5-Day Accelerated TMS Showed Comparable Short-Term Relief for Many Patients

A condensed, high-intensity five-day transcranial magnetic stimulation schedule—described as the “5x5 TMS protocol” (five sessions per day for five days)—was reported as producing depression symptom reduction broadly comparable to a standard multiweek schedule in patients undergoing rTMS treatment for major depressive disorder (MDD).

The report frames the comparison around whether compressing the timeline changes overall symptom outcomes and how soon improvement can be detected after the last session, with study design and response timing presented as central themes.

The report describes 175 patients with major depressive disorder, with 135 receiving a conventional schedule of one session per day, five days per week, over six weeks and 40 receiving the accelerated five-by-five format over five consecutive days. This was not a randomized clinical trial, and participants were not randomly assigned to the two schedules. As presented, the study is framed as a comparison of two delivery schedules within an MDD population receiving rTMS treatment.

For the overall comparison, both groups experienced significant reductions in depression symptoms, and outcomes did not differ in a statistically significant way between the accelerated and conventional approaches. The write-up emphasizes a short-term pattern in which symptom reduction was observed with each schedule under the conditions studied. In this account, compressing sessions into one week was not associated with a clear separation in overall outcomes in this cohort.

The report also highlights a timing-related observation in the accelerated group: some participants who did not show substantial improvement immediately after the five-day course went on to improve at follow-up. When researchers reassessed these individuals at a two-to-four-week check-in, depression scores were reported to drop by an average of 36% among those characterized as delayed improvers. The report presents this as a reminder that immediate post-treatment assessment may not capture later-emerging gains for some patients treated on the condensed schedule.

Caveats are also noted. Larger, carefully controlled randomized trials are needed to confirm the findings.

Key Takeaways:

• A nonrandomized cohort compared 175 total patients allocated to conventional versus accelerated schedules, without random assignment.
• Both schedules were reported to be associated with significant symptom reduction, with overall outcomes described as similar across groups in the reported comparison.
• A delayed-improvement pattern was highlighted for some accelerated-schedule participants, alongside author statements and a call for larger randomized trials to confirm findings.