Theta burst stimulation (iTBS) is one of the most exciting advancements in modern TMS therapy. It delivers the same antidepressant benefits as standard transcranial magnetic stimulation (TMS) therapy in a fraction of the time. As providers continue refining treatment protocols, researchers are also looking closely at how medications interact with TMS.

But will it work alongside medications? One of the questions we receive most often is if TMS therapy works with antidepressants and other prescriptions.

A recent study conducted by AwakeningsKC found that benzodiazepines (a class of tranquilizer medications including Xanax) do not diminish TMS effectiveness, easing a long-standing concern among many patients. Even more promising, early evidence suggests that the antibiotic D-cycloserine may enhance TMS outcomes, potentially boosting neuroplasticity and accelerating symptom relief.

For individuals seeking faster, more effective treatment options, these findings highlight how iTBS (and the medications used alongside it) may shape the next generation of depression care.

“Can TMS Work with Medication?” Our Study and Its Findings

AwakeningsKC was proud to present our study at the annual gathering of the Clinical TMS Society (CTMSS) in Boston during the summer of 2026. We examined 63 of our patients, 36 of whom were using prescribed benzodiazepines as they engaged in iTBS therapy. Over the course of the study, we examined our patients’ scores on anxiety and depression tests we gave them.

iTBS and other forms of TMS therapy are often added to a treatment regimen that includes medications. Certain medications, like stimulants, appear to make TMS more effective. Others, like benzodiazepines, appear to make the therapy less effective. However, we were pleased to learn that our study results showed something unexpected.

Our patients’ scores on both the anxiety and depression tests decreased, showing us that benzodiazepines appear to have no effect on outcomes from TMS therapy.

It’s an exciting development – many patients often express concern that their current prescriptions may negatively interact with TMS. We’re happy to say that doesn’t appear to be the case. In fact, some medications seem to actually improve the effectiveness of TMS.

Interestingly, one of these is a medication you wouldn’t expect.

What Is D-Cycloserine?

D‑cycloserine (Seromycin) is a broad‑spectrum antibiotic produced by Streptomyces orchidaceus and Streptomyces garyphalus. It was approved by the FDA in thr 1thes to treat tuberculosis.

In the late 1980s, a team of researchers in Kansas City discovered that patients treated with D-cycloserine reported antidepressant effects. D‑cycloserine crosses into the central nervous system and acts as a partial agonist at the NMDA receptor’s glycine site, a receptor involved in learning, memory, and helping neurons sprout. This dual identity is what makes D‑cycloserine relevant in psychiatric research.

What Is Theta Burst Stimulation (iTBS)?

Theta burst stimulation (iTBS) is one of the most innovative advancements in modern transcranial magnetic stimulation. It delivers the equivalent therapeutic efficacy as standard TMS, but in a faster, more efficient pattern designed to work with the brain’s natural rhythms. This allows for more stimulation provided in less tine – it’s a more rigorous form of treatment.

For individuals seeking relief from treatment-resistant depression, iTBS offers a streamlined, research-backed option that fits more easily into daily life without sacrificing results.

TMS, including iTBS, enhances neuroplasticity, the brain’s ability to sprout new connections. By aligning stimulation with the brain’s natural theta rhythm, iTBS more effectively engages circuits involved in mood regulation. This can support:

• Faster symptom improvement
• More efficient neural strengthening
• Potential for accelerated treatment protocols (multiple sessions per day in research settings)
• Improved tolerability due to shorter sessions — headache-free

For many patients, this means less time in the clinic and more time living life, while still receiving a powerful, evidence‑based treatment.

How Does Theta Burst Stimulation Work?

iTBS uses a patterned sequence of magnetic pulses that mimic the brain’s theta rhythm, a frequency associated with learning, memory, and neuroplasticity. Instead of delivering steady pulses like traditional 10 Hz TMS, iTBS sends bursts of three pulses at 50 Hz, repeated every 200 milliseconds. This rhythm helps the brain strengthen healthier neural pathways, similar to how repetition reinforces learning.

Because the stimulation pattern is more efficient, the brain responds more quickly, allowing treatment sessions to be significantly shorter while maintaining the same antidepressant benefits.

Is Theta Burst Stimulation Right for Me?

Theta Burst Stimulation (iTBS) is an FDA‑cleared form of TMS that offers the same antidepressant benefits as standard TMS in a much shorter session. Whether it’s right for you depends on your diagnosis, treatment history, and personal preferences—but many people find iTBS appealing because it’s fast, well‑tolerated, and backed by strong clinical evidence.

People may be good candidates for iTBS if they:

• Have major depressive disorder and haven’t found relief from multiple antidepressant medications
• Prefer a non‑medication treatment or want to reduce reliance on medications
• Need a treatment option that fits into a busy schedule
• Have experienced side effects or limited benefit from traditional TMS and want a faster alternative

Theta Burst Stimulation at Awakenings KC

At AwakeningsKC, we offer an accelerated TMS program. It’s a faster, more intensive form of TMS that’s designed to shorten treatment time via theta burst stimulation (iTBS). Our accelerated TMS program consists of 6-8 sessions per week, turning a potential eight weeks of treatment into one week.

Awakenings provides traditional TMS therapy for depression as well. Our treatment program typically consists of 36 sessions over six to eight weeks. Each session lasts between three and 10 minutes.

While we provide TMS for depression, we also offer TMS for OCD (obsessive-compulsive disorder). For OCD, our patients typically complete 20 to 36 sessions over a four- to eight-week period, with each session lasting from five to 10 minutes.

AwakeningsKC: At the Leading Edge of TMS Therapy

We pride ourselves on being at the leading edge of research, always searching for the best way to help our clients live the lives they were meant for. Want to learn more about our effective treatment programs for depression and more, including our ketamine therapy program? Just reach out to AwakeningsKC today, and we’ll get started.

Frequently Asked Questions

What is TMS?

Transcranial magnetic stimulation is a non‑invasive treatment that uses magnetic pulses to stimulate mood‑regulating areas of the brain. It’s FDA‑cleared for major depressive disorder and does not require anesthesia or medication.

How is iTBS different from standard TMS?

iTBS delivers patterned bursts of stimulation that mimic the brain’s natural theta rhythm. It’s just as effective as traditional TMS but takes about 3 minutes per session instead of 37.

Does iTBS work for treatment‑resistant depression?

Yes. iTBS is FDA‑cleared for major depressive disorder and is commonly used when multiple antidepressants haven’t provided enough relief.

Is TMS or iTBS painful?

Most people describe the sensation as tapping or pressure on the scalp. Discomfort is usually mild and decreases over time.

Can medications be used alongside TMS or iTBS?

Yes. Many patients continue their current medications during treatment. Some medications, like NMDA‑modulating agents such as D‑cycloserine, are being studied for their potential to enhance neuroplasticity.