UCLA study suggests accelerated TMS may ease treatment-resistant depression in five days, but follow-up timing matters

Researchers at UCLA Health say an accelerated form of transcranial magnetic stimulation, or TMS, may deliver comparable symptom relief for some people with treatment-resistant depression in just five days. The approach aims to reduce the practical burden of the standard schedule, which typically requires daily weekday visits over six to eight weeks.

TMS is a noninvasive brain stimulation therapy that uses magnetic pulses to target regions involved in mood regulation. It is commonly offered when patients do not improve after multiple antidepressant trials, and it has become a widely used option in outpatient psychiatric care.

A five-by-five TMS schedule

In the study, clinicians compared a compressed protocol known as 5×5, meaning five sessions per day for five consecutive days, with a conventional six-week course. The analysis included 175 patients, with 40 receiving the accelerated format and 135 receiving standard treatment.

Both groups saw significant reductions in depression symptoms, and overall outcomes were not meaningfully different between schedules. The findings were published in the Journal of Affective Disorders, and the authors noted the results could expand access for patients who struggle to attend weeks of appointments.

Why follow-up may change results

One key observation was that some patients in the accelerated group did not appear to improve immediately after the five-day course ended. When assessed again two to four weeks later, those individuals showed substantial improvement, with depression scores falling by an average of 36%.

That pattern suggests end-of-week assessments may underestimate the benefit of accelerated TMS for certain patients. The researchers said timing could be important when clinicians and patients decide whether a short course is working.

What the study did not prove

The researchers cautioned that the comparison was not a randomized clinical trial, meaning patients were not randomly assigned to the accelerated or standard schedule. They also reported that the traditional course performed better on some longer-term measures, underscoring the need for larger controlled trials.

Even so, the team argues that a shorter TMS pathway could help more eligible patients start and complete care, especially those facing transportation, work, or caregiving barriers. Further research is expected to refine who benefits most, and whether booster sessions after a short course improve durability.