SAINT® vs MeRT for Treatment-Resistant Depression

If you are comparing SAINT® and MeRT, you are comparing two approaches to transcranial magnetic stimulation (TMS) — a non-invasive treatment that uses magnetic pulses to stimulate areas of the brain involved in mood regulation. Both aim to personalize TMS, but they do it differently and have different evidence bases.

SAINT® (Stanford Accelerated Intelligent Neuromodulation Therapy) is delivered on the Magnus Medical SAINT Neuromodulation System. It uses a functional MRI (fMRI) scan to identify each person's individual treatment target, then delivers 10 sessions per day over 5 consecutive days — about 50 sessions total. It is FDA-cleared for major depressive disorder (MDD) in adults whose depression has not improved enough on prior antidepressant medication. Neuro Wellness treats adults 22 and older.

MeRT (Magnetic e-Resonance Therapy) is a protocol that uses an EEG (electroencephalogram) — a recording of the brain's electrical activity — to personalize the TMS stimulation frequency and coil placement. MeRT is typically delivered on a standard TMS schedule of one session per day over 4 to 6 weeks. The TMS devices used in MeRT are FDA-cleared for depression, but the MeRT protocol itself is not a separately FDA-cleared protocol.

Both are legitimate approaches to brain-based depression treatment. The question is which fits your diagnosis, your schedule, and how much evidence you want behind the specific protocol. Learn more about SAINT® and take the free candidacy screener to see which may apply to you.

MeRT stands for Magnetic e-Resonance Therapy. It is a clinical protocol developed by the Brain Treatment Institute (BTI) that combines TMS with quantitative EEG (qEEG) analysis. The EEG recording is used to identify each person's brainwave patterns, and the clinician uses that information to set the stimulation frequency and coil placement for TMS sessions.

MeRT is a protocol, not a device. The TMS devices used in MeRT — such as the NeuroStar TMS Therapy System — are FDA-cleared for major depressive disorder. However, the MeRT protocol itself, which adds EEG-guided personalization on top of standard TMS, is not a separately FDA-cleared protocol. This means the FDA clearance covers the device and its cleared indications, not the specific MeRT methodology.

This distinction matters. A clinic offering MeRT is using an FDA-cleared TMS device, but the EEG-guided personalization layer is a clinical protocol that has not received separate FDA clearance as a distinct treatment system. SAINT®, by contrast, is FDA-cleared as a complete system — the Magnus Medical SAINT Neuromodulation System received 510(k) clearance (K220177) and a Breakthrough Device designation specifically for the SAINT® protocol, including the fMRI-guided targeting software.

If you are considering MeRT, ask the clinic which TMS device it uses, what that device is FDA-cleared for, and what published outcome data supports the MeRT protocol specifically. For more on what treatment-resistant depression means and how TMS fits, see our treatment-resistant depression guide.

The evidence base for SAINT® and MeRT differs in design and specificity. SAINT® has published randomized controlled trial (RCT) data for the SAINT® protocol on the Magnus system. MeRT has published studies, but the evidence base is smaller and less specific to a single standardized protocol.

In the 2022 randomized trial, 79% of participants reached remission (Cole et al., Am J Psychiatry 2022;179(2):132–141). Individual results may vary. That figure comes from the SAINT® trial and applies to the SAINT® protocol on the Magnus system — it does not transfer to MeRT, standard TMS, or any other TMS protocol.

MeRT studies have reported improvements in depression scores, but the published evidence is less extensive than SAINT®'s RCT data and is based on smaller, often open-label studies. Ask any clinic offering MeRT for its own published outcome data for the specific protocol and device it uses.

For a deeper look at SAINT® remission and response data, see our SAINT® TMS success rates page.

Both SAINT® and MeRT are non-invasive, outpatient treatments. Neither requires anesthesia, sedation, or a hospital stay. The patient sits in a chair while a coil placed on the scalp delivers magnetic pulses. The main differences are time and cost.

SAINT® compresses the entire course into 5 consecutive days, with 10 sessions per day. You are in the clinic for most of the day during treatment week, but the course is over in one week instead of six. MeRT, like standard TMS, typically runs one session per day over 4 to 6 weeks — about 36 sessions.

On cost: SAINT® at Neuro Wellness starts at $25,000. That price reflects the fMRI scan, the FDA-cleared targeting software, the Magnus system, physician oversight, and the full 50-session week. Standard TMS (including MeRT-style protocols) may be covered by insurance; coverage varies by plan. SAINT® may also be covered — coverage varies by plan. We verify your benefits for free, whatever carrier you have, so you know what your plan allows before you commit. Financing is available for SAINT® on a case-by-case basis and is discussed during your consultation.

For the full SAINT® cost breakdown, see our SAINT® TMS cost page. To check what your plan covers, start with a free benefits verification.

SAINT® fits adults with major depressive disorder whose depression has not improved enough on prior antidepressant medication and who can commit to 5 consecutive days in the clinic. The compressed schedule suits people who want to avoid six weeks of daily visits and who want a protocol with fMRI-guided personalized targeting and published randomized trial data. It is not for people with non-removable magnetic-sensitive metal near the head, certain implanted devices, or increased intracranial pressure.

MeRT may appeal to adults who want EEG-guided personalization of their TMS treatment and who can commit to a standard 4-to-6-week schedule. Because the MeRT protocol is not separately FDA-cleared, it is best suited for someone who has reviewed the evidence and is comfortable with a protocol that has a smaller published evidence base than SAINT® or standard TMS.

Standard TMS remains the option with the largest evidence base and the most established insurance coverage. Its trade-off is time: 4 to 6 weeks of daily visits. Neuro Wellness offers SAINT® and standard TMS, along with SPRAVATO® (esketamine), IV ketamine, psychotherapy, and medication management. A free consultation is the best way to learn which fits your diagnosis and circumstances.

For more comparisons, see our guides to SAINT® vs accelerated TMS, SAINT® vs deep TMS, and what accelerated TMS is.