Able Psychiatry

Glossary

What Is Accelerated TMS?

Written by the Able Psychiatry clinical team

Updated September 27, 2026

Accelerated TMS is a way of delivering rTMS with several sessions in a single day, spaced apart by a rest period, so a full course finishes in days rather than weeks. The best-studied accelerated protocol, developed at Stanford and known as SAINT or SNT, was cleared by the FDA as its own device in September 2022.

Key takeaways

  • Accelerated TMS compresses treatment by giving multiple sessions per day with a rest interval between them — it changes the schedule, not necessarily the pulse pattern or targeting method.
  • The FDA’s device database shows the “Magnus Neuromodulation System (MNS) with SAINT Technology” (Magnus Medical, Inc.) received 510(k) clearance on September 1, 2022 — a clearance, not a drug-style “approval,” and it is specific to that device.
  • In the open-label trial that established the SAINT protocol, 19 of 21 participants who completed treatment (90.5%) met remission criteria after 5 days; 19 of 22 (86.4%) met remission criteria in the intent-to-treat analysis.
  • In a later double-blind, sham-controlled trial of the same protocol (renamed SNT), the active-treatment group’s depression scores improved 52.5% on average over 4 weeks, versus 11.1% with sham treatment.

How accelerated TMS works

The Stanford research team built its accelerated protocol by combining three changes to standard theta burst stimulation: more sessions per day, a higher total pulse dose, and — in their specific protocol — individualized targeting guided by resting-state functional MRI (fMRI) rather than scalp landmarks. In the open-label study, participants received “50 iTBS sessions (1,800 pulses per session, 50-minute intersession interval)… delivered as 10 daily sessions over 5 consecutive days at 90% resting motor threshold.” The later double-blind trial used fMRI “to individually target the region of the left dorsolateral prefrontal cortex most functionally anticorrelated with the subgenual anterior cingulate cortex.”

That fMRI-guided targeting step is part of what the FDA cleared for the Magnus Neuromodulation System specifically — it is not a required feature of “accelerated TMS” as a general category. Other accelerated protocols use the same idea of multiple sessions per day, but locate the treatment site using motor threshold and scalp-based measurements instead of a brain scan. Able Psychiatry’s own accelerated, “SAINT-inspired” protocol is one example: it uses a MagStim TMS machine with scalp-based targeting rather than fMRI, delivered as 5 sessions a day over two weeks (50 sessions total) rather than 5 consecutive days.

Types of accelerated TMS

  • SAINT / SNT (FDA-cleared device): the Stanford-developed protocol, cleared by the FDA under the device name Magnus Neuromodulation System (MNS) with SAINT Technology, pairing an accelerated iTBS schedule with fMRI-guided targeting.
  • SAINT-inspired accelerated protocols: clinics may offer a similar multiple-sessions-per-day schedule without the cleared device or its fMRI-guidance step, instead using conventional scalp-based (motor threshold) targeting on a different TMS machine.
  • Accelerated standard rTMS: multiple daily sessions of the standard, non-patterned rTMS pulse rather than theta burst.

Example of accelerated TMS

In the open-label trial that established the SAINT protocol, 22 participants with treatment-resistant depression received 50 iTBS sessions (10 sessions a day, 5 consecutive days), with fMRI-guided targeting of the left dorsolateral prefrontal cortex. One participant withdrew; of the remaining 21, 19 (90.5%) met remission criteria on the Montgomery-Åsberg Depression Rating Scale, and testing “demonstrated no negative cognitive side effects.” The authors called for “double-blinded sham-controlled trials… to confirm the remission rate observed in this initial study.” A later double-blind trial of 29 participants found the active group’s depression scores improved 52.5% on average versus 11.1% for sham — a smaller, interim-analysis sample that supported the protocol’s effect but did not repeat a 90% remission figure.

What people get wrong

“SAINT” gets used loosely online to mean any fast, multi-session-per-day TMS protocol. The FDA clearance, though, covers one specific device and its fMRI-guided targeting method — not the general idea of compressing sessions into fewer days. A clinic can offer an accelerated schedule inspired by that research, at a lower cost, without using the cleared device or the brain-imaging step. Ask any clinic directly which machine they use and how they locate the treatment site.

Accelerated TMS vs. a standard TMS course

Standard TMS course Accelerated TMS
Schedule One session a day, five days a week, over four to six weeks Multiple sessions a day (with a rest interval), compressed into days or about two weeks
Targeting method Scalp/motor-threshold-based fMRI-guided in the FDA-cleared SAINT/SNT device; scalp-based in other accelerated protocols
Evidence base Tested in a large multicentre trial (THREE-D: 205 participants randomized to 10 Hz rTMS, 209 to iTBS) Smaller trials to date (22 participants open-label; 29 in the interim double-blind analysis)

Accelerated TMS trades a longer trial history for a shorter time commitment. The tradeoff looks different depending on whether a given accelerated protocol also includes fMRI-guided targeting or not.

Frequently asked questions

Is “accelerated TMS” the same thing as SAINT?
No. SAINT (now also called SNT) is one specific, FDA-cleared accelerated protocol that pairs a compressed schedule with fMRI-guided targeting. “Accelerated TMS” more broadly just means multiple sessions per day, and can be delivered with or without that specific device or imaging step.

Has accelerated TMS been shown to work?
In the open-label study of the SAINT protocol, 90.5% of participants who completed treatment met remission criteria after 5 days. A later, smaller double-blind sham-controlled trial found a statistically significant benefit over sham at 4 weeks, though further trials were called for to confirm durability.

Does Able Psychiatry use the FDA-cleared SAINT device?
No. Able Psychiatry offers a “SAINT-inspired” accelerated protocol using a MagStim TMS machine with scalp-based targeting, not the fMRI-guided Magnus Neuromodulation System that the FDA cleared. It follows a similar accelerated schedule but is a distinct, self-pay protocol.

The bottom line

Accelerated TMS means multiple sessions a day instead of one, so a course finishes in days rather than weeks. Only one specific version of that idea — the Stanford-developed SAINT/SNT protocol with fMRI-guided targeting — has its own FDA device clearance; other accelerated protocols, including scalp-targeted versions offered by individual clinics, are inspired by that research without being the same cleared device.

Sources

Considering TMS? Read what to expect at a TMS appointment, or learn about TMS treatment at Able Psychiatry in Chicago, including our accelerated, SAINT-inspired protocol.

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