Linda Carpenter, MD, is a professor of psychiatry and human behavior at Brown University. 

Linda Carpenter, MD

This video features Linda Carpenter, MD, Professor of Psychiatry and Human Behavior at Brown University, Andrew Leuchter, MD, Professor and Director of the Neuromodulation Division at UCLA TMS Clinical and Research Services, and Scott Wilke, MD, PhD, Assistant Professor of Psychiatry and Penske Family Chair in Neuromodulation at UCLA Health, discussing accelerated TMS protocols, at-home brain stimulation, and new mechanistic data in the treatment of major depressive disorder. Topics include accelerated TMS for treatment-resistant depression, the 5x5 accelerated rTMS protocol, the SWIFT deep TMS protocol, theta burst stimulation, intermittent theta burst stimulation, deep TMS for MDD, ProlivRx FDA approval, at-home neuromodulation for major depressive disorder, the MOOD trial, physician-directed brain stimulation therapy, TMS insurance coverage, TMS reimbursement 2026, Medicare TMS coverage, TMS after antidepressant failure, prefrontal cortex neuromodulation, intratelencephalic neurons, personalized TMS treatment, TMS patient access, accelerated TMS efficacy, TMS vs conventional treatment, TMS clinical practice, treatment-resistant MDD, TMS psychiatry 2026, brain stimulation therapy for depression, noninvasive brain stimulation, repetitive transcranial magnetic stimulation, rTMS for depression, deep transcranial magnetic stimulation, TMS schedule, TMS protocol comparison, TMS outcomes, PHQ-9 TMS, HDRS TMS, TMS remission rates, TMS response rates, TMS delayed response, TMS maintenance, TMS and antidepressants, TMS adjunctive therapy, neuromodulation psychiatry, interventional psychiatry, brain stimulation MDD 2026.

 TMS for MDD Is Changing Fast. Here's What Psychiatrists Need to Know

Transcranial magnetic stimulation (TMS) has been 

 since 2008, but for many patients with treatment-resistant depression (TRD), the traditional TMS treatment schedule has been the biggest obstacle to accessing it.

 The standard protocol requires 36 sessions, once daily, over 6 to 8 weeks, a commitment that costs patients their mornings, their commutes, and sometimes their jobs. For those living far from a TMS clinic, it has often meant no treatment at all.

In this video, 3 clinician-researchers, Linda Carpenter, MD, of Brown University; Andrew Leuchter, MD, of UCLA TMS Clinical and Research Services; and Scott Wilke, MD, PhD, Penske Family Chair in Neuromodulation at UCLA Health, walk through what is new in TMS for MDD and what it means for practicing psychiatrists treating patients who have not responded to antidepressants.

What New TMS Protocols for Treatment-Resistant Depression Mean for Clinical Practice

The clinical case for accelerated TMS protocols is building. A retrospective analysis published in March 2026 found that a

, 5 sessions per day over 5 consecutive days, produced efficacy comparable to the conventional 6-week TMS course.

 As Leuchter explained in an interview with 

, the compressed timeline has real implications for patient access and adherence, though insurance reimbursement for accelerated TMS approaches remains a significant gap.

—yet access barriers have limited TMS use in TRD for nearly 2 decades.

—a March 2026 retrospective analysis found comparable outcomes between 5x5 accelerated rTMS and the conventional 6-week daily course (

remission rates for ProlivRx vs sham in the MOOD trial (

 — Medicare reimburses up to 2 TMS sessions per day; accelerated protocols of 5 or more sessions per day remain unreimbursed as of 2026.

On the at-home neuromodulation front, the

 FDA approved Neurolief’s ProlivRx in January 2026

, the first prescription, physician-directed at-home brain stimulation therapy for MDD, indicated for adults who did not achieve satisfactory improvement from ≥ 1 prior antidepressant.

 Carpenter, who led the MOOD trial studying the device as adjunctive therapy, describes how the physician-directed model works in practice and what the current reimbursement landscape looks like for patients.

Wilke adds mechanistic context on how accelerated intermittent theta burst stimulation acts on specific cell types in the prefrontal cortex and what that could mean for personalizing TMS treatment for MDD.

For a deeper dive into the data behind each of these developments, read the full written feature here: 

TMS for MDD Reimagined: Faster, Fewer Visits, and Now at Home

Editor’s note: Reported disclosures include Neuronetics and Janssen Pharmaceuticals for Carpenter and Abbott Laboratories for Leuchter. Wilke has no reported disclosures.

Patel, P. The FDA Approved TMS For Treating Depression In 2008. TMS Institute of Arizona. Published May 13, 2025. 

https://tmsinstitute.co/the-fda-approved-tms-for-treating-depression-in-2008/

Leuchter A. Accelerated 5×5 rTMS Matches Standard Protocols in TRD, With Andrew Leuchter, MD. HCPLive. Published on March 24, 2026. Accessed June 18, 2026. 

https://www.hcplive.com/view/accelerated-5-5-rtms-matches-standard-protocols-trd-andrew-leuchter-md

Derman C. Accelerated Deep TMS Matches Standard Outcomes in TRD in 6 Days. HCPLive. Published on March 18, 2026. Accessed June 18, 2026. 

https://www.hcplive.com/view/accelerated-deep-tms-matches-standard-outcomes-trd-6-days

Derman C. FDA Approves ProlivRx, First At-Home Neuromodulation Device for MDD. HCPLive. Published on January 13, 2026. Accessed June 18, 2026. 

https://www.hcplive.com/view/fda-approves-proliv-rx-first-home-neuromodulation-mdd

Derman C. TMS for MDD Reimagined: Faster, Fewer Visits, and Now at Home. HCPLive. Published on May 15, 2026. Accessed June 18, 2026. 

https://www.hcplive.com/view/tms-mdd-faster-fewer-visits-home

Videos

New accelerated TMS protocols and an FDA-approved at-home device are changing how psychiatrists treat MDD after antidepressant failure.

Linda Carpenter, MD

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