SAINT® vs One-Day TMS (ONE-D)

SAINT® (Stanford Accelerated Intelligent Neuromodulation Therapy) and one-day TMS (sometimes called ONE-D) are both accelerated transcranial magnetic stimulation protocols. Both try to deliver relief faster than standard TMS, which runs one session a day for four to six weeks. But they are not the same treatment, and the differences matter.

SAINT® is an FDA-cleared protocol delivered on the Magnus Neuromodulation System. It uses a functional MRI (fMRI) scan to personalize the treatment target for each person, then delivers ten sessions per day for five consecutive days — about 50 sessions total. It has published randomized trial data for major depressive disorder (MDD) in adults whose depression has not improved enough on prior antidepressant medication.

ONE-D is an emerging concept that aims to deliver TMS in a single day. Its evidence base is earlier than SAINT®'s, and its FDA status depends on the specific device and protocol used. Before choosing either, ask what evidence supports the specific protocol a clinic is offering you.

ONE-D, or one-day TMS, is the idea of compressing an entire TMS treatment course into a single day. Where standard TMS spreads roughly 36 sessions across six weeks and SAINT® spreads about 50 across five days, ONE-D would deliver all of them in one extended session.

The concept is appealing: one day in a clinic instead of weeks of daily visits. But the evidence for delivering TMS this way is early. Published randomized trial data for a single-day protocol is limited compared with SAINT® and standard TMS, which both have established trial data for multi-session courses. Ask any clinic offering a one-day protocol for its own published outcome data for the specific protocol and device it uses.

ONE-D's FDA clearance status also depends on the specific device and protocol. Standard TMS devices are FDA-cleared for depression; SAINT® is FDA-cleared for MDD specifically. Whether a one-day delivery of TMS on a given device is cleared is a separate question — confirm it directly with the clinic or manufacturer before proceeding.

SAINT® — Stanford Accelerated Intelligent Neuromodulation Therapy — was developed at Stanford University and is delivered on the Magnus Medical SAINT Neuromodulation System. It received FDA 510(k) clearance (K220177) and a Breakthrough Device designation for major depressive disorder in adults whose depression has not improved enough on prior antidepressant medication.

The protocol combines three things: an fMRI scan that maps each person's individual treatment target, an accelerated schedule of ten sessions per day for five consecutive days, and an intermittent theta-burst stimulation (iTBS) pulse pattern. The total is about 50 sessions in one week. Neuro Wellness treats adults 22 and older.

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. SAINT® is not cleared for anxiety, OCD, PTSD, bipolar disorder, concussion, or any other condition — eligibility is clinical only.

The table below compares the three protocols on the factors that usually drive the decision: time, targeting, FDA status, published evidence, and cost.

SAINT® fits adults with major depressive disorder whose depression has not improved enough on prior antidepressant medication and who can commit to five consecutive days in a clinic. The compressed schedule suits people who want to avoid six weeks of daily visits and who want a protocol with 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.

ONE-D is a concept that may appeal to people who want the shortest possible time commitment. But because its evidence base is earlier, it may be a better fit for someone who has weighed the evidence and accepted that trade-off. Ask any clinic offering ONE-D for its own published outcome data for the specific protocol and device it uses.

Standard TMS remains the option with the largest evidence base and the most established insurance coverage. Its trade-off is time: four to six weeks of daily visits. For someone whose schedule can absorb that, standard TMS is a well-supported choice.

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 option fits your diagnosis and circumstances.