A ‘game changer’ for severe depression that cuts treatment time in half
October 20, 2026
Transcranial magnetic stimulation (TMS) has proved to be a very effective non-invasive treatment for people with severe depression who have not had success with medication. But traditional TMS has one significant drawback: time.
Standard TMS treatment usually requires you to come to a clinic five days a week for about six weeks. When you are already dealing with depression or anxiety, finding time for daily in-person appointments on top of work, school, and family responsibilities can be challenging and stressful.
At the Peter O’Donnell Jr. Brain Institute at UT Southwestern, we have spent the past five years helping develop a way to reduce that burden.
A specialized, accelerated form of TMS called the Triple TBS Thirty-Minute Interval protocol allows you to complete treatment in about three weeks instead of six. Rather than receiving one treatment a day, you receive three brief theta burst stimulation (TBS) treatments during each visit, separated by carefully timed breaks.
Based on the results of our research, the accelerated protocol received Food and Drug Administration (FDA) clearance in May 2026.
The benefits for patients are significant: You can spend fewer weeks arranging your life around treatment and potentially improve your quality of life sooner. For doctors, accelerated treatment also means we can help more patients.
We believe this approach can be a game changer in treating severe depression.
What is TMS and how is TBS different?
TMS is a noninvasive treatment that uses magnetic pulses to stimulate specific areas of your brain involved in mood regulation. It has been used for many years to treat major depressive disorder, particularly when antidepressant medications have not provided enough relief.
During treatment, we position a magnetic coil against your scalp. The device delivers magnetic pulses to stimulate brain circuits associated with depression. There is no surgery, sedation, or anesthesia.
Theta burst stimulation is a newer, faster variation of TMS. Both TMS and TBS use the same machine and apparatus, but the magnetic pulses are delivered in different patterns. Traditional TMS typically delivers repetitive stimulation at 10 hertz, or 10 pulses per second. TBS delivers stimulation in rapid bursts patterned after your naturally occurring theta brainwave rhythms.
This pattern allows us to deliver the necessary stimulation much more quickly. While standard TMS sessions can take about 40 minutes, TBS can deliver a clinical dose in just a few minutes.
TBS also appears to increase neuroplasticity, which is your brain’s ability to adapt and change. Depression is associated with decreased neuroplasticity; in simplified terms, the brain of someone with depression may not respond as fully to their environment. By stimulating these networks, our goal is to help restore healthier brain activity.
How does the accelerated TBS protocol work?
During the session, a magnetic coil will be placed over the front left region of the scalp. Once in place, the coil pulses rapidly, providing a gentle electrical stimulus to cells in the outer layer of the brain beneath the coil. As the magnetic pulses are delivered, it’s normal to feel light tapping on the head. Some patients also experience a nonpainful pressure sensation.
With the Triple TBS Thirty-Minute Interval protocol, you will receive three TBS treatments during each visit. Each stimulation lasts about six minutes, with a 30-minute break before the next stimulation.
Altogether, you’ll spend about 90 minutes in the clinic. You will do this five days a week for three weeks – half the duration of standard TMS treatment.
Our research suggests that this interval hits an important “sweet spot” for effectiveness. In developing this protocol, we were thinking about how your brain responds to stimulation and how treatment fits into your life. Neurophysiological research indicates that a 30-minute interval is optimal for increasing the effects of the second and third stimulations.
Are you a candidate for accelerated TBS?
Because accelerated TBS is relatively new, we don’t yet have evidence that certain patients may benefit more from TBS than from traditional TMS.
In general, if you are a candidate for TMS, you’re also likely a candidate for TBS.
This option is primarily intended for people with treatment-resistant depression. This means that your depression has not adequately responded to commonly used antidepressant medications.
Your doctor will review your medical history before recommending TMS or accelerated TBS. Because the treatment generates electromagnetic pulses, certain implanted devices or electromagnetic devices in or around your head can prevent you from safely receiving treatment.
Related: Modern electroconvulsive therapy may help relieve depression when other treatments fail
Are there side effects from accelerated TBS treatment?
TMS and TBS are generally very safe. One advantage of both is that you do not need anesthesia or sedation. You can come to your appointment on your own, and you do not need a recovery period afterward.
Side effects tend to be mild and occur during TBS treatment or for a short time afterward. Some rare side effects include brief headaches, scalp discomfort at the stimulation site, lightheadedness, or tingling or twitching of facial muscles. The only known serious medical risk is a very small chance for seizure activity during the procedure.
Because the treatment works by stimulating your brain rather than circulating medication throughout your body, it does not cause many of the systemic side effects associated with antidepressant medications. Because TBS is new, not all insurance plans currently cover the protocol. Our team can discuss coverage and treatment options with you.
Related: Exploring deep brain stimulation to manage treatment-resistant depression
What’s next for TMS and TBS?
FDA clearance of TBS is an exciting milestone, but we believe there is much more to learn about how we can make transcranial magnetic stimulation faster, more precise, and more effective.
At UT Southwestern, we are continuing to study what happens in your brain during TMS and TBS. We use advanced brain mapping equipment including electroencephalography (EEG) and functional resting-state MRI (fMRI) to better understand the effects of stimulation.
One important area of research is precision. You do not need an MRI or other neuroimaging to receive TBS, which makes this treatment easier to offer to more people. At the same time, we are studying whether neuroimaging could help us identify an even more precise location in your brain to stimulate, potentially improving the effects of treatment.
We are also investigating ways to further optimize TMS for specific groups of patients, including older adults with depression.
Depression can already take time away from your relationships, your work, and the activities that matter to you. Your treatment should not demand more of that time than necessary. By reducing a treatment course from six weeks to three weeks, accelerated TBS can give some of that time back to you.
If your depression has not improved with medication, ask your psychiatrist whether TMS — conventional or accelerated — might be an option for you.
To talk with an expert about TMS or TBS for depression, make an appointment by calling 214-645-8500 or request an appointment online.
