NeuroStim Announces Single-Day TMS Protocol With High Remission Rates in Depression

NeuroStim TMS Centers has introduced a single-day transcranial magnetic stimulation (TMS) protocol that condenses a full therapeutic course for depression into one day.

The Optimized, Neuroplasticity-Enhanced Depression Treatment (ONE-D) protocol delivers 20 TMS sessions within a single visit, compared with standard protocols that require up to a month or more of daily treatments, according to an August 26 announcement from NeuroStim.¹

_{Transcranial Magnetic Stimulation}

_{©PATTARAWIT/stock.adobe.com}

One-Day TMS is based on findings of the ONE-D clinical study,² which enrolled 32 adults with major depressive disorder. More than 90% of participants achieved significant improvement and over 75% reached full remission of symptoms. All participants completed treatment with no major side effects.²

“For patients, one of the biggest obstacles with TMS has always been the large number of treatment visits required,” protocol co-inventor Jonathan Downar, MD, PhD, associate professor in the department of psychiatry and Institute of Medical Science at the University of Toronto, said in a statement.¹ “But a single-day protocol puts TMS within reach for many more people—especially those with busy schedules or those who live far away from clinics."¹

The protocol also involves enhancing the brain's neuroplasticity with one-time administration of 2 suportive low-dose medications at the beginning of treatment: D-cycloserine (DCS) and lisdexamfetamine (Vyvanse).² "Enhancing plasticity during TMS is a new technique… and it’s the key discovery that makes single-day TMS possible,” Downar said.¹

Compared with standard repetitive TMS (rTMS)—delivered once daily over 30–36 sessions—ONE-D offers a more condensed format. Conventional rTMS achieves remission rates of 30–35% in treatment-resistant depression,³ with some reviews reporting 20–30% in real-world settings.⁴ A large meta-analysis found remission rates of 36% for active rTMS versus just over 8% with sham.⁵ By contrast, ONE-D achieved remission in more than 75% of participants, suggesting substantially greater efficacy.²

Brief History of the ONE-D Protocol

The protocol draws on accelerated depression treatment models such as Stanford’s SAINT, during which 50 sessions are administered over 5 days. The treatment also requires functional MRI for targeting. ONE-D instead uses heuristic targeting similar to standard TMS, with fewer stimulation pulses (12,000 vs 90,000 in SAINT) and no imaging requirement.

“We have treated over 150 patients with single day TMS treatment protocols and have consistently seen patient outcomes that meet, and often exceed, remission results from standard TMS, all without any major side effects,” Nick Weiss, MD, medical director of NeuroStim said.

Weiss' summation of patient response was echoed by the trial's lead research practitioner Brooke Marino, DNP, PMHNP. “Having consistently followed up with over 100 patients who have been treated with One-Day TMS, I can say that the patient experience has been overwhelmingly positive."

The treatment's accessibility and convenience is augmented by the rapid relief observed during the trial. "The effects are quite durable, with the majority of patients still in remission 6 months later.”

In the study, investigators noted that onset of symptom improvement was delayed for a number of participants, a pattern that suggests ONE-D may be less appropriate for acute or inpatient settings where rapid remission is required. Protocols such as SAINT may remain better suited in those contexts. Still, the combination of intensive same-day sessions, heuristic targeting, and pharmacological augmentation may support both durable remission and expanded access.

“If replicated under more formal randomized controlled conditions, the efficacy of a single-day, neuroplastogen-enhanced treatment regimen could substantially increase the value of TMS as a practical treatment option for more patients under real-world conditions.… single-day TMS protocols could potentially achieve a meaningful impact on the overall prevalence of TRD and other TMS-treatable conditions, in the years to come.”

References

1. NeuroStim TMS pioneers accelerated One-Day TMS for depression. News release. NeuroStim TMS Centers.August 26, 2025. Accessed August 26, 2025. https://prnmedia.prnewswire.com/news-releases/neurostim-tms-pioneers-accelerated-one-day-tms-for-depression-302538498.html

2. Vaugh DA, Marino B, Engelbertson A, et al. Real-world effectiveness of a single-day regimen for transcranial magnetic stimulation using Optimized, Neuroplastogen-Enhanced techniques in Depression (ONE-D). Preprint. Research Square. doi:10.21203/rs.3.rs-5679327/v1

3. Rizvi S, Khan AM. Use of transcranial magnetic stimulation for depression. Cureus. 2019;11(5):e4736. doi:10.7759/cureus.4736

4. Trapp NT, Purgianto A, Taylor JJ, et al. Consensus review and considerations on TMS to treat depression: A comprehensive update endorsed by the National Network of Depression Centers, the Clinical TMS Society, and the International Federation of Clinical Neurophysiology. Clin Neurophysiol. 2025;170:206-233. doi:10.1016/j.clinph.2024.12.015

5. Via RG, Sághy E, Bella R, et al. Efficacy of repetitive transcranial magnetic stimulation (rTMS) adjunctive therapy for major depressive disorder (MDD) after two antidepressant treatment failures: meta-analysis of randomized sham-controlled trials. BMC Psychiatry. 2023 Jul 27;23:545. doi: 10.1186/s12888-023-05033-y