SAINT® TMS Success Rates: What the Research Shows

SAINT® (Stanford Accelerated Intelligent Neuromodulation Therapy) is FDA-cleared for major depressive disorder (MDD) in adults whose depression has not improved enough on prior antidepressant medication. The most cited success rate comes from the 2022 double-blind randomized controlled trial: 79% of participants reached remission after the five-day protocol (Cole et al., Am J Psychiatry 2022;179(2):132–141). Individual results may vary.

That 79% remission figure is specific to the SAINT® system — the FDA-cleared SAINT® Neuromodulation System by Magnus Medical, which uses proprietary fMRI-guided targeting software. Other accelerated TMS protocols may copy the treatment schedule but do not use the same targeting system, and the SAINT® trial outcomes do not transfer to them. NWCOA is a Verified SAINT® Provider in Coral Springs, Florida. Learn more about SAINT® or check if you're a candidate.

The SAINT® research program at Stanford produced several studies before the pivotal 2022 trial. The earlier studies were open-label, meaning participants and researchers knew they were receiving the real treatment. Open-label studies reported remission rates of roughly 78–80% or higher. These results were encouraging and justified a larger, more rigorous trial.

The 2022 study was a double-blind randomized controlled trial — the gold standard in clinical research. Participants were randomly assigned to either real SAINT® or a sham (placebo) control, and neither they nor the raters knew which group they were in. In that trial, 79% of participants who received SAINT® reached remission, compared to 13% in the sham group (Cole et al., Am J Psychiatry 2022;179(2):132–141). Individual results may vary.

The randomized trial is the strongest published evidence because it controls for placebo effects and researcher bias. When someone asks about the SAINT® success rate, the 79% figure from the 2022 randomized trial is the most reliable answer.

Two terms come up in depression treatment research: response and remission. They measure different levels of improvement, and the distinction matters.

Response means a meaningful improvement in depression symptoms — typically a 50% or greater drop in score on a standardized mood scale. A responder feels better, but may still have significant symptoms. In the SAINT® studies, response rates were even higher than remission rates.

Remission is stricter. It means the depression score drops below a set threshold — in the SAINT® trials, a score of 10 or below on the Montgomery-Åsberg Depression Rating Scale (MADRS). Remission suggests the depression is no longer meeting the clinical threshold for a major depressive episode. The 79% figure from the 2022 trial refers to remission, not just response. Individual results may vary.

To put the 79% remission rate in context, it helps to compare it to other depression treatments. Standard TMS — one session per day over about 6 weeks — has published remission rates ranging from about 30% to 40% across various studies. Antidepressant medication has lower rates, especially for treatment-resistant depression.

The STAR*D study, a large federally funded trial of antidepressant medications, found that after one antidepressant, about 28% of participants achieved remission. After two medications, the rate dropped further. By the time patients had tried multiple medications without success — the population SAINT® is designed for — the odds of remission from the next medication alone were quite low.

SAINT® is designed for adults whose depression has not improved enough on prior antidepressant medication. The 79% remission rate in the 2022 trial was achieved in that treatment-resistant population (Cole et al., 2022). Individual results may vary. The comparison is not about one treatment being universally better — it is about which evidence applies to which system and which patient group.

The SAINT® targeting approach is based on brain imaging. Researchers use functional MRI (fMRI) to identify a personalized target for stimulation in each person. The target is chosen based on an anticorrelation between two brain regions: the subgenual anterior cingulate cortex (sgACC), which is often overactive in depression, and the dorsolateral prefrontal cortex (DLPFC), the area stimulated during TMS.

Anticorrelation means that when one region is more active, the other tends to be less active. In depression, this normal push-and-pull between the two regions can be disrupted. SAINT® aims to stimulate the specific DLPFC location that has the strongest anticorrelation with the sgACC for each individual — the spot where stimulation is most likely to calm the overactive region.

After SAINT®, the Stanford research group reported changes in brain connectivity visible on fMRI — patterns associated with depression appeared to normalize. These imaging findings are from the SAINT® research program and apply to the SAINT® targeting system. They do not necessarily transfer to other TMS protocols that use different targeting methods. Learn about fMRI-guided TMS.

[PATIENT STORY PLACEHOLDER — A real patient story with signed consent and HIPAA authorization will be added here. No patient story will be fabricated. Individual results may vary.]

The 79% remission rate comes from a specific trial of a specific system. It applies to the SAINT® Neuromodulation System by Magnus Medical, used in adults with major depressive disorder whose depression had not improved enough on prior antidepressant medication. NWCOA treats adults 22 and older.

SAINT® is FDA-cleared for MDD in adults. It is not cleared for anxiety, OCD, PTSD, bipolar disorder, or any other condition. If you have treatment-resistant depression and want to know whether SAINT® may be appropriate for you, the first step is a free consultation. Check if you're a candidate or verify your insurance benefits. SAINT® at NWCOA starts at $25,000; coverage varies by plan and we verify your benefits for free.