Protocol

Accelerated rTMS

Accelerated rTMS in Marylebone, London compresses a course into a small number of days, with several short sessions each day instead of one session a day spread over several weeks.

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Treatment chair at the Naya clinic, UNTIL Marylebone

The short answer

What accelerated rTMS is

An accelerated course delivers a similar total number of sessions in days rather than weeks. That suits people who cannot attend a clinic five afternoons a week for a month, and people who would rather not have treatment stretched across a season of their life.

It is possible because of theta burst stimulation, a pattern of pulses delivered in short high-frequency bursts. A theta burst session can be a few minutes long where conventional stimulation runs much longer, which is what allows several sessions to fit into one day with rest periods between them.

Whether it suits you depends on the condition being treated and on your own circumstances. It is not automatically better than a conventional course, and your clinician will tell you which schedule they would choose for you and why.

Areas treated

Why a compressed course suits some people

A course measured in days rather than weeks, for people who cannot attend across a month
Theta burst sessions are short, so several fit into one day with rest between them
The same measured baseline and the same individually chosen target as a conventional course
Fewer separate trips to Marylebone, which matters if you are travelling in
Non-invasive and drug-free, with no sedation and no overnight stay
A straight recommendation between accelerated and conventional, rather than a default

Patient journey

What an accelerated course involves

Consultation & preparation

Clear the treatment days properly rather than working around them, because you are in the clinic for a block of the day. Bring food, water and something to do in the rest periods. Eat and drink as normal and take your usual medication unless your clinician has said otherwise. Avoid alcohol the night before each treatment day, since it lowers the seizure threshold. Tell us about any metal in your head, any implanted cardiac device and any history of seizure before your first appointment rather than on the day.

During treatment

What accelerated actually means

An accelerated protocol delivers several sessions a day across a small number of days. The total number of sessions is broadly similar to a conventional course; the calendar is what changes. Suitability depends on the condition being treated and on your own circumstances, so it is a decision made at assessment rather than a menu option.

Theta burst patterning

Theta burst stimulation delivers pulses in short high-frequency bursts rather than in an even train. That allows a session to be much shorter while still delivering a comparable dose, and it is the pattern used in most accelerated courses. Rest periods between same-day sessions are part of the protocol, not a scheduling convenience.

Where the published evidence comes from

The strongest published trial of a compressed schedule is Cole, E. J. et al. (2022) Stanford Neuromodulation Therapy (SNT): A Double-Blind Randomized Controlled Trial, American Journal of Psychiatry, 179(2), pp. 132 to 141. That trial ran in treatment-resistant depression and used its own targeting method and its own schedule. A course here is informed by it and is not the same protocol, and we would rather you heard that from us.

What is measured first

Nothing changes about the preparation. Your motor threshold is measured so your dose is calibrated to you. Candidate sites are tested and the one producing the clearest heart-rate deceleration is treated. A NayaScore assessment gives the baseline that later results are compared against.

A day on an accelerated course

You come in for a block of the day rather than for a single appointment. Sessions are separated by rest periods, and you sit awake in a low-lit room throughout. People read or work between sessions. You can drive yourself home at the end of the day, as there is no sedation at any point.

Aftercare

You can drive yourself home at the end of a treatment day and work normally the next. Scalp tenderness and a dull headache are more likely to build up across a compressed day than across a weekly course; ordinary painkillers are fine and it usually settles within a couple of hours. Tell your clinician if a headache is severe or persistent, and contact the clinic immediately if you experience any loss of consciousness or seizure-like episode. Your NayaScore is repeated so progress is compared against your own baseline.

Written and medically reviewed byNaya, Precision neuromodulation clinic · NCBI Bookshelf, StatPearls: repetitive transcranial magnetic stimulation, on protocols, dosing and safety screening.

FAQ

Accelerated rTMS questions

How is accelerated rTMS different from a standard course?

The calendar, mainly. An accelerated protocol delivers several sessions a day across a small number of days, where a conventional course delivers one a day over several weeks. The total number of sessions is broadly similar. Theta burst patterning is what makes each session short enough for that to work.

Is the accelerated schedule better than the standard one?

Not automatically, and the honest answer is that it depends on your condition and your circumstances. The published evidence for compressed schedules is strongest in treatment-resistant depression. Your clinician will recommend one schedule over the other at assessment and will explain the reasoning rather than leave it to you.

How many sessions will I have in a day?

Several, separated by rest periods that are part of the protocol rather than gaps in the diary. The exact number depends on the protocol chosen for you and is confirmed at your assessment. Etienne Balland described having two or three in a day during his own course in The Telegraph.

Does having sessions closer together increase the risk?

Seizure remains the serious risk with any magnetic stimulation, and it is rare. We screen for metal in the head, cardiac devices and seizure history before anyone is treated on any schedule. Scalp tenderness and headache are more likely to accumulate across a compressed day, and we watch for that.

Can I work during an accelerated course?

You will need to clear the treatment days themselves, because you are in the clinic for a block of the day rather than an hour. Between sessions people read or work. There is no sedation, so you can drive home afterwards and return to normal work the next day.

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