TMS for depression that hasn't responded to medication
When two or three antidepressants have come and gone without much to show for it, the answer is rarely a fourth. Transcranial magnetic stimulation treats depression directly, without medication and without sedation. Our program delivers an FDA-cleared accelerated course over a single week in Bryn Mawr — twenty-five brief sessions across five days — with psychiatric care and therapy in the same practice.
When TMS is worth considering
Antidepressants haven't worked
Two or more adequate medication trials without meaningful, durable improvement.
Side effects are the limiting factor
Weight change, sexual side effects, blunting, or sedation that made otherwise effective medication untenable.
Partial response that stalled
You improved somewhat and then plateaued short of feeling like yourself.
Anxious depression
Depression carrying a heavy anxiety component, where sedating medication trades one problem for another.
Recurrent episodes
A long history of relapse where you want an option that is not another prescription.
Adolescents 15+ and adults
TMS is FDA-cleared for major depressive disorder in patients 15 and older; our practice treats adolescents 16+ and adults.
What the week looks like
- 1
Consultation and suitability review
A psychiatric evaluation that examines your treatment history in detail, confirms the diagnosis, and screens for the conditions that make TMS inadvisable.
- 2
Mapping and motor threshold
Before the course begins, we locate the treatment target and calibrate stimulation intensity to your individual threshold.
- 3
Five days of treatment
Five brief stimulation sessions per day across five consecutive days — twenty-five sessions in total — with breaks between sessions.
- 4
Structured follow-up
Symptom measures and clinical review after the course, so response is tracked rather than assumed.
- 5
Continuity afterward
Medication and therapy continue in the same practice, which is how gains are protected rather than lost to a handoff.
Honest about the evidence
TMS is well established for major depressive disorder and the equipment and stimulation parameters we use are FDA-cleared. Accelerated scheduling is a newer application, and while research — including work from Stanford — is encouraging, it is still developing. We tell you what is known, what is not, and what that means for your particular history before you decide.
Frequently asked questions
What is TMS for depression?+
Transcranial magnetic stimulation uses focused magnetic pulses to stimulate a region of the brain involved in mood regulation. It is non-invasive, requires no anesthesia or sedation, and does not cause the memory effects associated with electroconvulsive therapy. You are awake and can return to your day afterward.
Who is TMS for?+
TMS is typically considered for depression that has not responded adequately to medication, or for patients who cannot tolerate antidepressant side effects. It is FDA-cleared for major depressive disorder, including in adolescents 15 and older. We evaluate suitability individually rather than by checklist.
What does the accelerated course look like?+
Our program delivers an FDA-cleared accelerated course over one week: five brief stimulation sessions per day across five consecutive days, twenty-five sessions in total. That compresses a course that traditionally spans about six weeks of daily visits.
Is the accelerated schedule as well established as traditional TMS?+
The technology and stimulation parameters are FDA-cleared, and MagVenture protocols allow 2–10 sessions daily over five or more days. Research on accelerated scheduling — including Stanford's work — is encouraging but still developing. We review the evidence honestly with you rather than overstating it.
Does TMS hurt?+
Most patients describe a tapping sensation on the scalp. Scalp discomfort and mild headache are the most common side effects and usually fade after the first day or two as the scalp accommodates. Coil positioning and intensity are adjusted for tolerability.
How soon might I notice a difference?+
Some patients report shifts in sleep, energy, or reactivity within days of finishing; for others, change unfolds over the following weeks. We schedule structured follow-up so response is tracked rather than assumed, and we are candid that not everyone responds.
Do I stop my medication during TMS?+
Usually not. TMS is generally delivered alongside existing treatment, and because we manage your medication in the same practice, any changes are made deliberately rather than as an afterthought.
Can I keep working during the week of treatment?+
Many patients do. Sessions are brief and clustered, so the week is demanding but workable — with up to five workdays affected, compared with roughly six weeks of daily appointments in a traditional course.
Can patients from outside the Main Line do this?+
Yes. Because treatment is delivered in a single week in our Bryn Mawr office, patients traveling from Philadelphia, elsewhere in Pennsylvania, or New York can plan a short stay. Evaluation and follow-up can be virtual.
Does insurance cover TMS?+
We are an out-of-network concierge practice and provide superbills for possible out-of-network reimbursement. Coverage for accelerated protocols varies by plan, and we will be straightforward with you about what to expect before you commit.
Find out whether TMS fits your history
Send a short note and our clinical coordinator will arrange a consultation to review your treatment history and candidacy.
Start the process