TMS Therapy in Manhasset, NY: Depression Treatment That Reaches the Brain Directly, Not Through the Bloodstream

Standard TMS — the original repetitive transcranial magnetic stimulation, or rTMS — is the format with the longest research history and the widest insurance coverage. It runs as one session per weekday for roughly six weeks, followed by a taper phase.

Each visit delivers high-frequency 10 Hz magnetic pulses to your left DLPFC. Session by session, the stimulation restores normal activity in the previously underactive region. Individual sessions last 19 to 37 minutes depending on your specific protocol.

You’ll receive 3,000 magnetic pulses per session. Across a full 36-session course, the cumulative total exceeds 100,000 pulses — the level of stimulation required for durable neural change.

Treatment Schedule:

• One session per day, Monday through Friday
• Six weeks of daily treatment (30 sessions)
• Six additional “booster” sessions over three weeks
• 36 total treatments

Session Experience: You’ll sit in a comfortable chair while we position the TMS coil against your scalp. The device delivers magnetic pulses that feel like tapping on your head. Most patients read, watch videos on their phone, or simply relax during sessions. You’re awake and alert throughout.

Timeline for Results: Most patients begin noticing improvement within two to four weeks. Benefits typically continue building throughout the treatment course and often persist for months to years after completion.

Accelerated TMS collapses the six-week standard course into a single work week by delivering multiple sessions per day. Our protocol runs 50 total sessions across five consecutive days, adapted from the Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT) framework — the research approach that reshaped how rapidly depression can be treated.

The format works well for patients who need faster results, can dedicate a full week, or have completed standard TMS with limited response.

Stanford researchers built SAINT after recognizing that six weeks was often too long a treatment window for severely depressed or acutely suicidal patients. Their approach uses intermittent Theta Burst Stimulation (iTBS), a newer TMS format that delivers therapeutic pulses in dense bursts. Each iTBS session takes about three minutes rather than the 19 to 37 required for standard TMS, but clinical outcomes match.

A 2024 meta-analysis in BMC Psychiatry reviewed the accelerated TMS literature and confirmed substantial depression score reductions after treatment, with no meaningful difference in outcomes between accelerated and standard protocols. Sustained benefit was documented at follow-up.

Stanford’s original SAINT trial reported response rates near 90 percent and remission rates near 80 percent in treatment-resistant patients. A pragmatic 2024 pilot study in Brain Stimulation using a real-world accelerated protocol reported 70 percent response and 55 percent remission at four-week follow-up, with effect sizes almost three times what’s classified as “large.”

Treatment Schedule:

• 10 sessions per day for 5 consecutive days
• Sessions spaced approximately one hour apart
• 50 total treatments completed in one week
• Each iTBS session takes approximately 3 minutes

A Typical Treatment Day: You’ll arrive in the morning and receive your first session. After each treatment, you’ll have about 50 minutes before your next session. Many patients work on laptops, make phone calls, read, or relax between sessions. Lunch is taken between sessions. You’ll finish in the late afternoon.

The five-day schedule typically runs Monday through Friday. You’ll need to arrange transportation for the treatment week since we recommend not driving during the intensive treatment period.

Timeline for Results: Many patients notice improvement within the first few days of treatment. Research shows depression scores typically decrease progressively each treatment day. Benefits are often well-established by the end of the five-day protocol and maintained at follow-up.

One-Day TMS (ONE-D) delivers full TMS treatment across a single day using 20 iTBS sessions alongside medications that enhance neuroplasticity. This is the fastest TMS format available.

The ONE-D protocol builds on the same iTBS foundation as accelerated TMS but compresses the treatment window further. You’ll receive 20 iTBS sessions spaced across a single day, timed to allow adequate response intervals between each stimulation.

Two neuroplasticity-enhancing medications are administered during the day to temporarily heighten your brain’s capacity to form new connections. The goal is to maximize the plastic changes TMS produces during a brief, intensive treatment window.

One-day protocols represent the current frontier of TMS research. The ONE-D combination isn’t yet FDA-approved as a specific protocol, though its underlying components are established. Research has shown that multiple daily sessions are safe and effective, neuroplasticity-enhancing medications can meaningfully augment TMS effects, and compressed protocols can produce rapid improvement.

Early data from single-day intensive protocols is promising, though this approach has less long-term follow-up data than standard or five-day accelerated formats.

You’ll meet with a member of our psychiatric team for a full evaluation. Your treatment history, current symptoms, and treatment goals get reviewed to confirm TMS is appropriate and to identify the right protocol format. For standard TMS, we handle insurance verification and prior authorization end-to-end.

Session one includes motor threshold determination — the calibration step that identifies the minimum magnetic intensity needed to activate your motor cortex. That individualized calibration ensures treatment is precisely matched to your neural responsiveness.

You’ll settle into a comfortable chair with the coil positioned against your scalp. The magnetic pulses feel like firm tapping. The sensation is unfamiliar at first, but nearly every patient adjusts within the first session or two. You remain awake and alert throughout.

TMS has an excellent safety profile compared to psychiatric medications. The most common side effect is mild scalp discomfort or headache during or shortly after treatment, which typically responds to over-the-counter pain relievers and often diminishes as the treatment course progresses.

Unlike antidepressants, TMS doesn’t cause weight gain, sexual dysfunction, emotional blunting, or withdrawal. It’s safe for elderly patients and doesn’t create drug interactions.

Our practice is led by board-certified psychiatrists, unlike TMS centers run primarily by non-psychiatric clinicians. Diagnostic clarity comes first, so the recommendation you receive reflects real clinical fit rather than defaulting to the service the clinic happens to offer.

TMS is one tool in our comprehensive treatment toolkit. If TMS alone doesn’t provide complete relief, we can add medication management, therapy, ketamine treatment, or other approaches without referring you elsewhere. Your care stays coordinated under one roof.

We’re one of the few practices offering standard, accelerated, and one-day TMS protocols. Whether you need insurance-covered treatment that fits around work or the fastest possible results, we have an option for you.