A standard course of TMS therapy takes about six weeks, with five sessions per week totaling 30 to 36 sessions. But most people searching this question also want to know how long the results last, and that answer is more nuanced. For many patients, the antidepressant effects hold for several months, though the duration varies considerably from person to person.
What a Full Treatment Course Looks Like
The typical TMS schedule involves visiting a clinic five days a week for roughly six weeks. Each session lasts between 20 and 40 minutes depending on the specific protocol your provider uses. You sit in a chair, a magnetic coil is placed against your scalp, and the device delivers pulses to targeted areas of the brain involved in mood regulation. There’s no anesthesia and no recovery time, so most people drive themselves to and from appointments.
After the initial 30 to 36 sessions, many providers add a tapering phase where sessions gradually decrease in frequency over a couple of weeks rather than stopping abruptly. This transition helps consolidate the treatment effects before you’re fully on your own.
The Accelerated Option: Five Days Instead of Six Weeks
A newer protocol developed at Stanford compresses the entire treatment into five consecutive days. Called SAINT (Stanford Accelerated Intelligent Neuromodulation Therapy), it delivers 10 sessions per day, one per hour, with each session lasting about 10 minutes. You’d need to be in the clinic for roughly 10 hours each day, Monday through Friday. This approach uses stronger, more precisely targeted pulses and has shown promising results for people who can’t commit to a six-week schedule or who need faster relief.
How Long the Results Typically Last
This is the question that matters most, and the honest answer is that it varies. In a large naturalistic study following 120 patients who responded to TMS, 62.5% maintained their response throughout a full year of follow-up. The proportion of patients in remission at the end of acute treatment remained similar at the one-year mark, which is encouraging.
Other research paints a more detailed picture of the timeline. One study found that among patients who achieved remission, 75% remained event-free at two months, 60% at three months, and about 43% at four months. By six months, that number dropped to roughly 23%. A separate study found that when relapse did occur, it happened on average about seven weeks after treatment ended, though the majority of those patients regained remission with additional sessions.
Research on patients who underwent repeated courses of TMS found that benefits were sustained for a mean of nearly five months between treatment rounds. That five-month window aligns with broader findings suggesting the risk of relapse becomes most pronounced after about five months post-treatment.
What Predicts Longer-Lasting Results
A meta-analysis examining durability found two factors consistently linked to better long-term outcomes. The first was receiving maintenance TMS sessions after the initial course. The second was being female, though the reasons for this aren’t fully understood. Beyond these findings, individual factors like how severe your depression was before treatment, whether you’re also taking medication, and how completely you responded to the initial course all play a role in how long relief lasts.
Maintenance Sessions to Extend the Effects
Because TMS effects can fade over months, many providers now offer maintenance protocols to keep symptoms from returning. These come in several forms. The most common is a gradual taper: you might go from three sessions a week down to two, then one, then every other week, and eventually once a month over a span of several months to a year. Another approach uses monthly “cluster” sessions, where you come in for several consecutive days of treatment once a month.
The research is clear on one point: fewer than two sessions per month doesn’t appear to be enough. Studies that tried once-monthly maintenance found it ineffective at preventing relapse, while protocols delivering more than two monthly sessions showed significantly better outcomes. The most effective maintenance schedules in published studies lasted at least five months after the initial treatment phase, with some extending well beyond a year.
One long-term case series documented patients receiving one to two weekly maintenance sessions for periods ranging from six months to over five years, suggesting that for some people, ongoing low-frequency TMS becomes a long-term management strategy similar to staying on antidepressant medication.
Re-treatment if Symptoms Return
If depression does come back after a successful initial course, TMS can be repeated. In the large one-year follow-up study, about 36% of patients received reintroduction of TMS at some point during the follow-up period, mostly after the first month. Medicare guidelines explicitly recognize re-treatment as appropriate for patients who previously benefited from TMS and are experiencing a recurrence. Most insurers follow similar logic: if TMS worked the first time and symptoms have returned, another course is generally covered.
A second course of TMS typically follows the same basic structure as the first, though some providers use a shorter course of 10 to 20 sessions if the initial response was strong. The key advantage of re-treatment is that patients who responded once tend to respond again, making TMS a reliable option even when its effects don’t last permanently.