Certified SAINT® TMS in Orange County
For individuals with Major Depressive Disorder who do not find relief from medication or therapy, Transcranial Magnetic Stimulation (TMS) offers an alternative treatment. A recent advancement in this field is SAINT® (Stanford Accelerated Intelligent Neuromodulation Therapy), also known as SNT.
Developed at Stanford University and cleared by the FDA in 2022 for treatment-resistant depression, SAINT® is delivered via the Magnus Neuromodulation System. It differs from conventional multi-week TMS by compressing treatment into multiple daily sessions over roughly five days and utilizing fMRI brain imaging to pinpoint a highly customized stimulation target for each patient.
What is SAINT® TMS?
SAINT® is a specialized form of intermittent theta-burst stimulation (iTBS). Theta-burst stimulation is a form of TMS that delivers magnetic pulses in a patterned sequence, creating small electrical currents within a targeted area of the brain without requiring surgery, anesthesia, or device implantation.
What distinguishes SAINT® from many conventional TMS protocols is its combination of accelerated treatment, a higher cumulative stimulation dose, intermittent theta-burst stimulation, individualized MRI-based targeting, and neuronavigation to repeatedly stimulate the identified brain region.
Before treatment begins, structural and functional MRI scans are used to identify a custom location within the left dorsolateral prefrontal cortex (DLPFC). This targeting method evaluates the functional relationship between areas of the DLPFC and the subgenual anterior cingulate cortex, a region strongly associated with depressive illness, allowing the treatment target to be individualized for each patient rather than relying solely on standardized scalp measurements.
Who May Be Considered for SAINT® TMS?
The FDA-cleared indication for SAINT® is specifically for adult patients with Major Depressive Disorder who have failed to achieve satisfactory improvement from prior antidepressant medication during their current depressive episode.
Whether SAINT® is appropriate still requires an individualized evaluation by a specialized psychiatrist.
Before treatment, psychiatrists may consider factors such as:
Current diagnosis and severity of depressive symptoms
Previous antidepressant treatment
Previous psychotherapy and other treatments
Current medications and psychiatric history
Seizure history and other seizure-risk factors
Previous TMS treatments, if applicable
Implanted metallic or electronic devices
Ability to tolerate multiple treatment sessions
Other factors that may influence the safety or appropriateness of treatment
What does SAINT® TMS Treatment Look Like?
01
Evaluation and Treatment Planning
Before therapy begins, patients undergo structural and functional MRI scans to map their unique neural wiring. The care team uses these scans to locate a precise target in the left dorsolateral prefrontal cortex based on its connection to deeper emotion-regulating brain regions. Because treatment involves a high-density schedule of 10 daily sessions spaced roughly 50 minutes apart, patients plan to remain at the clinic for most of the day across five consecutive days.
02
SAINT® TMS Sessions
During each treatment day, the patient sits comfortably while neuronavigation technology aligns the coil with their personalized brain target. The device delivers 1,800 magnetic pulses over a 10-minute active session while the patient stays fully awake, followed by a scheduled 50-minute break in the clinic before the next session begins.
03
Treatment Course and Response
Over the complete five-day protocol, patients complete 10 sessions per day for a total of 50 sessions and roughly 90,000 magnetic pulses. Because this massive cumulative dose is compressed into a single week, clinical response can occur much faster than with traditional multi-week TMS, though symptom relief may continue to develop in the days and weeks following treatment.
Why Evidence-Based SAINT® TMS Matters
TMS is more than placing a magnetic coil against the head.
High-quality TMS care involves appropriate diagnosis, patient selection, safety screening, individualized treatment parameters, accurate targeting, symptom monitoring and ongoing clinical oversight.
A thorough TMS evaluation should leave patients feeling informed and supported. Physicians work with patients to walk through key aspects of their care, including:
- Explaining the specific diagnosis and clinical rationale for choosing TMS.
- Outlining the specific protocol being used and the evidence behind it.
- Setting clear expectations for how progress will be monitored.
- Discussing a strategy for next steps if the treatment does not yield the desired response.
These questions help turn TMS from simply a procedure into part of a thoughtful, individualized mental-health treatment plan.
Considering SAINT® TMS?
For patients whose depression has continued despite previous antidepressant treatment, SAINT® provides another treatment option.
At Bridge Physicians Group, treatment decisions begin with a clinical evaluation of the individual's symptoms, diagnosis, previous treatments, medical and psychiatric history, treatment goals and overall clinical circumstances.
SAINT® represents an important development in precision neuromodulation, but the objective remains the same as with any psychiatric treatment: determining which evidence-based treatment strategy makes the most sense for the individual patient.
This information is provided for educational purposes and is not a substitute for individualized medical advice, diagnosis or treatment. SAINT® eligibility, treatment protocols, expected outcomes and insurance coverage vary. A qualified healthcare professional should determine whether SAINT® or another form of TMS is appropriate for you.
Faq
Frequently Asked Questions
What are the side effects?
SAINT is non-invasive and has generally been well tolerated in clinical studies.
Reported treatment-related side effects have included:
Headache
Fatigue
Scalp or treatment-site discomfort
Neck or back discomfort
Anxiety or agitation
Temporary muscle sensations
Dizziness
Tinnitus in some patients
In the studies included in the FDA review, no serious adverse events were reported in the active SAINT treatment groups evaluated for clearance. Researchers also did not identify negative cognitive effects in the early clinical studies.
However, SAINT remains a form of TMS, and seizure is a recognized but uncommon serious risk associated with TMS generally.
For this reason, appropriate medical screening, review of medications, evaluation of seizure risk and adherence to established treatment parameters remain important.
How Effective Is SAINT® for Depression?
SAINT® has demonstrated efficacy for depression treatment in several clinical trials, including randomized, sham-controlled studies.
An early open-label study involving 21 treated participants reported that 19 of 21 participants, or 90.5%, met the study's remission criteria following treatment.
Because there was no sham-control group in that study, these findings required confirmation through randomized trials.
A subsequent double-blind randomized controlled trial included 29 participants who received active or sham SAINT. Among participants receiving active treatment:
85.7% met the study's response criteria
78.6% met remission criteria
This compared with approximately 27% responding and 13.3% reaching remission in the sham group. Four weeks after treatment, the average reduction in depression severity measured using the Montgomery-Åsberg Depression Rating Scale was 52.5% with active treatment compared with 11.1% with sham treatment.
Importantly, newer evidence provides a more cautious estimate.
A larger double-blind randomized trial published in 2026 included 48 participants who received active or sham SNT. At one month:
50.0% of patients receiving active SNT were in remission, compared with 20.8% receiving sham treatment.
54.2% responded to active SNT, compared with 25.0% receiving sham treatment.
The study therefore replicated the antidepressant effect of SNT, although the remission rate was lower than the rates reported in the initial studies.
Some patients may experience major improvement, others partial improvement, and others may not respond.
How Quickly Can SAINT® Work?
Unlike conventional TMS - where patients typically wait two to four weeks before noticing clinical improvement - SAINT® is designed to produce a rapid onset of relief.
Because 50 sessions are compressed into five consecutive days, many patients experience a reduction in depressive symptoms during the treatment week itself or within days of completing the protocol.
However, a rapid onset does not guarantee an immediate response for every individual. While some patients report relief by the end of the five-day course, others experience more gradual changes in the weeks following treatment.
It is also important to separate the speed of improvement from the durability of those effects. Clinical evidence evaluated during SAINT®’s original FDA clearance focused on outcomes up to four weeks post-treatment.
Because long-term durability continues to be studied, individual responses vary, and some patients may require monitoring, maintenance, or retreatment over time.
Our other treatment options
Neuromodulatory protocols are highly individualized based on your unique clinical context. Your Bridge specialist will precisely map and tailor a treatment plan optimized for your specific brain network and recovery goals.
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Theta-Burst Stimulation (TBS)
Deep TMS (dTMS)
Accelerated TMS
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For treatment-resistant OCD, TMS enters the plan as a coordinated recommendation from both Dr. Nattagh and Dr. Dickey — each with full clinical context.
Research Center
Where TMS protocol decisions come
from.
The same physician directing your TMS is tracking the outcomes. Protocol development and clinical decisions are one continuous process at Bridge.
Bridge Research Center
— 60 year old male with depression
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