Referring a Patient for SAINT® TMS: Clinician Guide & Co-Management

Treatment-resistant depression (TRD) presents an immense clinical challenge: after two failed antidepressant trials, the likelihood of achieving remission with a subsequent oral agent drops to less than 15% (STAR*D trial, Rush et al., 2006). For patients suffering severe, refractory symptoms who cannot spend 6 to 9 weeks in conventional daily TMS or who cannot tolerate pharmacologic side effects, SAINT® (Stanford Accelerated Intelligent Neuromodulation Therapy) offers an evidence-based, rapid alternative.

Neuro Wellness TMS Centers of America in Coral Springs, FL, operates under a cooperative specialist model. We view ourselves as an extension of your diagnostic and interventional toolkit. We manage the pre-treatment functional MRI targeting scan, administer the intensive 50-session week on the FDA-cleared Magnus Neuromodulation System, monitor acute tolerability, and promptly transfer care back to your practice for maintenance.

Ideal candidates for referral meet the following clinical profile:

• Diagnosis: Major Depressive Disorder (single episode or recurrent), typically moderate to severe (baseline PHQ-9 ≥ 10, MADRS ≥ 20).

• Treatment Resistance: History of failing two or more adequate antidepressant medication trials (adequate dosage for ≥6 weeks) from at least two different classes, or documented intolerance to multiple classes.

• Age: Adults aged 22 and older (Magnus Medical FDA 510(k) K220177 clearance parameters). For patients aged 18–21, standard daily TMS or SPRAVATO® can be evaluated.

• Commitment: Ability to participate in a full 5-day outpatient course (Monday through Friday, approximately 9:00 AM to 5:30 PM).

• For out-of-area patients: Feasibility to travel to our South Florida clinic in Coral Springs (conveniently accessible via Fort Lauderdale-Hollywood FLL, Miami MIA, or West Palm Beach PBI airports).

Because TMS utilizes high-intensity pulsed magnetic fields and SAINT® requires pre-treatment 3T MRI brain mapping, several absolute and relative contraindications must be screened prior to scheduling:

• Absolute: Non-removable ferromagnetic implants or metallic objects in or within 30 cm of the head (aneurysm clips, cochlear implants, deep brain stimulators, ocular metallic foreign bodies).
• Absolute: Implanted medical devices controlled by physiological signals (cardiac pacemakers, implantable cardioverter-defibrillators, vagus nerve stimulators).
• Absolute: Known active seizure disorders, history of unprovoked epilepsy, or conditions with increased intracranial pressure.
• Relative: Severe claustrophobia or inability to tolerate 3T MRI scanning (pre-scan mild anxiolytic premedication may be arranged if clinically appropriate).
• Relative: Active severe substance use disorders or acute psychosis, which require medical stabilization prior to elective accelerated outpatient neuromodulation.

Our structured intake ensures rapid review and constant coordination with your office:

To ensure compliance with HIPAA and protect sensitive psychiatric history, please do not use public unencrypted web forms. Follow these secure steps:

1. Download and complete our Patient Eligibility Checklist.

2. Attach recent psychiatric intake/progress notes, medication trials, and recent psychiatric rating scales (PHQ-9, MADRS, or HAM-D if available).

3. Fax the referral packet directly to our secure clinical fax: 954-827-9793.

4. For peer-to-peer discussions regarding complex candidacy, call 954-827-9793 to speak directly with our clinical team.