Depression treatment
completed in one day

Traditional TMS requires patients to attend the clinic 5 days a week for 4–6 weeks, typically 20–36 separate visits. The AMPA Health ONE-D protocol delivers the equivalent of a full TMS course in a single day: 20 iTBS sessions spaced every 30 minutes across 9.5 hours, combined with neuroplasticity-priming medications taken before treatment. Published outcomes show response and remission rates substantially higher than conventional protocols, in a fraction of the time.

One hour before your first TMS session, you take a single oral dose of d-cycloserine and lisdexamfetamine. The rationale is grounded in neuroscience: iTBS works through synaptic plasticity, but depression impairs plasticity, which may limit how much TMS alone can achieve. D-cycloserine is an NMDA receptor partial agonist that addresses this directly. A 2022 double-blind, placebo-controlled RCT in JAMA Psychiatry (Cole et al., n=50) found response rates of 73.9% with iTBS plus d-cycloserine versus 29.2% with iTBS plus placebo, and remission rates of 39.1% versus 4.2%, with a large effect size (Hedges g = 0.99). Timing matters: the medication needs to be present in the brain during stimulation. Lisdexamfetamine (a Schedule II controlled substance) augments dopamine and norepinephrine signaling to further support neuroplasticity during stimulation. Its use in this context is off-label and based on mechanistic rationale rather than a dedicated RCT specifically for ONE-D augmentation. Both medications are physician-prescribed after a thorough safety and medical evaluation, with particular attention to cardiovascular history, stimulant sensitivity, and potential drug interactions.

Most patients describe iTBS as a rapid tapping or clicking sensation on the scalp. It is generally well-tolerated. Each session is only 3 minutes long. You remain fully awake throughout and can listen to music, browse, or rest between sessions in the waiting room, where WiFi and refreshments are provided. The most common side effects are mild scalp discomfort or a light headache, which typically resolve quickly. Serious adverse events are rare.

The foundational ONE-D paper (Vaughn et al., Transcranial Magnetic Stimulation, 2025) reported outcomes for 32 adults with medication-resistant unipolar depression. At 6 weeks: 87.5% response and 71.2% remission on HDRS-17; 90.6% response and 68.8% remission on BDI-II. At 26 weeks, 50% maintained remission. These are intention-to-treat results from an unblinded retrospective case series, not a randomized controlled trial, and should be interpreted with appropriate caution. They are nonetheless highly promising and consistent with the emerging accelerated TMS literature.

TMS as a modality has an established safety record in adults, and several TMS devices have recently received FDA clearance for adolescents aged 15 and older (NeuroStar, 2024; BrainsWay, 2025). This is meaningful for the general safety profile of TMS in younger patients. However, the AMPA Health ONE-D protocol specifically has been studied only in adults. FDA clearance of other devices for adolescents does not extend to or validate the ONE-D protocol in pediatric populations. Whether ONE-D is appropriate for a given adolescent is determined through individualized clinical evaluation, not assumed based on adult data. Dr. Hasassri involves parents fully in the consent process, uses age-adapted parameters, and coordinates with the patient's existing treatment team.

Yes. Because ONE-D requires only a single treatment day (plus an initial evaluation, which can often be done via telehealth), it is particularly well-suited for travel patients. You would need a telehealth or in-person initial consultation, then one in-person treatment day in Menlo Park. A follow-up appointment at one month can typically be done via telehealth. Please contact us to discuss your situation.

Dr. Hasassri's practice is cash-pay only and does not bill insurance. Exact fees are discussed at your consultation.

Yes. The AMPA Health TMS device is portable, allowing the complete ONE-D protocol to be delivered at a patient's home, hotel, or other location of their choosing. Off-site treatment is available within the greater Bay Area. A travel fee applies for all off-site treatment days, calculated based on distance from the clinic at 648 Menlo Ave, Suite 1, Menlo Park to the treatment location and back. Travel fees are in addition to the standard program fee and are confirmed prior to scheduling. At-home ONE-D follows the same clinical protocol and physician supervision as in-office treatment.

Yes. TMS received FDA clearance for obsessive-compulsive disorder (OCD) in 2018, when the FDA authorized BrainsWay's Deep TMS system as an adjunct treatment for adult OCD patients. Multiple device manufacturers have since received their own FDA clearances for OCD, including NeuroStar and MagVenture. The FDA-cleared OCD protocol targets the anterior cingulate cortex and medial prefrontal cortex (ACC/mPFC) using deep TMS, and uniquely incorporates symptom provocation before each session to activate the relevant neural circuits. In the pivotal RCT (n=99), active deep TMS achieved a 38% response rate versus 11% for sham. TMS is indicated as an adjunct for OCD patients who have not had adequate response to medication and psychotherapy (ERP). Dr. Hasassri can evaluate whether TMS is appropriate for your OCD and discuss the available protocols.

TMS has FDA clearance for decreasing anxiety symptoms in adults with MDD who also have significant comorbid anxiety (anxious depression), with multiple devices cleared for this indication since 2021. This is distinct from a primary anxiety disorder diagnosis. For generalized anxiety disorder (GAD) as a standalone diagnosis, TMS does not currently have FDA clearance, though there is a growing body of research supporting its use and it is offered at many centers off-label. Multiple RCTs have found meaningful reductions in anxiety symptoms with rTMS targeting the left DLPFC and other circuits. Dr. Hasassri can discuss whether TMS is appropriate for your anxiety presentation, whether as an adjunct to depression treatment or as an off-label approach for primary anxiety.

TMS does not currently have FDA clearance specifically for PTSD, though it is one of the most actively studied off-label applications. Multiple RCTs have shown significant reductions in PTSD symptom severity with right-sided DLPFC inhibition and other targeting approaches. Beyond PTSD, FDA-cleared TMS indications include migraine headache (cleared since 2013 for the eNeura single-pulse device) and smoking cessation (BrainsWay Deep TMS, cleared 2020). Outside the US, TMS holds CE certification in Europe for a broader range of conditions including PTSD, bipolar disorder, Alzheimer's disease, Parkinson's disease, chronic pain, and the negative symptoms of schizophrenia. Research into accelerated protocols for many of these conditions is ongoing. Contact Dr. Hasassri to discuss whether TMS may be appropriate for your specific situation.