VERIGRATE HEALTH · NEUROMODULATION

Accelerated TMS, within a broader psychiatric treatment plan.

Accelerated TMS, within a broader psychiatric treatment plan.

Accelerated TMS, within a broader psychiatric treatment plan.

One-day TMS is offered selectively as part of a physician-led review of diagnosis, medications, prior treatment, and broader factors affecting recovery—not as an isolated procedure.

One-day TMS is offered selectively as part of a physician-led review of diagnosis, medications, prior treatment, and broader factors affecting recovery—not as an isolated procedure.

Verigrate Health is a limited-panel private psychiatry practice led by board-certified psychiatrist Christian S. Monsalve, M.D. One-day TMS for selected adults with major depressive disorder is considered only when it belongs in a more coherent treatment plan.

Verigrate Health is a limited-panel private psychiatry practice led by board-certified psychiatrist Christian S. Monsalve, M.D. One-day TMS for selected adults with major depressive disorder is considered only when it belongs in a more coherent treatment plan.

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BOARD-CERTIFIED PSYCHIATRIST

CLINICAL TMS SOCIETY MEMBER

PRIVATE PAY

DALLAS + SELECT PRIVATE LOCATIONS

What is one-day TMS?

What is one-day TMS?

What is one-day TMS?

One-day TMS is an accelerated form of transcranial magnetic stimulation in which multiple treatment sessions are delivered during one structured treatment day rather than across weeks of repeated appointments.

One-day TMS is an accelerated form of transcranial magnetic stimulation in which multiple treatment sessions are delivered during one structured treatment day rather than across weeks of repeated appointments.

At Verigrate Health, one-day TMS is available to carefully selected adults with major depressive disorder after individualized psychiatric and safety evaluation.

At Verigrate Health, one-day TMS is available to carefully selected adults with major depressive disorder after individualized psychiatric and safety evaluation.

Treatment is considered within the patient’s complete psychiatric picture—including diagnosis, previous treatment response, medication exposure, medical history, psychotherapy, and longer-term goals.

Treatment is considered within the patient’s complete psychiatric picture—including diagnosis, previous treatment response, medication exposure, medical history, psychotherapy, and longer-term goals.

Where is Verigrate Health’s one-day TMS program based?

One-day accelerated TMS is available through Verigrate Health in Dallas, Texas. Physician-directed private-location treatment can also be arranged for selected patients in Dallas–Fort Worth and appropriate settings in New York City, Teaneck, Bergen County, and northern New Jersey. Other destinations are considered individually, subject to clinical suitability, jurisdiction, safety, staffing, and logistics. It is not a consumer or self-administered home TMS product.

THE VERIGRATE MODEL

More than a TMS protocol.

More than a TMS protocol.

More than a TMS protocol.

Neuromodulation can be valuable, but adding another treatment is not always the same as improving a treatment plan. At Verigrate Health, Dr. Christian S. Monsalve examines diagnosis, medication history, prior response, current treatment burden, and opportunities to simplify or deprescribe when appropriate.

Neuromodulation can be valuable, but adding another treatment is not always the same as improving a treatment plan. At Verigrate Health, Dr. Christian S. Monsalve examines diagnosis, medication history, prior response, current treatment burden, and opportunities to simplify or deprescribe when appropriate.

Sleep, exercise, metabolic health, substance use, medical contributors, and other modifiable factors may also be considered. The question is not simply whether TMS can be delivered. It is whether TMS belongs in this patient’s treatment plan. Treatment recommendations follow the evaluation—not the other way around.

Sleep, exercise, metabolic health, substance use, medical contributors, and other modifiable factors may also be considered. The question is not simply whether TMS can be delivered. It is whether TMS belongs in this patient’s treatment plan. Treatment recommendations follow the evaluation—not the other way around.

01

CLARIFY

Diagnosis, history, previous treatment, and clinical context.

Diagnosis, history, previous treatment, and clinical context.

02

RECONSIDER

Whether current treatment remains necessary, beneficial, proportionate, or burdensome.

Whether current treatment remains necessary, beneficial, proportionate, or burdensome.

03

TREAT

Medication, psychotherapy, metabolic approaches, or neuromodulation when clinically appropriate.

Medication, psychotherapy, metabolic approaches, or neuromodulation when clinically appropriate.

04

CONTINUE

One physician maintains the larger clinical picture over time.

One physician maintains the larger clinical picture over time.

Explore the clinical approach →

Precision psychiatry →

For referring physicians →

THE TREATMENT DAY

One day, intentionally structured.

One day, intentionally structured.

One day, intentionally structured.

01

ARRIVE

Private intake, consent review, and final same-day readiness.

Private intake, consent review, and final same-day readiness.

02

CALIBRATE

Personalized targeting and dosing setup under physician direction.

Personalized targeting and dosing setup under physician direction.

03

TREAT

Accelerated stimulation blocks with interval safety checks.

Accelerated stimulation blocks with interval safety checks.

04

BETWEEN SESSIONS

Guided intervals with safety checks and environment control.

Guided intervals with safety checks and environment control.

05

COMPLETE

Day-end clinical review and follow-up planning.

Day-end clinical review and follow-up planning.

One-Day TMS, Accelerated TMS, and Conventional TMS

One-Day TMS, Accelerated TMS, and Conventional TMS

One-Day TMS, Accelerated TMS, and Conventional TMS

CONVENTIONAL TMS

Usually delivered over several weeks

Usually delivered over several weeks

Typically one treatment session per visit

Typically one treatment session per visit

Most established evidence base

Most established evidence base

Broadly available

Broadly available

ACCELERATED TMS

Multiple treatment sessions per day

Delivered over a shorter overall period

Growing evidence base

Protocols vary substantially

ONE-DAY TMS

Multiple treatment sessions in one structured day

Multiple treatment sessions in one structured day

Highly concentrated schedule

Highly concentrated schedule

Emerging evidence base

Emerging evidence base

Appropriate only for carefully selected patients

Appropriate only for carefully selected patients

Accelerated TMS describes schedules that provide more than one TMS session per day. One-day TMS is one form of accelerated treatment. It should not be assumed to be clinically equivalent to every conventional or accelerated protocol.

THE EVIDENCE

What does the evidence show for one-day TMS?

What does the evidence show for one-day TMS?

What does the evidence show for one-day TMS?

Promising findings. Important limitations.

Conventional multi-week TMS has a substantially more established evidence base for major depressive disorder. Accelerated TMS is an active area of research, and preliminary studies of single-day treatment have reported promising outcomes in selected populations. However, evidence for one-day protocols remains limited compared with conventional schedules, and results from one protocol should not automatically be generalized to another.

Conventional multi-week TMS has a substantially more established evidence base for major depressive disorder. Accelerated TMS is an active area of research, and preliminary studies of single-day treatment have reported promising outcomes in selected populations. However, evidence for one-day protocols remains limited compared with conventional schedules, and results from one protocol should not automatically be generalized to another.

YEAR

2018

2018

STUDY DESIGN

Randomized controlled trial

Randomized controlled trial

SAMPLE SIZE

n = 414

n = 414

PUBLICATION

The Lancet

The Lancet

KEY FINDING

Compared two TMS schedules over 4–6 weeks rather than a one-day treatment schedule.

Compared two TMS schedules over 4–6 weeks rather than a one-day treatment schedule.

LIMITATION

Not a single-day protocol comparison and does not establish equivalence for a different planned program.

Not a single-day protocol comparison and does not establish equivalence for a different planned program.

View publication →

YEAR

2018

2018

STUDY DESIGN

Randomized comparison

Randomized comparison

SAMPLE SIZE

n = 115

n = 115

PUBLICATION

Neuropsychopharmacology

Neuropsychopharmacology

KEY FINDING

Compared accelerated treatment delivered over 3 weeks with standard treatment over 4 weeks.

Compared accelerated treatment delivered over 3 weeks with standard treatment over 4 weeks.

LIMITATION

Not single-day treatment; reported greater treatment discomfort and does not infer outcomes for a different planned program.

Not single-day treatment; reported greater treatment discomfort and does not infer outcomes for a different planned program.

View publication →

YEAR

2025

2025

STUDY DESIGN

Open-label case series

Open-label case series

SAMPLE SIZE

n = 32

n = 32

PUBLICATION

Transcranial Magnetic Stimulation

Transcranial Magnetic Stimulation

KEY FINDING

Reported symptom changes after a single-day regimen in an uncontrolled cohort.

Reported symptom changes after a single-day regimen in an uncontrolled cohort.

LIMITATION

Pharmacologic augmentation and no direct evidence that a different planned regimen produces the same outcomes.

Pharmacologic augmentation and no direct evidence that a different planned regimen produces the same outcomes.

View publication →

EMERGING SINGLE-DAY EVIDENCE

What has been reported in a real-world single-day case series?

What has been reported in a real-world single-day case series?

A 2025 retrospective, naturalistic, open-label case series reported outcomes in 32 adults with unipolar major depression who underwent an optimized single-day TMS regimen. The published treatment course consisted of 20 intermittent theta-burst stimulation (iTBS) sessions delivered approximately every 30 minutes over about 9.5 hours, together with pharmacologic augmentation.

CHARACTERISTICS OF THE PUBLISHED CASE SERIES — NOT A VERIGRATE TREATMENT PROMISE

32

ADULTS

20

TMS SESSIONS

9.5 hours

APPROXIMATE TREATMENT DAY

26 weeks

LONGEST REPORTED FOLLOW-UP

Reported outcomes at six weeks

On the clinician-rated HDRS-17 depression scale, the case series reported:

87.5%

RESPONSE · HDRS-17

71.9%

REMISSION · HDRS-17

Response was defined as at least 50% improvement. Remission was defined according to the study’s prespecified HDRS-17 threshold.

These percentages describe this uncontrolled case series and should not be interpreted as expected outcomes for an individual patient or as results Verigrate will reproduce.

TIME COURSE

Improvement was not immediate.

Improvement was not immediate.

In this case series, symptom improvement continued over the weeks following the treatment day rather than occurring primarily during the treatment itself. Average improvement generally approached a plateau around weeks 4–6.

A one-day treatment schedule does not necessarily mean a one-day clinical response.

What happened over longer follow-up?

At 12 weeks, the reported HDRS-17 response and remission rates remained 84.4% and 71.2%, respectively, using the original 32-patient sample as the denominator.

At approximately 26 weeks, 16 of the original 32 patients—50%—were classified as having sustained remission on both HDRS-17 and BDI-II.

By 26 weeks, some patients had relapsed or received retreatment, and some were lost to follow-up. These are preliminary durability observations, not a guarantee of lasting benefit.

Safety and tolerability in the case series

All 32 patients completed the 20-session treatment day.

No seizures, emergent mania or hypomania, or other serious adverse events were reported during treatment or the six-week safety follow-up in this small case series. This does not mean TMS is risk-free.

The most common treatment-related issue was discomfort. Mean scalp discomfort was approximately 5.8 on a 10-point scale. Transient headache or jaw discomfort was also reported.

INTERPRETING THE EVIDENCE

Promising findings. Important limitations.

Promising findings. Important limitations.

WHAT THIS STUDY ADDS

01 Practical feasibility of completing 20 TMS sessions in a single treatment day.

02 Real-world symptom observations from 32 adults with major depression.

03 Symptom follow-up through approximately six months and initial safety and tolerability observations.

04 A signal that improvement may continue over several weeks after treatment.

WHAT REMAINS UNCERTAIN

01 No sham or placebo control, no blinding, and a small sample.

02 Thirteen of 32 participants had previously responded to TMS.

03 Pharmacologic augmentation was used. The separate contributions of TMS, D-cycloserine, and lisdexamfetamine cannot be determined.

04 Results may not generalize to more severe or acute populations.

05 Long-term durability and optimal retreatment remain uncertain. Randomized controlled replication is needed.

The published regimen was not TMS alone.

The published single-day regimen included single-dose D-cycloserine 125 mg and lisdexamfetamine 20 mg before treatment as pharmacologic augmentation. These uses for TMS augmentation were off-label. The study cannot determine how much of the observed outcome was attributable to TMS, either medication, or their combination.

SOURCE & STUDY DISCLOSURES

Vaughn DA, Marino B, Engelbertson A, et al. Real-world effectiveness of a single-day regimen for transcranial magnetic stimulation using Optimized, Neuroplasticity-Enhanced techniques in Depression (ONE-D): An open-label case series. Transcranial Magnetic Stimulation. 2025;5:100200. doi:10.1016/j.transm.2025.100200

Several study authors disclosed employment, board, equity, consulting, patent, or other relationships with Ampa Health and other TMS-related organizations. Readers should consider these published disclosures alongside the observational study design. This is not an allegation of misconduct.

View publication and disclosures →

WHAT WE KNOW

Conventional multi-week TMS has deeper evidence maturity. Accelerated schedules show promising signals in selected research contexts.

Conventional multi-week TMS has deeper evidence maturity. Accelerated schedules show promising signals in selected research contexts.

WHAT REMAINS UNCERTAIN

How single-day outcomes compare directly with conventional pathways for broad patient populations remains uncertain, as does which patient subgroups are best suited for a one-day schedule.

How single-day outcomes compare directly with conventional pathways for broad patient populations remains uncertain, as does which patient subgroups are best suited for a one-day schedule.

Accelerated schedules continue to evolve, and outcomes vary across individuals. No outcome guarantees are made.

Accelerated schedules continue to evolve, and outcomes vary across individuals. No outcome guarantees are made.

Treatment begins with diagnosis, not a device.

Treatment begins with diagnosis, not a device.

Treatment begins with diagnosis, not a device.

TMS is considered only after careful psychiatric evaluation. Diagnosis, prior treatment response, medication exposure, bipolar-spectrum symptoms, psychosis, seizure risk, sleep, substance use, medical history, psychotherapy, and patient preferences may all affect whether TMS is appropriate and which schedule makes sense. Some people with difficult-to-treat depression may be considered, but an accelerated schedule is not appropriate for everyone.

TMS is considered only after careful psychiatric evaluation. Diagnosis, prior treatment response, medication exposure, bipolar-spectrum symptoms, psychosis, seizure risk, sleep, substance use, medical history, psychotherapy, and patient preferences may all affect whether TMS is appropriate and which schedule makes sense. Some people with difficult-to-treat depression may be considered, but an accelerated schedule is not appropriate for everyone.

PRIVATE CARE, DESIGNED AROUND LOCATION

One treatment model. Three settings for care.

One treatment model. Three settings for care.

One treatment model. Three settings for care.

01

DALLAS

Private treatment at Verigrate Health in Preston Center, near the Park Cities.

Private treatment at Verigrate Health in Preston Center, near the Park Cities.

02

DFW PRIVATE LOCATION

For selected patients in Dallas–Fort Worth, treatment may be considered in an approved private residence or other suitable setting.

For selected patients in Dallas–Fort Worth, treatment may be considered in an approved private residence or other suitable setting.

03

NATIONAL PRIVATE LOCATION

Private-location treatment may be available for selected patients in eligible jurisdictions.

Private-location treatment may be available for selected patients in eligible jurisdictions.

One-day TMS in New York & Bergen County →

Christian S. Monsalve, M.D. holds medical licensure in 44 states and Washington, D.C. Private-location treatment availability is determined separately based on jurisdiction, clinical eligibility, safety requirements, staffing, and operational feasibility.

Christian S. Monsalve, M.D. holds medical licensure in 44 states and Washington, D.C. Private-location treatment availability is determined separately based on jurisdiction, clinical eligibility, safety requirements, staffing, and operational feasibility.

BEYOND A PROCEDURE

Less treatment when appropriate. Different treatment when necessary.

Less treatment when appropriate. Different treatment when necessary.

Less treatment when appropriate. Different treatment when necessary.

The goal is not to maximize the number of treatments delivered. It is to determine which treatments are worth continuing, which may be unnecessary, what may be missing, and where TMS can contribute meaningfully. Privacy is not an ancillary amenity. It is part of how care is designed.

The goal is not to maximize the number of treatments delivered. It is to determine which treatments are worth continuing, which may be unnecessary, what may be missing, and where TMS can contribute meaningfully. Privacy is not an ancillary amenity. It is part of how care is designed.

Explore precision medication tapering →

Neuromodulation beyond depression

Neuromodulation beyond depression

Neuromodulation beyond depression

TMS technology also has device- and protocol-specific applications beyond major depressive disorder. Verigrate evaluates neuromodulation according to diagnosis, available evidence, regulatory status, device capabilities, and individual clinical context.

TMS technology also has device- and protocol-specific applications beyond major depressive disorder. Verigrate evaluates neuromodulation according to diagnosis, available evidence, regulatory status, device capabilities, and individual clinical context.

Christian S. Monsalve, M.D.

YOUR PHYSICIAN

Physician-led from evaluation through treatment planning.

Physician-led from evaluation through treatment planning.

Physician-led from evaluation through treatment planning.

Christian S. Monsalve, M.D.

Christian S. Monsalve, M.D. is a board-certified psychiatrist and Founder & Medical Director of Verigrate Health. His practice focuses on complex psychiatric consultation, diagnostic clarification, psychopharmacology, medication tapering and deprescribing, and individualized treatment planning. He is a member of the Clinical TMS Society; his TMS training includes participation in its PULSES program. Full training and scholarship details are available on his professional record.

Christian S. Monsalve, M.D. is a board-certified psychiatrist and Founder & Medical Director of Verigrate Health. His practice focuses on complex psychiatric consultation, diagnostic clarification, psychopharmacology, medication tapering and deprescribing, and individualized treatment planning. He is a member of the Clinical TMS Society; his TMS training includes participation in its PULSES program. Full training and scholarship details are available on his professional record.

About Dr. Monsalve →

CLINICAL CONTENT REVIEWED BY

Christian S. Monsalve, M.D.

Board-Certified Psychiatrist · Founder & Medical Director, Verigrate Health · Member, Clinical TMS Society

Last medically reviewed: September 2026

PRIVATE-PAY CARE

Private-pay accelerated treatment

Private-pay accelerated treatment

Private-pay accelerated treatment

Comprehensive accelerated treatment in Dallas is $10,000. Private or destination treatment begins at $15,000 and is quoted individually according to the treatment setting, specialist time, equipment transport, travel, and logistical complexity. The initial psychiatric consultation is $1,000 separately. Treatment follows physician evaluation and is recommended only when appropriate.

Comprehensive accelerated treatment in Dallas is $10,000. Private or destination treatment begins at $15,000 and is quoted individually according to the treatment setting, specialist time, equipment transport, travel, and logistical complexity. The initial psychiatric consultation is $1,000 separately. Treatment follows physician evaluation and is recommended only when appropriate.

The standard $1,000 initial psychiatric consultation is the clinical entry point. Inquiries address fit, logistics, and availability—not individualized recommendations.

The standard $1,000 initial psychiatric consultation is the clinical entry point. Inquiries address fit, logistics, and availability—not individualized recommendations.

View private psychiatry and TMS fees →

QUESTIONS

Frequently Asked Questions

Frequently Asked Questions

Frequently Asked Questions

ONE-DAY TMS · VERIGRATE HEALTH

Clinical judgment before intervention.

Clinical judgment before intervention.

Clinical judgment before intervention.

One-day TMS is available for selected patients after physician evaluation. Written inquiries address questions and logistics; the separate $1,000 initial psychiatric consultation begins formal clinical assessment.

One-day TMS is available for selected patients after physician evaluation. Written inquiries address questions and logistics; the separate $1,000 initial psychiatric consultation begins formal clinical assessment.

Inquire About One-Day TMS

Schedule Initial Consultation — $1,000