Interventional Psychiatry · Standard Daily Protocol
Standard rTMS
Transcranial magnetic stimulation (TMS) is a non-invasive, FDA-cleared treatment for major depression that uses focused magnetic pulses to activate brain regions involved in mood. Standard rTMS is the original, most-studied schedule: one short session per weekday over several weeks.
How It Works
How TMS works
Depression is linked to reduced activity in the left dorsolateral prefrontal cortex, a region that helps regulate mood and connects to deeper emotional circuits. During TMS, a magnetic coil placed against your scalp delivers brief, focused pulses that induce small electrical currents in that region.
Repeated over a course of treatment, this stimulation strengthens activity and connectivity in mood-regulating networks. Unlike medication, TMS doesn't circulate through your body, so it avoids side effects like weight gain, sexual side effects, or drowsiness.
Why TMS
- FDA-cleared since 2008, backed by years of clinical data
- Non-invasive, no anesthesia, no recovery time
- No systemic medication side effects
- Can be used alongside your current medication and therapy
- Psychiatrist-supervised from evaluation through follow-up
What to Expect
Your course of treatment
- Evaluation. A comprehensive psychiatric evaluation to confirm TMS is appropriate, followed by a TMS safety screen.
- Mapping session. At your first treatment, we find your motor threshold and set the coil position and dose that fit you.
- Daily treatment. One session a day, five days a week, for about six weeks. Sessions take 20–40 minutes with standard stimulation, or about 3 minutes with theta-burst. You're awake and can talk, listen to music, or relax.
- Taper. Sessions are typically reduced over the final weeks to help maintain your gains.
- Progress tracking. Standardized rating scales throughout let you and your psychiatrist see how you're responding.
Candidacy
Who may benefit
- Adults with major depressive disorder who haven't improved enough with at least one antidepressant
- People who couldn't tolerate antidepressant side effects
- Patients who prefer a non-medication treatment
- Those who prefer a steady daily rhythm over a compressed or single-day schedule
TMS is also being studied and used for anxiety, OCD, and other conditions. Ask your psychiatrist whether it fits your situation.
Safety
Side effects and screening
TMS is generally well tolerated. The most common side effects are mild headache and scalp discomfort at the treatment site, which usually improve after the first week. You'll hear clicking during treatment, and we provide earplugs.
Seizure is a rare but serious risk, reduced with careful screening and dosing. TMS isn't appropriate if you have non-removable metal in or near the head, such as aneurysm clips, cochlear implants, or implanted stimulators.
Compare Protocols
Choosing a TMS schedule
We offer three TMS schedules. Your psychiatrist will recommend one based on your history, how quickly you need relief, and how much time you can commit.
| Protocol | Schedule | Sessions | Time in office | Medication add-on | FDA status |
|---|---|---|---|---|---|
| ONE-Day TMS | 1 day | 20 iTBS | ~10–11 hrs in clinic | Single pre-treatment dose | Off-label |
| Accelerated TMS | 1–2 weeks | Up to ~40 iTBS | ~2–4 hrs/day | None | Off-label schedule |
| Standard rTMS | ~6 weeks + taper | ~30–36 | ~20–40 min/day | None | FDA-cleared for MDD |
Schedules are typical; your psychiatrist sets the final protocol. Mindspring Health is self-pay and does not bill insurance — see the Fees page for current pricing. We can provide a superbill for possible out-of-network reimbursement, but reimbursement isn't guaranteed.
Physician-Led Care
Overseen by a board-certified psychiatrist
Dr. A. Umair Janjua, M.D., FAPA, founded Mindspring Health and oversees its interventional psychiatry program. Every interventional treatment is reviewed with you by a psychiatrist before it becomes part of your plan, and monitored and adjusted the same way the rest of your care is.
Common Questions
Frequently Asked Questions
Does TMS hurt?
Most people describe a tapping sensation on the scalp. It can feel uncomfortable at first, but it usually becomes easier after the first few sessions, and settings can be adjusted for comfort.
How long until I see results?
Many patients begin noticing changes around weeks two to four of daily treatment, with continued improvement through the end of the course.
Can I drive and work after a session?
Yes. TMS doesn't require sedation, so you can drive and return to normal activities immediately.
Do I have to stop my medications?
Usually not. Many patients continue their medications during TMS. Your psychiatrist reviews every medication beforehand, especially any that affect seizure threshold.
How long do results last?
Many people maintain their improvement for months or longer. If symptoms return, booster or maintenance sessions are an option.
What's the difference between rTMS and theta-burst?
Both are FDA-cleared ways of delivering TMS. Standard rTMS sessions take 20–40 minutes; theta-burst (iTBS) delivers stimulation in about 3 minutes. Your psychiatrist chooses the approach that fits your plan.
Does insurance cover TMS?
Mindspring Health is self-pay and does not bill insurance directly. Many insurers cover standard TMS for depression when criteria are met, so we can provide a superbill for possible out-of-network reimbursement.
Interventional Psychiatry
Other options we offer
Single-Day Protocol
ONE-Day TMS
A full TMS course in one clinic day.
1–2 Week Protocol
Accelerated TMS
Multiple short sessions per day over 1–2 weeks.
In-Office Infusion
IV Ketamine Therapy
Medically supervised infusion series.
EEG-Guided Neurofeedback
PRISM for PTSD
Medication-free, FDA-cleared PTSD therapy.
Implantable Neuromodulation
VNS Therapy
Long-term option for treatment-resistant depression.
Find out if you're a candidate
Every interventional treatment at Mindspring Health starts with a comprehensive psychiatric evaluation by a board-certified psychiatrist.