What Is the Duration of TMS Therapy?

For many people considering transcranial magnetic stimulation (TMS) as a treatment option for depression or other mental health conditions, one of the most common questions is, “How long will it take?” Understanding the time commitment of this innovative therapy is crucial because it helps plan the recovery journey. Whether you are exploring TMS for the first time or have been recommended this treatment by your healthcare provider, knowing what to expect in terms of duration can help you make an informed decision about your mental wellness. Overall, the course of TMS therapy may take anywhere from 5 days to 8 weeks, plus follow-up sessions if necessary. Let’s explore the available options that might suit your individual needs.

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TMS Treatment Duration for Different Disorders

Major Depressive Disorder

rTMS

The traditional rTMS protocol typically involves 20-30 treatments (1 session five days per week for 4-6 weeks), delivering magnetic pulses to the left dorsolateral prefrontal cortex (DLPFC). This standard method usually includes 3,000 pulses per procedure, with patients receiving approximately 60,000 pulses throughout therapy. The rTMS approach has been well-studied and has demonstrated consistent efficacy in addressing treatment-resistant depression, with response rates typically ranging from 40 to 60%.

Deep TMS

This type of TMS therapy utilizes a unique H-coil design to reach deeper brain structures than traditional rTMS. Treatment sessions are typically shorter, lasting about 20 minutes, with the total number of procedures being 20-30. The schedule is divided into two periods:

Active Phase (Weeks 1-4) – 5 sessions per week
Maintenance Period (Weeks 5-9) – 2 procedures weekly

The H-coil’s broader and deeper stimulation field may provide more comprehensive coverage of the DLPFC and connected regions, offering significant advantages for patients who have not responded to traditional rTMS treatment.

TBS

TBS is an accelerated form of TMS that delivers the equivalent stimulation in just 3-10 minutes. The protocol typically involves bursts of three pulses at 50 Hz, repeated at 5 Hz intervals, although these parameters can vary. TBS provides the same therapeutic benefits as traditional rTMS but with less time commitment. This efficiency makes it an increasingly popular choice for patients with busy schedules and wide-ranging responsibilities. One of the most popular iTBS treatments – the SAINT Protocol – involves 10 daily sessions (nearly 10 minutes each, with 50-minute breaks) over 5 days. This intense therapy often leads to significant improvements in depression symptoms and supports mental recovery.

MeRT

MeRT takes a more personalized approach using quantitative EEG to guide treatment parameters. This protocol customizes the stimulation frequency, location, and intensity based on the patient’s unique brain wave patterns. Treatment sessions typically last 30-40 minutes, with the standard course running 5 days weekly for 4-8 weeks (20-40 procedures in total). The individualized nature of MeRT allows for ongoing adjustments throughout the therapy course based on the patient’s brain activity and clinical response.

Obsessive-Compulsive Disorder

rTMS

For OCD treatment, rTMS typically targets the supplementary motor area (SMA) or the orbitofrontal cortex (OFC). Sessions run five days weekly for four to six weeks, and each procedure lasts approximately 20 to 30 minutes. The total number of treatments is 20-30. This approach has shown promising results in reducing OCD symptoms, particularly in cases resistant to traditional therapies. Studies have indicated response rates of more than 50%.

Deep TMS

Deep TMS for OCD is FDA-cleared and uses the H7 coil, which is specifically designed to target the anterior cingulate cortex and medial prefrontal cortex — regions crucial in OCD development. The protocol typically involves 29 sessions with a brief symptom provocation to activate the relevant neural circuits. This unique “provocation and stimulation” approach sets Deep TMS apart from other techniques, with response rates reaching up to 57% in clinical trials.

TBS

TBS protocols for OCD also show promising results. The treatment targets areas similar to conventional rTMS but delivers stimulation in concentrated bursts. Sessions are significantly shorter, lasting 3-10 minutes, making it a more time-efficient option. Current research and practice show that both intermittent and continuous TBS techniques may be effective for OCD.

MeRT

MeRT’s individualized approach involves mapping the patient’s brain activity patterns through qEEG and tailoring stimulation parameters accordingly. This protocol is particularly relevant for OCD, as it can identify and target specific neural networks responsible for obsessive-compulsive symptoms. Treatment sessions typically last 30-45 minutes, and parameters are adjusted based on ongoing EEG measurements. The entire therapy involves 20-40 procedures. The personalized nature of MeRT allows for precise targeting of the irregular brain wave patterns often observed in OCD patients.

Smoking Addiction

rTMS

For smoking cessation, rTMS primarily targets the DLPFC and insula, areas associated with craving and addiction. The protocol typically employs high-frequency stimulation (10-20 Hz) in 20-30 TMS sessions. What distinguishes this therapy from other treatments is its focus on reducing nicotine cravings and enhancing cognitive control over addictive behaviors. It can reduce cigarette consumption and strengthen quit attempts, with some protocols combining stimulation with smoking cues to improve effectiveness.

Deep TMS

Deep TMS for smoking addiction utilizes the H4 coil, specifically designed to reach deeper brain structures involved in addiction circuits, including the insula and limbic system. The protocol often incorporates smoking-related cues during stimulation to target craving responses directly. Nineteen procedures (25-30 minutes each) are performed over 6 weeks. Sessions typically include:

Provocation
18-minute TMS treatment
Brief counseling

Clinical trials have reported success rates of 24-82% in achieving smoking cessation.

TBS

TBS protocols for smoking addiction represent a newer approach, delivering rapid bursts of stimulation to addiction-related brain circuits. The shorter session length (3-10 minutes) makes this treatment particularly suitable for acute craving management. Some protocols combine intermittent and continuous TBS patterns to activate reward centers and inhibit dysfunctional responses. Practice shows that TBS might be especially effective in reducing the immediate urge to smoke when administered during peak craving periods. The number of sessions varies widely, depending on the protocol and patient response.

MeRT

MeRT’s application in smoking addiction focuses on normalizing brain wave patterns associated with addictive behaviors and cravings. The protocol maps individual variations in neural activity related to nicotine dependence and withdrawal. Treatment parameters are adjusted based on how the brain wave patterns change throughout the cessation process. This personalized approach is particularly valuable in addressing the varying addiction severity and withdrawal symptoms among different patients.

Anxious Depression

TMS therapy for anxious depression requires a carefully calibrated approach, as the affected individuals experience both heightened anxiety and depressive symptoms that often interact and amplify each other. Treatment protocols generally extend over 4-6 weeks, with most patients receiving daily procedures five times weekly (20-40). Standard rTMS sessions last 30-40 minutes, while accelerated protocols like TBS can reduce this to 3-10 minutes.

Autism

TMS therapy for autism stimulates nerve cells in specific brain regions associated with social communication and behavior regulation. Most treatment plans consist of 20-30 TMS sessions scheduled over 4-6 weeks, each lasting approximately 30 minutes. While individual responses vary, many patients and families report noticing gradual improvements in social engagement and sensory processing as the therapy progresses.

ADHD

Parents of children with ADHD and patients who develop this condition in adulthood often wonder how many sessions are needed when considering TMS. The initial treatment course typically consists of 20-30 procedures delivered over 4-6 weeks, each lasting nearly 30 minutes. Most protocols follow a five-day-per-week schedule, making them compatible with school or work activities. Some patients may require maintenance procedures after completing the primary treatment phase to sustain improvements.

PTSD

Like other mental health disorders, PTSD requires a carefully structured TMS treatment approach that typically spans 4-8 weeks. The standard protocol consists of daily procedures Monday through Friday, each lasting 20-40 minutes, depending on the specific method used. Most patients with post-traumatic stress disorder complete 30-36 sessions in total, though some may benefit from additional maintenance treatments based on their symptom improvement and individual response.

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Start your search today and take the next step toward effective TMS therapy. Browse our database to compare providers and find the best fit for your mental health needs!