Accelerated TMS & Theta Burst Stimulation (iTBS)

What accelerated TMS is

Standard TMS treats depression with focused magnetic pulses delivered over sessions of roughly twenty minutes. Theta burst stimulation — iTBS — delivers those pulses in a patterned rhythm modeled on the brain's own natural theta rhythms, which compresses an effective treatment session into as little as about three minutes. The FDA cleared iTBS for depression in 2018, and a large head-to-head clinical trial found it comparably effective to standard TMS.

The practical difference is time. A course of TMS involves treatment five days a week over several weeks. With three-minute sessions, that commitment fits around work, school, and caregiving in a way twenty-minute sessions sometimes can't — you can genuinely come in on a lunch break.

Accelerated protocols

Beyond shorter sessions, "accelerated TMS" can also refer to protocols that deliver multiple iTBS sessions per day, shortening the overall course from weeks toward days. This is an active and promising area of depression research — Stanford's SAINT® protocol, which pairs multiple daily theta-burst sessions with individualized targeting, drew wide attention after receiving FDA clearance — and it reflects where the field is moving. Whether an accelerated schedule fits a particular patient depends on their clinical picture and insurance coverage, and it's exactly the kind of question our psychiatrist evaluates person by person.

Who accelerated TMS may fit

iTBS treats the same condition standard TMS treats: depression that hasn't responded adequately to antidepressant medication. It may be an especially practical fit for people whose schedules have kept them from committing to daily twenty-minute sessions — parents, shift workers, students, and anyone commuting from across the Denver metro or the Front Range. During your evaluation, our psychiatrist reviews your history and recommends the protocol that fits your situation; some patients are better served by standard TMS, and honest guidance on that question is part of the evaluation.

What a session is like

An iTBS session at our Aurora clinic works like standard TMS: you're seated and awake, a treatment coil rests against your head, and you feel a tapping sensation during stimulation. There's no sedation and no downtime — you drive yourself to and from every visit. The most common side effects are mild scalp discomfort or a headache early in treatment, which typically fade within the first week. Treatment is delivered on our Magstim® system with the same physician oversight as every service we offer.

Insurance and cost

Standard-schedule iTBS is covered by many insurance plans under the same criteria as standard TMS — generally, documentation that antidepressant medications were tried first. Coverage for multi-session-per-day accelerated schedules varies more between plans. Our team verifies your specific benefits and handles prior authorization before treatment begins, so you know where you stand before anything starts. Consultations are free and no referral is required.

Frequently asked questions