “all in your head.” The goal is to recognize that the mind and body influence each other, and both deserve attention. Therapy strategies that can help Several therapy approaches can be especially useful for people living with chronic pain. Cognitive behavioral therapy can help patients identify unhelpful thought patterns, reduce catastrophizing, and build more realistic coping strategies. Acceptance and commitment therapy can help people focus on values and function even when symptoms are still present. Mindfulness-based strategies can also reduce reactivity and improve the way the brain responds to discomfort. Other helpful tools may include: Relaxation training. Breathing exercises. Pacing activities to avoid overexertion and burnout. Gentle exposure to movement when fear of pain has led to avoidance. Journaling to track pain, mood, sleep, and triggers. These strategies do not erase pain, but they can reduce suffering and help people feel more in control. The role of sleep, stress, and routine Sleep problems are common in both chronic pain and mental health conditions. Poor sleep lowers pain tolerance, increases fatigue, and can make emotions harder to regulate. Stress also plays a major role, since the body’s stress response can heighten tension and pain sensitivity. Building a steady routine can help stabilize both systems. Regular sleep, balanced meals, light movement, and predictable daily structure may seem simple, but they can make a meaningful difference over time. Even small improvements can help break the cycle of pain, exhaustion, and low mood. When to seek help It may be time to seek psychiatric support if chronic pain is affecting your mood, sleep, relationships, or ability to function. You should also consider evaluation if you are feeling hopeless, overwhelmed, anxious, or stuck in a cycle of pain and sadness. Getting help is especially important if: Pain is interfering with work or daily life. You feel socially isolated or unable to cope. You are losing interest in things you used to enjoy. Sleep and energy are getting worse. You have thoughts of self-harm or feel like giving up. You do not need to wait until everything falls apart. Early support can make a real difference. How Irvine Psychiatry and TMS can help Irvine Psychiatry and TMS offers care that recognizes the connection between emotional health and physical symptoms. For patients with chronic pain and depression or anxiety, treatment may include psychiatric evaluation, medication management, psychotherapy, and consideration of neuromodulation options such as TMS when appropriate. If depression has become harder to treat because of chronic pain, or if emotional distress is making pain feel worse, a personalized treatment plan can help. The most effective care is often the kind that sees the full picture instead of treating symptoms in isolation. Chronic pain and mental health are closely linked, but that does not mean patients are stuck. With the right support, it is possible to reduce distress, improve function, and regain a greater sense of control. Treating both the physical and emotional sides of pain can lead to better outcomes and a better quality of life.
August 14, 2026
U.S. mental health care in 2026 is being shaped by three big forces: policy changes, technology, and access pressure. For patients, that means more conversation around insurance coverage, telehealth, integrated care, and faster treatment options like TMS while systems continue to struggle with workforce shortages and uneven access. For Irvine Psychiatry and TMS, this is a timely topic because it lets you connect current news to practical care options like psychiatric evaluation, medication management, psychotherapy coordination, and TMS. Why 2026 feels different Mental health care is not changing in just one area; it is changing across the whole system. Reports this year point to a mix of federal policy shifts, state-level differences, and increased pressure on behavioral health services, which is making access more uneven depending on where a person lives. At the same time, more patients are looking for care that is faster, more flexible, and more personalized. That combination is pushing clinics to rethink how they deliver treatment. It also means patients are hearing more about options that used to feel specialized, such as brain stimulation, virtual care, and collaborative treatment models. Policy and access shifts One of the most important themes in 2026 is access. Policy reports and behavioral health trend analyses show ongoing concerns about funding, insurance parity, and the ability of patients to actually get timely care. Even when coverage exists on paper, administrative barriers still make treatment hard to start or continue. The result is a growing need for clinics that can help patients navigate benefits, prior authorization, and treatment planning. For our practice at Irvine Psychiatry and TMS, that means continuing to do what we’ve always done, guide patients through options like TMS while also helping them understand how their coverage and clinical needs fit together. Telehealth is still evolving Telehealth remains a major part of mental health care in 2026, but it is still being sorted out. Reports point to both its strengths and its limits: it can improve access, especially for follow-up visits and people who live far from care, but it also depends on technology, privacy, and regulation. Some experts are also warning that telehealth needs stronger oversight to avoid misuse and preserve quality care. For many patients, the lesson is simple: telehealth is useful, but it works best when paired with in-person services when needed. Without the option for in person visits, care can be limited. A hybrid model often gives the best balance of convenience and clinical support. Integrated care is gaining ground Another major shift in 2026 is the push toward integrated behavioral health. More systems are trying to bring mental health care into primary care and other medical settings, especially for patients with chronic illness, depression, and anxiety. This matters because we know that mental health symptoms regularly show up alongside pain, sleep problems, diabetes, heart disease, and other long-term conditions. Integrated care reduces fragmentation. Instead of sending patients from one office to another without a clear plan, doctors can coordinate treatment more effectively. That approach can improve follow-through, reduce stress, and make care feel less overwhelming. New treatment conversations Patients are also hearing more about treatment innovation. In 2026, news about faster brain stimulation protocols, new neuromodulation technologies, and emerging psychiatric treatments has made mental health care feel more dynamic. TMS in particular is getting more attention because newer protocols can shorten treatment time and improve precision. This is important for patients with depression who have not improved with medication alone. It also opens the door for a more hopeful conversation: mental health care is no longer limited to just one medication change after another. Why TMS matters in this landscape TMS fits naturally into the 2026 mental health conversation because it addresses several of the biggest pain points in care: time, tolerability, and access to another evidence-based option. Standard TMS has already helped many patients with depression, and accelerated protocols are making it easier to complete treatment in a shorter period. That is especially relevant in a year when patients are looking for efficient care that still feels thorough and medically grounded. At Irvine Psychiatry, TMS is part of a broader treatment strategy, not a standalone solution. It can be a strong option for patients who have treatment-resistant depression, medication side effects, or difficulty with long treatment timelines. You can connect this section to your TMS services page and your homepage for readers who want to learn more or schedule care. What patients should take away The biggest takeaway from 2026 is that mental health care is becoming more complex, but also more flexible. Patients are seeing more choices, more talk about integrated care, and more attention to faster, evidence-based treatments. At the same time, access challenges remain real, which makes supportive, well-organized practices even more important. For patients, that means it is worth asking questions like: What treatment options fit my symptoms and schedule? Is my care team coordinating across therapy, medication, and medical issues? Could TMS or accelerated TMS be a good fit if depression has not improved? How Irvine Psychiatry and TMS can help Irvine Psychiatry and TMS is well positioned to help patients navigate this changing landscape. Whether someone needs help with depression, anxiety, medication management, TMS, or a treatment plan that considers chronic pain or eating concerns, the goal is the same: personalized, evidence-based care. If you want to direct readers to action, you can link to: the Irvine Psychiatry homepage , the TMS Therapy page , and the blog page for more mental health education. Mental health care in 2026 is being reshaped by policy, access, and innovation. The system has major challenges, but patients also have more tools, more awareness, and more treatment options than before. For people struggling with depression or other mental health symptoms, that means there is reason to stay informed and reason to stay hopeful. We are here to help you along the journey.
June 8, 2026
Major Depressive Disorder (MDD) affects millions of people across the United States and worldwide. For many, the path to meaningful improvement can be long, often involving trial-and-error with medications, therapy, or traditional repetitive transcranial magnetic stimulation (rTMS) delivered once daily over several weeks. Now, there is an option that can compress effective treatment into days rather than weeks. MagVenture has received FDA clearance for Accelerated Transcranial Magnetic Stimulation (aTMS), and this development expands the tools Irvine Psychiatry and TMS can offer patients living with MDD. In this article we explain what aTMS is, how it differs from traditional TMS, what a typical treatment course looks like, who may benefit, and how to consider aTMS as part of a comprehensive depression care plan. We’ll also explore the important link between physical pain and emotional pain, because addressing both is the best way to improve outcomes for patients with depression. What is Accelerated TMS (aTMS)? Transcranial magnetic stimulation (TMS) is a noninvasive neuromodulation therapy that uses magnetic pulses to stimulate targeted regions of the brain involved in mood regulation. Conventional TMS protocols typically deliver a single daily session, weekday visits for 4-6 weeks using either high-frequency repetitive TMS (rTMS) or intermittent theta burst stimulation (iTBS). Accelerated TMS applies the same FDA-cleared TMS protocols but compresses treatment by delivering multiple sessions per day across a shorter overall timeframe. Rather than spreading treatment across several weeks, aTMS organizes sessions into a treatment window that usually lasts 5-15 days, depending on the protocol and clinical plan. The goal is the same, normalize dysfunctional circuits associated with depression, but with faster delivery of cumulative stimulation. How accelerated protocols work in practice The new FDA clearance supports a flexible approach clinicians can tailor to a patient’s needs. Typical elements include: Multiple sessions per day: Treatment regimens range from 2 to 10 sessions daily, allowing clinicians to achieve the required dose more quickly. Pulses per session: Each session usually delivers between 600 and 1,800 pulses. Pulses are the individual magnetic stimulations that modulate neural activity. Inter-session intervals: Sessions are separated by 15-50 minutes to allow short recovery windows between stimulations. Overall schedule: The condensed course typically spans 5–15 days, compared with 4-6 weeks for standard daily TMS. Protocol compatibility: aTMS uses the same FDA-cleared rTMS and iTBS protocols already proven effective for MDD. Navigation options: aTMS can be done with or without MRI-guided neuronavigation depending on clinical preference and available equipment. Why accelerate treatment? There are several advantages to accelerated delivery: Speed of symptom relief: For many patients, faster symptom reduction is a critical clinical and practical benefit. In acute situations such as severe depression with suicidal thoughts or marked functional decline a faster-acting therapy can be lifesaving. Reduced burden of time: Condensing treatment into days reduces the duration of repeated clinic visits over months, which can be a major barrier for people with busy schedules, caregiving responsibilities, or transportation challenges. Improved adherence: Shorter overall treatment windows can increase the likelihood patients complete the recommended course, which supports better outcomes. Rapid response for nonresponders: aTMS may be advantageous for patients who have not responded to medication trials or who need quicker evaluation of a neuromodulation strategy. Who is a candidate for aTMS? aTMS is intended for adults diagnosed with Major Depressive Disorder who are appropriate candidates for TMS. Potential candidates include: People with moderate-to-severe depression who did not achieve adequate response with antidepressant medications or psychotherapy. Individuals who need a faster approach due to symptom severity or life circumstances. Patients who prefer a short, intensive course rather than daily visits for several weeks. As with all medical treatments, candidacy is determined through a comprehensive clinical assessment that considers medical history, psychiatric comorbidities, seizure risk, presence of metal implants, and concurrent medications. At Irvine Psychiatry, we follow evidence-based screening protocols to ensure safety and maximize likelihood of benefit. Efficacy and safety: what the evidence shows The same stimulation protocols used in aTMS (rTMS, iTBS) have robust evidence supporting their use in MDD. Accelerated protocols are an emerging area of research: studies and clinical experience indicate many patients can achieve meaningful symptom relief faster when aTMS is used, though response varies by individual. The FDA clearance reflects that manufacturers have demonstrated aTMS delivery is safe when performed under specified conditions. Common side effects mirror those of standard TMS: mild scalp discomfort or headache during or after treatment, transient fatigue, and rare risk of seizure (low but present). Clinicians minimize risk by adhering to safety guidelines, choosing appropriate stimulation parameters, and monitoring patients closely during sessions. What to expect during aTMS at Irvine Psychiatry and TMS If you are referred for aTMS, here’s a typical patient journey: Consultation and evaluation: You come into the clinic for a full evaluation. Dr. Creighton reviews your psychiatric history, medication profile, and potential contraindications to TMS. Individualized treatment plan: Based on your clinical presentation, we select rTMS or iTBS protocol, number of daily sessions, pulse counts, and overall schedule. Orientation session: You’ll meet the treatment team, learn what to expect, and undergo baseline assessments of mood and functioning. Treatment days: Sessions last 20-40 minutes each depending on protocol. Breaks of 15-50 minutes occur between sessions. Patients relax in a comfortable chair during treatment and are observed by staff. Monitoring and follow-up: Mood, side effects, and functioning are assessed throughout and after the course to guide ongoing care. Integrating aTMS into comprehensive care aTMS is most effective when integrated into a broader treatment strategy that can include psychotherapy, medication management, lifestyle interventions, and supports for sleep, nutrition, and activity. Rapid improvements from aTMS can create a window in which psychotherapy and behavioral changes become more feasible and effective. Addressing cost and access Insurance coverage for TMS (including aTMS) differs across plans and is evolving. Some payers cover FDA-cleared TMS for treatment-resistant depression under specific criteria. Our administrative team at Irvine Psychiatry and TMS can assist patients with benefits verification, prior authorization where needed, and exploring financing options. When to consider immediate care If you or someone you care about is experiencing active suicidal ideation, severe psychomotor slowing, inability to perform basic self-care, or other signs of a psychiatric emergency, please seek immediate help: call local emergency services or the nearest emergency department.  Accelerated TMS may be part of urgent treatment planning for some patients, but emergency-level care should be the first step when risk is imminent.