Approximately one in three people treated for major depressive disorder do not achieve adequate relief from their first antidepressant, and a substantial share of patients with major depression continue to experience symptoms after multiple adequate treatment steps (Rush et al., 2006). For patients in this category, the neurobiological underpinning of persistent depression often involves dysfunctional activity in subcortical and deeper prefrontal circuits that standard surface-level interventions cannot reliably reach. At Complete Mind Care, we offer Deep Transcranial Magnetic Stimulation — a brain-based therapy that targets those deeper structures directly, giving our patients near Philadelphia a clinically validated path to remission when medications have fallen short.
What Sets Deep TMS Apart From Standard TMS
Transcranial Magnetic Stimulation works by delivering electromagnetic pulses through a coil placed against the scalp, inducing electrical currents in targeted cortical regions. Standard TMS coils — typically figure-eight designs — stimulate tissue to a depth of roughly 2 centimeters, which is sufficient to engage the dorsolateral prefrontal cortex (DLPFC) at the surface. Deep TMS, delivered through the BrainsWay H-coil system, penetrates to depths of 3 to 4 centimeters, reaching the DLPFC more broadly and engaging additional circuits including the anterior cingulate cortex and subgenual cingulate — regions strongly implicated in the anhedonia, emotional blunting, and cognitive fatigue that define treatment-resistant presentations.
The BrainsWay H-coil generates a wider and more diffuse magnetic field than conventional figure-eight coils, which enables it to stimulate larger volumes of neural tissue simultaneously. This broader stimulation footprint is not simply a technical detail — it correlates with clinical outcomes. The pivotal randomized controlled trial supporting FDA clearance for Deep TMS in MDD demonstrated a 38.4% response rate compared to 21.4% for sham treatment, with a remission rate of 32.6% in the active group versus 14.6% in the sham group (Levkovitz et al., 2015). These figures represent meaningful clinical gains in a population that has already exhausted multiple medication options. Results vary by individual, and we discuss with each patient what response rates mean in practical terms before beginning treatment.
The Neurobiological Rationale for Deeper Stimulation
Depression is not a single-circuit condition. Contemporary neuroimaging research has shifted the field’s understanding away from simple monoamine deficiency toward a network dysregulation model in which the prefrontal-limbic axis — including the DLPFC, subgenual cingulate, amygdala, and striatum — fails to maintain appropriate inhibitory control over emotional and ruminative processing. Functional imaging and related neuromodulation research in patients with treatment-resistant depression has helped identify abnormal activity in mood-regulation circuits involving the prefrontal cortex and subgenual cingulate region (Mayberg et al., 2005).
Deep TMS addresses this network by driving repetitive high-frequency stimulation of the left DLPFC, which may influence cortical excitability and downstream limbic activity through neuroplastic mechanisms. What makes the H-coil particularly relevant for TRD is that patients with significant treatment resistance often show patterns of dysfunction in the deeper DLPFC and connected mood-regulation circuits that standard coils may not reach as broadly. By accessing these structures, Deep TMS addresses the biology of treatment resistance rather than simply repeating a surface-level approach that has already proven insufficient.
Who Is a Candidate for Deep TMS Near Philadelphia
At our Horsham clinic, we evaluate Deep TMS candidacy through a comprehensive psychiatric assessment that considers diagnostic history, prior treatment trials, current medications, and relevant medical factors. The primary indication we treat with Deep TMS is major depressive disorder with treatment-resistant features — specifically, patients who have not achieved remission after at least two antidepressant trials at adequate dose and duration.
Beyond MDD, Deep TMS using the BrainsWay system has received FDA clearance for obsessive-compulsive disorder (OCD) using a different H-coil configuration, and for smoking cessation using another coil configuration. This multi-indication platform means that patients who present with comorbid depression and OCD — a clinically common combination — may be evaluated for a treatment plan that considers both conditions within the same modality when clinically appropriate. We also evaluate patients with bipolar depression, postpartum depression, and anxious depression on a case-by-case basis, as evidence, indication status, and insurance coverage vary by diagnosis.
Patients with cardiac pacemakers, cochlear implants, or ferromagnetic implants near the head are generally excluded from TMS-based therapies. We conduct a thorough screening during the intake process to identify any contraindications. Discuss with your provider whether Deep TMS is appropriate for your specific clinical history and medical background.
What the Treatment Course Looks Like at Complete Mind Care
Deep TMS treatment at our Horsham location involves daily sessions — typically Monday through Friday — over a four- to six-week period, for a standard course of 20 to 30 sessions. Each session lasts approximately 20 minutes. Patients remain awake and alert throughout; no anesthesia is used, and no recovery time is needed. Most patients drive themselves to and from appointments.
One of the barriers we hear from patients considering Deep TMS is scheduling: the daily commitment over several weeks feels daunting alongside work and family obligations. We work with patients to build a schedule that fits their lives, including early morning appointments to accommodate commuters traveling from Dresher, Abington, Willow Grove, Lansdale, and surrounding Montgomery County communities. Another barrier we frequently encounter is uncertainty about insurance coverage. Deep TMS for MDD is covered by many major insurance plans when TRD criteria are met, and our team handles prior authorizations and benefits verification as part of the intake process.
The treatment itself involves placing the helmet-shaped H-coil device over the head, calibrating the stimulation intensity to the patient’s motor threshold (a brief procedure performed at the first session), and then delivering a standardized stimulation protocol. Patients may feel a light tapping sensation on the scalp and hear a rhythmic clicking sound. Side effects are typically limited to mild scalp discomfort or headache, which generally diminish after the first few sessions. Serious adverse events are rare.
How We Integrate Deep TMS With Whole-Person Care
We do not deliver Deep TMS in isolation. Our clinical model at Complete Mind Care pairs brain-based therapies with the broader psychiatric services that support lasting remission — medication management for patients who continue to benefit from pharmacological support, and psychotherapy for patients who want to address the cognitive and behavioral dimensions of depression alongside its neurobiology. Research published in the Journal of Affective Disorders suggests that combining Deep TMS with cognitive-emotional reactivation may influence antidepressant outcomes (Isserles et al., 2011), and this informs how we build individualized treatment plans for TRD patients at our Horsham clinic.
Remission is our mission. For patients near Philadelphia who have spent years cycling through medications without adequate relief, Deep TMS represents a genuine alternative rooted in neuroscience rather than trial-and-error pharmacology. We believe every patient deserves access to the most advanced brain-based therapies available, not simply the most convenient ones.
FAQ
What is Deep TMS and how is it different from regular TMS?
Deep TMS uses the BrainsWay H-coil system to stimulate brain tissue at depths of 3 to 4 centimeters, compared to roughly 2 centimeters for standard figure-eight TMS coils. This deeper reach engages a broader network of prefrontal circuits implicated in treatment-resistant depression, which is why Deep TMS is specifically studied in patients who have not responded to standard treatments.
Is Deep TMS FDA-cleared for depression?
Deep TMS using the BrainsWay H1 coil is FDA-cleared for major depressive disorder. “FDA-cleared” indicates that the treatment has been cleared through the FDA’s 510(k) regulatory pathway, which is the standard designation for many medical devices including TMS systems.
How many Deep TMS sessions does it take to see results?
Most patients complete 20 to 30 sessions over four to six weeks, and many begin noticing improvements in mood, sleep, or energy within the second or third week of treatment. Full clinical response is typically assessed at the end of the acute treatment course. Individual timelines vary, and results may differ from person to person.
Does insurance cover Deep TMS for treatment-resistant depression?
Many major insurance plans, including commercial plans widely used in Montgomery County and the broader Philadelphia suburbs, cover Deep TMS when documented TRD criteria are met — typically two failed antidepressant trials. Our team at Complete Mind Care handles prior authorization and coverage verification as part of the intake process.
Can Deep TMS be combined with antidepressant medication?
Yes. Most patients who receive Deep TMS at our Horsham clinic continue their existing psychiatric medications during the treatment course. We review each patient’s medication regimen during the initial evaluation to identify any interactions or optimization opportunities, and we monitor for symptom changes throughout treatment.
Key Takeaways
Deep TMS uses the BrainsWay H-coil to stimulate brain tissue 3–4 cm deep, reaching circuits involved in treatment-resistant depression that standard TMS coils cannot reliably access.
The pivotal clinical trial showed a 32.6% remission rate in the active Deep TMS group versus 14.6% in the sham group among patients with major depressive disorder.
Deep TMS is FDA-cleared for MDD and OCD, and typically requires no anesthesia, no medication changes during treatment, and no downtime after sessions.
At Complete Mind Care in Horsham, Deep TMS is integrated with medication management and psychotherapy as part of an individualized treatment plan.
Results vary by individual; treatment candidacy is determined through a comprehensive psychiatric evaluation including medical screening for contraindications.
Conclusion
If you or someone you care about is living with major depression that has not responded to medications, you do not have to accept that outcome as permanent. At Complete Mind Care, our Horsham clinic — located at 721 Dresher Rd #1100, Horsham, PA 19044 — offers Deep TMS therapy using the FDA-cleared BrainsWay system, delivered by a team with deep experience in brain-based psychiatric care. We serve patients from across Montgomery County, the greater Philadelphia area, and the surrounding suburbs. Call us at 215-607-7250 or schedule a consultation to find out whether Deep TMS belongs in your individualized treatment plan.
References
BrainsWay Ltd. (2013). 510(k) summary: BrainsWay Deep TMS System (K122288). U.S. Food and Drug Administration. https://www.accessdata.fda.gov/cdrh_docs/pdf12/K122288.pdf
Isserles, M., Rosenberg, O., Dannon, P., Levkovitz, Y., Kotler, M., Deutsch, F., Lerer, B., & Zangen, A. (2011). Cognitive-emotional reactivation during deep transcranial magnetic stimulation over the prefrontal cortex of depressive patients affects antidepressant outcome. Journal of Affective Disorders, 128(3), 235–242. https://doi.org/10.1016/j.jad.2010.06.038
Levkovitz, Y., Isserles, M., Padberg, F., Lisanby, S. H., Bystritsky, A., Xia, G., Tendler, A., Daskalakis, Z. J., Winston, J. L., Dannon, P., Hafez, H. M., Reti, I. M., Morales, O. G., Schlaepfer, T. E., Hollander, E., Berman, J. A., Husain, M. M., Sofer, U., Harroch, E., … Zangen, A. (2015). Efficacy and safety of deep transcranial magnetic stimulation for major depression: A prospective multicenter randomized controlled trial. World Psychiatry, 14(1), 64–73. https://doi.org/10.1002/wps.20199
Mayberg, H. S., Lozano, A. M., Voon, V., McNeely, H. E., Seminowicz, D., Hamani, C., Schwalb, J. M., & Kennedy, S. H. (2005). Deep brain stimulation for treatment-resistant depression. Neuron, 45(5), 651–660. https://doi.org/10.1016/j.neuron.2005.02.014
Rush, A. J., Trivedi, M. H., Wisniewski, S. R., Nierenberg, A. A., Stewart, J. W., Warden, D., Niederehe, G., Thase, M. E., Lavori, P. W., Lebowitz, B. D., McGrath, P. J., Rosenbaum, J. F., Sackeim, H. A., Kupfer, D. J., Luther, J., & Fava, M. (2006). Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: A STAR*D report. American Journal of Psychiatry, 163(11), 1905–1917. https://doi.org/10.1176/ajp.2006.163.11.1905
Medical Disclaimer
The information provided in this blog is for educational purposes only and does not constitute medical advice. Treatment outcomes vary by individual. Results may vary. Please consult with a qualified healthcare provider before beginning any new treatment. Discuss with your provider whether this treatment is appropriate for you.