Researchers at UCLA Health report that delivering transcranial magnetic stimulation (TMS) in an intensive five-day schedule—five sessions per day for five days—was associated with depression symptom improvements comparable to a conventional six-week schedule in a retrospective analysis of 175 patients with treatment-resistant depression. The study also found that some patients who showed little immediate change after the accelerated course improved noticeably in the following weeks.
Transcranial magnetic stimulation (TMS) is a noninvasive treatment that uses magnetic pulses to stimulate targeted brain regions associated with mood, and is commonly used for people whose depression has not improved with antidepressant medications.
A UCLA Health analysis, published in the Journal of Affective Disorders, evaluated whether a condensed schedule could produce results similar to the conventional approach. The study compared outcomes for 175 patients with treatment-resistant depression treated in routine clinical care: 135 received a standard schedule of one session per day, five days a week, for six weeks, while 40 received an accelerated “5x5” schedule of five sessions per day for five consecutive days.
According to UCLA Health, both groups experienced meaningful reductions in depression symptoms, and the researchers reported no statistically significant difference in overall outcomes between the accelerated and conventional schedules.
The report also highlighted a delayed-response pattern in a subgroup of patients who received accelerated treatment. While some showed little improvement immediately after the five-day course, follow-up assessments two to four weeks later found an average 36% reduction in depression scores.
“For patients with treatment-resistant depression, getting to the clinic every weekday for at least six weeks can be a real obstacle,” said lead author Michael Apostol, a Ph.D. student at the UCLA Semel Institute for Neuroscience and Human Behavior. “What this study suggests is that we may be able to offer those same patients a path to meaningful relief in less than one week by condensing 25 TMS treatments over just five days.”
Senior author Dr. Andrew Leuchter, a distinguished professor and director of the TMS Service in UCLA’s Department of Psychiatry and Biobehavioral Sciences, said that patients in the analysis had not benefited from multiple antidepressant trials but improved with the accelerated schedule, and he urged patients not to assume the approach has failed if they do not feel better immediately after completing five days of treatment.
The researchers cautioned that the work was not a randomized clinical trial, meaning patients were not randomly assigned to receive one schedule or the other. UCLA Health also reported that the conventional six-week schedule performed better on some longer-term measures, and the authors said larger controlled studies are needed to confirm the findings.
UCLA Health noted that TMS has been shown in large studies to reduce symptoms in a majority of patients and that it is covered under most insurance plans for eligible patients. The team also said UCLA is studying TMS for other conditions, including obsessive-compulsive disorder and chronic pain.
