One-Day TMS: A Rapid Protocol

One-Day TMS is a form of accelerated TMS that condenses treatment down to a single day. Early research points to excellent and durable results.

What Is One-Day Accelerated TMS?

One-day TMS, also called One-D TMS, is developed from a growing body of research and clinical work in accelerated TMS. The primary launch point for one-day protocols and quoted results is a study, published in December 2024: Real-world effectiveness of a single-day regimen for transcranial magnetic stimulation using Optimized, Neuroplastogen-Enhanced techniques in Depression (ONE-D)

The one-day TMS protocol consists of 20 sessions of iTBS pulses administered over about 10 hours with the use of adjunct medications to enhance neuroplasticity toward increased efficacy.

The results from the limited study are extremely good. Improvement in symptoms is shown to increase in the weeks following the treatment, with a response rate greater than 90% and a remission rate greater than 70% at 12 weeks.

Why choose one-day TMS:

Preliminary, limited data is extremely good.
The approach is consistent with the best-available information across the field.
TMS is flexible – and can be administered in many ways with excellent results – supporting the adoption of different approaches to accelerated TMS.
The treatment protocol is super convenient – down from as many as 8 weeks with conventional rTMS to a single day.

One-Day TMS VS One-Week Accelerated TMS

One-Day TMS:

… also called single-day TMS, or ONE-D TMS.

More recent protocol
Includes the use of d-cycloserine and lisdexamfetamine to enhance neuroplasticity
DLFPC brain target site for depression
20 iTBS sessions in a single day
Approximately 12,000 total pulses
Strong durability following treatment that may be enhanced with maintenance treatments

One-Week TMS:

… often called accelerated TMS, and may also be referred to as SNT or SAINT TMS.

Excellent results
More total pulses delivered — more than conventional rTMS or one-day TMS
DLFPC brain target site for depression
10 iTBS sessions a day, for 5 days
Approximately 90,000 total pulses
Strong durability following treatment that may be enhanced with maintenance treatments

The Dose-Response Relationship of TMS

More TMS sessions, at higher intensities, and delivered closer together appear to yield better results. Accelerated TMS, and one-day TMS specifically, seek to capitalize on this relationship.

A comprehensive review of rTMS for depression shows that more treatment sessions yield great results and that, as stated by one such review, “The additional treatments given to patients with long TMS courses were associated with substantial clinical improvement.” As a rule of thumb then, and in general, the more treatment sessions the better.

Pushing the treatment sessions together is as least as good as slower protocols. With a broad review of accelerated TMS showing results “comparable with once-daily rTMS.” Clinicians and researchers further theorize that more-closely spaced treatments likely yield a greater response. The limited studies in this area to date appear to support that idea.

Accelerated one-week and one-day TMS protocols take advantage of the benefits of the dose-response relationship with more total treatments, more quickly. They also seek to incorporate best-practices that are likely to improve treatment outcomes even further. These include the use of higher-tolerated intensities of the electromagnetic pulses and the addition of adjunct medications for neuroplasticity.

TMS is flexible

It is possible to deliver TMS in a great variety of ways and see good results. Many published protocols with good success rates use different pulse settings, different frequencies, different intensities, different adjunct medications or therapies, different coil geometries, different target locations, different placement techniques, and more! It may even be fair to say that protocols in studies for accelerated TMS tend to be more different than similar. A comprehensive 2023 review of accelerated TMS in Nature’s Neuropsychopharmacology highlighted “notable variability across the majority of studies.”

This flexibility means that you are likely to see good results with a variety of approaches. It is possible to see reduction and remission even from stubborn and treatment-resistant symptoms of depression and other mood disorders and conditions across a spectrum of approaches.

Some approaches to TMS will be better than others. This is true with respect to results we might see, but also in consideration of time commitment, cost, and other important factors.

One-Day TMS is An Excellent Option

It is worth looking for the best practical combination for your needs. The information we have suggests that conventional rTMS is very good, and that accelerated TMS appears to yield far better results in less time. Within accelerated TMS, one-week or SAINT-type protocols have strong demonstrated efficacy in studies to date, and one-day or ONE-D protocols are emerging as an extremely promising and extremely convenient approach.

About Us

Wells Medicine is a Houston-based practice designed to provide meaningful care for mental health. Providing targeted interventional treatments for Depression, Anxiety, OCD, PTSD and other conditions, with Ketamine Treatments, Stellate Ganglion Blocks, TMS, and Nitrous-Oxide Treatments. Focused on comprehensive care and integration with Psychiatry, Psychology, and Support Services. We are evidence-based, patient-focused and mission-driven.

The content here is for informational purposes and should not be relied upon for medical decisions. For the details of your specific medical conditions and treatments consult your doctors or other qualified healthcare professionals.

One-Day TMS