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Accelerated TMS: Can Depression Treatment Really Be Done in One Week—or One Day?
If you’ve been researching TMS for depression, you may have come across terms like SAINT, SNT, accelerated TMS, one-week TMS, or one-day TMS.
They can sound like different names for the same thing. They aren’t.
"Accelerated TMS” is a broad category of treatment approaches that deliver more than one TMS session in a day. And right now, there is no single universally accepted accelerated protocol.
That is actually one of the most interesting things happening in TMS research.
SAINT Helped Pioneer Accelerated TMS
SAINT, developed at Stanford, was one of the major breakthroughs that brought accelerated TMS into the spotlight. Instead of spreading treatment across six or more weeks, SAINT condensed an intensive course of TMS into five days. Early studies showed striking results, and the approach ultimately received FDA clearance.
That was important not only because of SAINT itself, but because it challenged a long-standing assumption:
Do TMS treatments really have to be spread out over weeks?
Since then, researchers around the world have been trying to answer a much bigger question: What is the “secret sauce” that makes accelerated TMS work?
Accelerated TMS Is Now a Whole Family of Protocols
There are now many versions of accelerated TMS being studied and offered clinically. They can differ in almost every meaningful treatment variable:
standard 10 Hz TMS versus theta burst stimulation
individualized MRI-based targeting versus more pragmatic targeting methods
three, five, six, eight, or ten treatments in a day
different amounts of time between treatments
different numbers of pulses per treatment
different total numbers of treatments
treatment courses lasting one day, several days, or a full week
That makes “accelerated TMS” less like the name of one treatment and more like the name of a developing treatment strategy:
Can we safely and effectively deliver the therapeutic dose of TMS over a much shorter period of time?
And if we can, what is the best way to do it?
Researchers Are Trying to Find the Parts That Matter Most
SAINT combined several things at once: individualized targeting, theta burst stimulation, a high number of treatments per day, and a very specific spacing schedule. But when a treatment works, that creates a new scientific problem:
Which parts of it were actually necessary?
Does accelerated TMS need individualized fMRI targeting?
Does it need theta burst stimulation?
Does it need ten sessions per day?
How important is the interval between sessions?
Does the brain respond differently to six treatments in a day versus ten?
Is the total number of pulses more important than the exact pattern used to deliver them?
Could standard 10 Hz TMS also be effectively accelerated?
Those questions are now being tested rather than assumed.
Different Accelerated Approaches Are Showing Promise
The research increasingly suggests that SAINT is not the only way to successfully accelerate treatment.
For example, a 2026 multicenter randomized trial evaluated an accelerated approach using the H1 coil and five theta-burst treatments per day. The accelerated treatment was noninferior to conventional once-daily treatment at the primary endpoint, while patients receiving accelerated treatment improved and reached remission more quickly.
This was not the SAINT protocol.
It used a different device, a different treatment schedule, and a different approach to targeting.
That matters because it adds to a growing body of evidence suggesting that the broader concept of accelerated TMS may be valid even when the exact recipe changes.
The field is moving from:
“Does SAINT work?” to:
“Which accelerated approaches work, and which treatment parameters matter most?”
New Chapter Is Helping Study That Question
At New Chapter TMS, we aren't just watching that research develop. We're participating in it!
New Chapter is completing participation as one of the clinical sites in a nationwide multi-center research trial studying a different model of accelerated TMS for depression.
The trial uses a particularly pragmatic approach:
standard 10 Hz TMS
3,000 pulses per treatment
the traditional 36-treatment course
multiple treatment sessions each day
all 36 treatments completed over five days
In other words, rather than changing the basic treatment itself, the study asks what happens when a familiar 36-session course of 10 Hz TMS is dramatically compressed. Instead of approximately six weeks of once-daily treatment, patients receive the same number of treatment sessions across one intensive week.
And importantly, the study doesn't stop measuring outcomes when that week ends. Participants are followed for six months after treatment. That long-term follow-up is critical, because one of the biggest questions in accelerated TMS is not simply:
Can people improve quickly?
It is also:
Do those improvements last?
Because the study is still being completed, we give information about the results yet. But the trial is part of a much larger effort in the field to determine which accelerated treatment approaches are effective, practical, and durable. We are especially proud that patients treated here in Spokane are contributing directly to worldwide TMS knowledge.
So What Does “Accelerated TMS” Mean for a Patient?
For now, it means you need to ask a few more questions. If a clinic says it offers accelerated TMS, that tells you the treatment is being delivered more frequently than traditional once-daily TMS.
It does not tell you exactly what protocol you will receive.
Two accelerated programs can differ substantially.
Before choosing one, it is reasonable to ask:
What type of TMS are you using? Is it standard high-frequency TMS, theta burst stimulation, or another form?
How many treatments will I receive?
How many are given each day?
How much time is there between treatments?
How is the treatment location determined?
What research supports this particular protocol?
What happens after the accelerated week is finished?
A provider should be able to answer those questions clearly.
What We Offer at New Chapter
At New Chapter, we offer both one-week and one-day accelerated TMS options.
One-week accelerated TMS
Our one-week program uses a pragmatic approach similar to the model being studied in the multicenter research trial:
NeuroStar TMS standard 10 Hz left-sided stimulation
3,000 pulses per treatment
36 total treatments
6–8 treatments per day
approximately one hour between treatments
treatment completed over five days
We use scalp-based targeting methods for treatment rather than individualized fMRI targeting.
One-day accelerated TMS
We also offer a single-day accelerated treatment option for patients who need an even more condensed approach. Rather than attempting to reproduce an entire traditional 36-session course in one day, this approach delivers multiple TMS treatments over the course of a single intensive treatment day.
It represents another branch of the accelerated-TMS question: how much therapeutic benefit can we achieve when treatment is compressed into the shortest practical timeframe?
A one-day protocol is not interchangeable with our five-day, 36-treatment course, and we discuss those differences with patients when determining which approach makes sense for their situation.
Neither protocol is SAINT. We call them what they are: accelerated TMS.
And we think that distinction—and transparency about exactly what treatment someone is receiving—matters.
The Bottom Line
SAINT was a pioneer in accelerated TMS and helped prove that depression treatment does not necessarily have to follow the traditional once-a-day-for-six-weeks model. But it didn't end the conversation. It started one.
Researchers are now testing different combinations of stimulation type, dose, targeting, spacing, and treatment schedules—from intensive single-day approaches to multi-day and week-long protocols—to figure out which components matter most.
In other words, the field is still trying to find the secret sauce.
Some accelerated approaches may ultimately work better for certain patients than others. Some may prove easier to deliver, more affordable, or more durable. And some questions may take years of careful research to answer.
What matters right now is transparency.
If you're considering accelerated TMS, you should know exactly what protocol you're receiving, why your provider uses it, and what evidence supports it.
At New Chapter, we're excited not only to offer both one-day and one-week accelerated treatment options, but to be directly involved in the research helping determine what the next generation of accelerated TMS will look like.
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