Accelerated TMS for ADHD

Extended off-label theta-burst protocol for attention and focus support. 80 sessions in 4 days. San Antonio & Houston.

Why an Extended Protocol?

ADHD involves the prefrontal cortex circuits that govern attention, working memory, and executive function. Our extended protocol delivers double the standard session count — 80 sessions over 4 days — to provide a fuller stimulation course targeting these networks. The extended dose reflects the complexity of attention-related circuits compared to mood-only protocols.

The Protocol

Day 0 — Screening & Setup: Psychiatric evaluation, ADHD symptom assessment, and motor threshold mapping
Days 1–4 — Treatment: Approximately 20 short theta-burst sessions per day with adequate inter-session spacing
Week 1 Follow-Up: Symptom check-in, focus and attention assessment, optional qEEG re-scan
Month 1 Follow-Up: Final evaluation and optional qEEG re-scan

What to Expect

Patient experiences vary widely with off-label TMS for ADHD. Some patients report improved focus, reduced mental restlessness, or better task completion within the first few weeks. Others may notice subtler changes or need adjunct strategies. We strongly recommend the qEEG add-on for ADHD patients to provide objective measurements of cortical changes alongside subjective reports.

Important: TMS for ADHD is not a substitute for established ADHD treatments such as stimulant medications, behavioral therapy, or coaching. Results vary significantly. Eligibility is determined after a thorough psychiatric evaluation. Patients with implanted metal devices, seizure disorders, or active substance use may not be eligible.

Pricing

$5,000

80 sessions over 4 days • all-inclusive • cash-pay

Book Your Screening

The Science Behind TMS for ADHD

ADHD is associated with altered activity in the prefrontal cortex (PFC) — particularly the right inferior frontal gyrus and dorsolateral prefrontal cortex — regions central to inhibitory control, working memory, and executive function. TMS targeting these networks is an active area of research. TMS for ADHD remains an off-label use and the evidence base is earlier-stage than for depression.

Cortical excitability in ADHD

Altered prefrontal physiology

Single- and paired-pulse TMS studies have documented differences in motor cortex excitability and inhibition between adults with ADHD and matched controls, supporting a neurophysiological rationale for cortical-targeted intervention.¹

Therapeutic rTMS in ADHD

Sham-controlled trials in adults

A double-blind sham-controlled trial of high-frequency rTMS to the right DLPFC in adults with ADHD reported improvements on attention and ADHD-rating scales relative to sham, though the effect size and durability remain under investigation in larger replications.²

Pediatric and adolescent considerations

Evidence is limited in younger populations

Most published rTMS-for-ADHD trials have been conducted in adults. Studies in adolescents are smaller and earlier-stage, and we treat only adult patients. Patients should also be aware that TMS is not a substitute for stimulant or non-stimulant medications when those are clinically appropriate.³

Why an extended protocol?

Higher session counts for executive networks

Executive function involves more distributed cortical-subcortical circuits than mood alone. Theta-burst dosing studies suggest that higher cumulative pulse counts may engage these networks more reliably, which is the rationale for our 80-session, 4-day protocol.⁴ We strongly recommend the qEEG add-on so progress is tracked objectively.

References

Gilbert DL, Isaacs KM, Augusta M, MacNeil LK, Mostofsky SH. Motor cortex inhibition: a marker of ADHD behavior and motor development in children. Neurology. 2011;76(7):615-621. PubMed: 21321333
Cao P, Xing J, Cao Y, et al. Clinical effects of repetitive transcranial magnetic stimulation combined with atomoxetine in the treatment of attention-deficit hyperactivity disorder. Neuropsychiatric Disease and Treatment. 2018;14:3231-3240. PubMed: 30568447
Westwood SJ, Radua J, Rubia K. Noninvasive brain stimulation in children and adults with attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Journal of Psychiatric Research. 2021;132:230-239. PubMed: 33176252
Huang YZ, Edwards MJ, Rounis E, Bhatia KP, Rothwell JC. Theta burst stimulation of the human motor cortex. Neuron. 2005;45(2):201-206. PubMed: 15664172

References are provided for educational purposes. Citation does not constitute endorsement by the cited authors. TMS for ADHD remains an off-label use; the evidence base is earlier-stage than for depression. Always consult a board-certified psychiatrist before pursuing any treatment.

ADHD FAQ

Is TMS FDA-cleared for ADHD?

No. TMS is not currently FDA-cleared for ADHD. Use of TMS for ADHD is considered off-label, which is legal and a recognized part of clinical practice but has not been evaluated by the FDA for this specific indication.

Why does ADHD need 80 sessions instead of 40?

Attention and executive function involve more complex prefrontal circuits than mood alone. Our extended protocol delivers a higher total dose of stimulation — about 20 sessions per day rather than 10 — to better engage these networks within the 4-day window.

Can I continue ADHD medication during TMS?

Medication decisions are made on a case-by-case basis during your screening. TMS is not a substitute for established ADHD treatments and is generally compatible with ongoing stimulant or non-stimulant therapy when clinically appropriate.

Where is treatment delivered?

At either of our two Texas clinics: San Antonio (7800 I-10 Suite 624) or Houston (6105 Beverly Hill Suite 101). You select your preferred location during booking.

Ready to Begin?

Start with a free 10-minute screening with a board-certified psychiatrist.