ONE-D (Single-Day TMS): 20 Sessions in 1–2 Days - What to Know

Quick Overview
Transcranial Magnetic Stimulation (TMS) is evolving quickly. ONE-D - sometimes described as a “single-day” TMS approach - concentrates a course of stimulation into a single visit (or into 1–2 days), typically delivering 20 iTBS sessions in that short window. At Inspire TMS Denver, we’re testing and offering ONE-D alongside other accelerated protocols; this page explains what we know, how ONE-D differs from 5-day accelerated treatments, the medications and equipment sometimes used to augment it, the evidence and safety profile, who might be a candidate, and practical details like cost and insurance.
What exactly is ONE-D?
ONE-D (Single-Day TMS) is an accelerated iTBS protocol designed to deliver a therapeutic “dose” quickly. Rather than one daily session for many weeks (standard) or 10 sessions/day for 5 days (one type of accelerated TMS), ONE-D compresses 20 iTBS sessions into a single intensive visit or into two consecutive days. Clinics experimenting with ONE-D sometimes pair stimulation with brief pharmacologic augmentation (for example, D-cycloserine and short-acting stimulants) and with specialized hardware (AMPA-type stimulators) intended to optimize neuroplastic response.
At Inspire, we’re presenting ONE-D as a research-informed, clinically supervised option.

How does ONE-D work
iTBS pulses:
iTBS (intermittent Theta Burst Stimulation) is a fast, potent TMS pattern. Each iTBS “session” lasts only a few minutes but is designed to produce plasticity-like effects.
Multiple sessions, short intervals:
ONE-D repeats iTBS many times with rest intervals; the cumulative stimulation aims to produce a strong, consolidated physiological response.
Medication augmentation:
Some protocols use agents thought to enhance neuroplasticity (for example, low-dose D-cycloserine or short-acting stimulants). These medications are given under a psychiatrist's supervision and always with a clear consent process
AMPA/advanced device use:
Specialized equipment that targets AMPA receptor–related mechanisms may be used experimentally to augment the effect. Device choice and settings matter and should be described by the treating clinic.
Important:
ONE-D is not simply “more of the same.” It’s an intensified biological intervention that must be individualized, medically screened, and supervised by a TMS-trained psychiatrist.
Evidence to date - what the research and clinical experience show
ONE-D is newer than standard TMS and many accelerated regimens. Preliminary case series and preprints show promising remission and response rates for highly accelerated protocols when combined with careful clinical support, but broader randomized data are still limited. Clinics piloting the ONE-D report are encouraging early outcomes and are cautious about claims. At Inspire, we will summarize relevant case series and our early clinic experience on the ONE-D page, and always frame it as emerging evidence rather than definitive proof.
For context, other accelerated approaches (for example, 50 sessions in 5 days or SAINT-style protocols) have produced strong results in trials and in real-world clinic experience; ONE-D is an extension of that thinking focused on even greater compression of sessions. When properly supervised, accelerated protocols have shown rapid benefit for some patients, but long-term durability and generalizability are active areas of study.

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Who might be a candidate for ONE-D?
ONE-D is typically considered for people who:
- Have treatment-resistant depression or severe depressive symptoms that warrant intensive approaches
- Want a very time-condensed option (travelers, people with limited availability)
- Are medically appropriate after careful screening (no contraindicated implants, controlled seizure risk, no untreated substance issues, etc.)
- Understand that ONE-D may be experimental and require informed consent about augmentation medications and devices.
A skilled clinician must determine candidacy after reviewing history, prior TMS (if any), medications, and a psychiatric evaluation. Inspire’s approach emphasizes physician supervision and a personalized plan.
Read More:
Is TMS right for me?
Safety, side effects & monitoring
- Common short-term effects: Scalp discomfort, brief headache, transient fatigue -similar to standard TMS.
- Seizure risk: Extremely rare with properly screened patients; clinics follow strict screening protocols (medication review, seizure history). ONE-D’s increased session density requires vigilance; clinical teams are trained and prepared to manage rare events.
- Medication interaction/augmentation risks: If medications such as D-cycloserine or stimulants (e.g., lisdexamfetamine) are used to augment, the psychiatrist will monitor for side effects and interactions. Augmentation increases potential benefit but also adds clinical considerations. Always discuss risks and alternatives in detail with your provider.
ONE-D should only be delivered in a setting with physician oversight, individualized mapping, and appropriate follow-up. It is not a DIY or consumer treatment.
How ONE-D compares to other TMS options
- Standard TMS: 1 session/day for 4–8+ weeks. Best-studied and commonly covered by insurance.
- 5-day Accelerated TMS (50 sessions in 5 days): Intensive week-long program showing strong outcomes for many patients. Often self-pay but sometimes covered for semi-accelerated variants.
- ONE-D (20 sessions in 1–2 days): More condensed; attractive for time-limited patients and those seeking an intensive “reset.” Emerging evidence: may use medication augmentation and AMPA equipment; typically self-pay initially (Inspire’s planned price: $3,000).
Read More: TMS Pricing Guide
What to expect if you choose ONE-D at Inspire
- Pre-visit consult & screening - psychiatric evaluation, medication review, seizure risk screening.
- Mapping & motor-threshold determination - before or at the visit to personalize the dose.
- ONE-D visit (1–2 days) - repeated iTBS sessions with short breaks; staff monitor comfort and vitals.
- Immediate follow-up & outcome tracking - PHQ-9 or similar scales, and follow-up calls/visits; touch-ups or maintenance discussed if needed.
Patient story: why someone might pick
ONE-D
Some patients travel specifically for accelerated care because it lets them complete a therapeutic course in days rather than weeks. For people balancing work, family, or long travel, ONE-D’s compressed schedule is appealing - especially when paired with physician oversight and clear aftercare. Inspire’s approach highlights convenience while retaining safety and personalization.
Is ONE-D experimental?
ONE-D is an emerging accelerated option with growing clinical interest and early positive reports; it’s best viewed as a research-informed clinical option requiring informed consent and physician oversight.
Is ONE-D safe?
Early experience suggests ONE-D can be delivered safely under proper screening and monitoring. Major risks (like seizure) remain very rare when standard safety protocols are followed.
Will insurance cover ONE-D?
As of now, ONE-D is generally self-pay. Some insurers (Medicare, Cigna) allow two sessions/day for eligible patients - a distinct policy that can shorten covered courses - but ONE-D’s single-day format is typically outside routine coverage. Always run a benefits check.
How soon will I feel better?
Responses vary. Some patients report early improvement days to weeks after accelerated stimulation; other patients need weeks to see full benefit. ONE-D aims to accelerate biological change, but individual timelines differ.
What medications are used to augment ONE-D?
Some programs use agents like D-cycloserine and short-acting stimulants (e.g., lisdexamfetamine) under psychiatric supervision to promote plasticity. These are given only when clinically appropriate and under informed consent; not every patient receives augmentation. Confirm with your psychiatrist.

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