Accelerated Deep TMS: How Two Weeks Compares to Nine Weeks

Accelerated Deep TMS compresses the standard nine-week TMS course into six half-day treatment sessions over two weeks, followed by four weekly follow-up visits. In a published multisite trial, patients on the accelerated protocol reached comparable response and remission rates to the trial’s standard protocol, with a faster median time to remission. Compared with Resiliency’s standard nine-week course, the accelerated schedule means about 80% fewer clinic visits during the acute phase (the first six weeks).

Here is how the two protocols actually compare, session by session.

What Is Accelerated Deep TMS, and How Is It Different From Standard TMS?

Accelerated Deep TMS, sometimes called the SWIFT protocol, delivers multiple BrainsWay Deep TMS sessions per day over a condensed schedule instead of one session a day spread across several weeks. Resiliency uses BrainsWay’s FDA-cleared SWIFT protocol, the same H1 Coil technology used in standard Deep TMS, just delivered on a different timeline.

The core difference is pacing, not the underlying technology:

	Standard Deep TMS	Accelerated Deep TMS (SWIFT)
Sessions per day	1	5
Treatment days	5 days/week for 6 weeks, then 2 days/week for 3 weeks (36 total sessions)	6 half-days over 2 weeks
Follow-up visits	Built into the 9-week course	4 weekly visits after the acute phase
Session length	About 10 minutes	About 9 minutes each
Total clinic visits	30 in the acute phase	6 half-days in the acute phase (about 80% fewer visits)

The acute phase refers to the first six weeks of the standard course (30 sessions at five days a week), or the two weeks of accelerated treatment. Standard-course numbers refer to Resiliency’s nine-week, 36-session course unless the text says otherwise.

Both protocols use the same H1 Coil and the same underlying stimulation target. What changes is how the total dose of stimulation gets delivered: spread across nine weeks, or compressed into six half-days with closely spaced sessions.

Neither protocol requires an MRI or neuronavigation equipment to plan treatment, which is a BrainsWay Deep TMS feature generally rather than something unique to the accelerated version.

That shared feature, along with the H-coil’s design itself, is the subject of its own companion piece covering what makes BrainsWay Deep TMS different from standard, figure-eight TMS machines.

“What changes is how the total dose of stimulation gets delivered: spread across nine weeks, or compressed into six half-days with closely spaced sessions.”

How Many Sessions a Day Does Accelerated TMS Involve?

Patients on the accelerated protocol receive five sessions a day, spaced out with rest periods between them, across six half-days over a two-week span. Each session runs about nine minutes, roughly the length of a single standard Deep TMS session. The difference is that several sessions happen in one day instead of one.

A typical accelerated treatment day isn’t five sessions back to back with no break. Sessions are spaced to allow the brain’s response to settle between stimulations, so a half-day at the clinic includes both treatment time and rest time, not continuous stimulation.

After the six half-days are complete, patients return for four weekly follow-up visits. These aren’t optional add-ons. They’re part of the protocol that produced the outcomes described in the next section, and skipping them changes what a patient should expect from the results.

For patients who’ve been through standard Deep TMS before, the biggest practical difference isn’t the five-sessions-a-day pace itself. It’s that the entire acute phase is finished in two weeks instead of six, which is the tradeoff this treatment is built around.

Does Accelerated TMS Work as Well as Nine Weeks of Standard TMS?

A published multisite, randomized non-inferiority trial, the largest controlled study of an accelerated Deep TMS protocol to date, compared the accelerated protocol directly against a standard Deep TMS protocol in 104 adult patients with depression across eight sites. Depression scores, measured on the Hamilton Depression Rating Scale, improved by 19.02 points in the accelerated group and 19.79 points in the trial’s standard group, a difference the trial’s non-inferiority design treats as clinically comparable rather than a meaningful gap.

The trial’s standard arm was not the same as Resiliency’s standard course. It ran five days a week for four weeks, then two days a week for two weeks: about 24 visits over six weeks. Resiliency’s standard course runs 36 sessions over nine weeks. The trial results below therefore compare SWIFT with the trial’s standard protocol, not with Resiliency’s course or with standard TMS in general.

The accelerated protocol doesn’t just pack more stimulation into less time. It uses intermittent theta burst stimulation, a different pulse pattern than the once-daily protocol typically uses, delivered with specific rest intervals between sessions that the trial protocol was built around. That spacing is part of why the published outcomes held up. The accelerated schedule isn’t simply a compressed version of standard dosing. It’s a protocol designed and tested as its own treatment course.

Response and remission rates told the same story. The accelerated protocol achieved response and remission rates in the same range as the trial’s standard protocol, and the median time to remission was about a week faster with the accelerated course (21 days versus 28). Neither protocol relied on fMRI or neuronavigation equipment to plan treatment.

A second manuscript from the same research program looked specifically at patient-reported outcomes rather than clinician-rated scores, comparing how patients themselves described their symptom changes and quality of life after accelerated versus standard treatment. That patient-reported data matters because clinician rating scales and a patient’s own sense of improvement don’t always move together, and researchers increasingly want both measured rather than relying on one alone.

In BrainsWay’s multisite trial, patients on the SWIFT protocol showed an 87.8% response rate and a 78% remission rate on the Hamilton Depression Rating Scale. These are the trial’s results, not Resiliency’s own patient outcomes.

Non-inferiority doesn’t mean identical. It means the trial was specifically designed to test whether the faster protocol loses meaningful ground compared to the established one, and in this case, it didn’t. That’s a different (and more rigorous) question than simply asking whether accelerated TMS “works,” and it’s why the comparison matters more than either number in isolation.

How Long Do Accelerated TMS Results Last?

BrainsWay presented 12-month durability data from the same trial population at the Clinical TMS Society’s annual meeting, following patients who had enrolled in the original accelerated-versus-standard comparison. The preliminary analysis found remission rates holding above 80% at one year, with a reported decline in severe functional impairment from 85% at baseline to 0% at follow-up, and found that the durability pattern held for both the accelerated and standard groups, not just the accelerated one.

“Severe functional impairment” in that data refers to how much depression was interfering with daily functioning, work, relationships, and basic routines, not just a symptom checklist score. A decline from 85% to 0% describes a shift from most of the study population struggling significantly with daily life to, a year later, essentially none of them being severely impaired by their symptoms.

That last point matters for how to read this data. The preliminary data describes durability as a feature of Deep TMS generally, not something unique to the accelerated timeline. In other words, the data doesn’t say accelerated TMS results last longer than standard TMS results. It says that however durable Deep TMS results are, that durability showed up in both protocols at a similar rate.

“The preliminary data doesn’t say accelerated TMS results last longer than standard TMS results. It says that however durable Deep TMS results are, that durability showed up in both protocols at a similar rate.”

How any individual patient’s results hold up depends on factors the published trial data can’t predict for a specific person: diagnosis, treatment history, and what happens after the acute treatment phase ends. That’s a conversation for a patient’s own evaluation, not something a national trial average can answer for everyone.

Is Accelerated TMS Covered by Insurance, and What Does It Cost?

Standard Deep TMS has an established insurance pathway at Resiliency, including CalOptima and Medi-Cal. Accelerated TMS is newer to the insurance landscape, and coverage is less consistent plan to plan than it is for the standard protocol. Patients considering the accelerated option should ask directly about their own plan’s policy rather than assuming the standard-protocol coverage automatically carries over.

When insurance coverage is a possibility, Resiliency verifies benefits for the accelerated protocol the same way it does for Spravato and standard Deep TMS: directly with the patient’s plan, before scheduling, rather than after a patient has already committed to a start date. Because accelerated TMS coverage varies so much by plan, that verification step carries more weight here than it does for standard Deep TMS, where coverage is more predictable.

Resiliency’s accelerated TMS program is priced at $9,000 for patients paying out of pocket, which covers the full six-half-day course and the follow-up visits. That figure comes from the practice’s own published pricing, not a national estimate, since self-pay costs for accelerated protocols vary significantly by clinic and region.

For patients weighing the cost against nine weeks of standard treatment, the honest comparison isn’t just dollars. It’s $9,000 and two weeks against a treatment course that may be more fully covered by insurance but takes nine weeks and five times as many clinic visits in the acute phase. Which one makes sense depends on how much a patient’s plan covers, how much time away from work or caregiving responsibilities actually costs them, and how urgently they want the acute treatment phase finished.

Patients who choose the accelerated self-pay option go through the same scheduling sequence as other self-pay patients at Resiliency: a confirmed payment arrangement before a start date is set, not after. For a six-half-day course booked to begin on a specific date, that sequencing matters more than it does for a longer standard course, since there’s less room to adjust once the two-week window is scheduled.

Patients who want to know what their specific plan covers, for either protocol, can call (949) 996-5355 or reach out through Resiliency’s contact page before committing to either timeline.

Who Tends to Choose the Accelerated Option?

The decision usually comes down to time, not symptom severity. Someone managing a demanding job, a caregiving role, or travel from outside Orange County may not be able to clear a recurring slot five days a week for nine weeks, even if standard Deep TMS is otherwise a good fit. Six half-days over two weeks, plus four follow-up visits, is a different kind of commitment: concentrated and disruptive for a short window, rather than spread thin over a season.

Both Newport Beach and San Juan Capistrano offer the accelerated protocol, so the choice of location usually comes down to which office is more practical for two weeks of near-daily visits rather than a difference in what’s available at each site.

Schedule is the reason that comes up most often. As Dr. Stefani LaFrenierre, Resiliency’s founding psychiatrist, describes the patients who choose SWIFT:

“Many patients simply can’t come in five days a week for six weeks. SWIFT becomes much easier to fit into their schedules. The tradeoffs are longer days at the clinic and less predictable insurance coverage. Other patients seek faster relief, and with SWIFT 78% of patients experience remission within the treatment course.”

Others choose it for a different reason: not a scheduling constraint, but a preference to be done with the acute phase quickly and move into whatever maintenance or follow-up care comes next. Standard and accelerated protocols aren’t a better-versus-worse choice clinically. They’re two paths to a similar destination, and which one fits better is mostly a question about a patient’s own schedule, travel distance, and tolerance for a compressed two weeks versus a longer, lighter nine.

Patients on CalOptima or other Medi-Cal plans face the same insurance-variability question as commercial patients when it comes to the accelerated protocol specifically, even though standard Deep TMS and Spravato both have established CalOptima pathways at Resiliency. That’s worth asking about directly rather than assuming accelerated coverage follows the same rules as the rest of the practice’s CalOptima relationship.

Patients traveling from outside Orange County for the accelerated option face a specific logistical question standard treatment doesn’t raise in the same way: where to stay, and how to structure two weeks away from home around five daily sessions. That’s a real planning conversation Resiliency’s team has with out-of-area patients before they commit to a start date, not an afterthought once treatment begins.

Frequently Asked Questions

Patients deciding between the two protocols can call (949) 996-5355 or reach out through Resiliency’s contact page to talk through which timeline fits their schedule and coverage.