At the 2024 Fall Psychiatric Symposium, international expert on Transcranial Magnetic Stimulation Dr. Jonathan Downar spotlighted groundbreaking developments in transcranial magnetic stimulation (TMS). Among the most discussed was the SAINT protocol (Stanford Accelerated Intelligent Neuromodulation Therapy), which condenses treatment into 10 sessions per day over five days—achieving outcomes equal to or better than the standard 36-session FDA-approved course.
Dr. Downar introduced an even more accelerated approach: a one-day protocol delivering 20 intermittent theta burst sessions (3 minutes, 10 seconds each at 50 Hz), spaced 30 minutes apart. Patients receive a pretreatment combination of d-cycloserine and 20 mg Vyvanse to enhance neuroplasticity. Early results suggest this may be the most significant advance in TMS in years, with rapid adoption worldwide.
Collaborating with Dr. Charles Hayden in Huntsville, Alabama, we refined the protocol for practicality and patient comfort—splitting sessions across two days and extending intervals to 50 minutes to reduce anxiety. Our initial cases show remarkable outcomes, including one patient achieving a 50% reduction in depression scores within two weeks after failing conventional TMS, ECT, ketamine, and multiple antidepressants.
As this is an off-label protocol, insurance coverage is not available; however, costs remain substantially lower than a full 36-session course. For details or referrals, please contact our clinic. We welcome collaboration and discussion on these exciting new frontiers in TMS.
