Late-Life Depression
Depression in older adults whose bodies do not tolerate more medications.
BrainsWay's 2024 label expansion to ages 22–86 makes it the only TMS device formally cleared for older adults across this range. The mechanistic rationale is straightforward: scalp-to-cortex distance increases with age and atrophy, which reduces figure-8 coil efficacy because the focal field falls off rapidly with depth. The H1 coil's deeper, broader field tolerates this anatomic variability.
Crucially, Deep TMS produces no demonstrated cognitive worsening — a meaningful contrast with ECT, which often is otherwise the next-line option in this population.
FDA status
FDA expansion (BrainsWay H1, June 2024 — ages 22–86)
Standard protocol at IPMG TMS
30 sessions over 6 weeks · H1, 18 Hz or iTBS
- 79% response · 60% remission247 patients ages 60–91 at 16 sites, 30 sessions, H1 coil — the dataset that supported the FDA expansion.Roth et al., J Clin Med 2024
- Remission 40% vs 14.8%, NNT = 4Foundational RCT in late-life TRD, no cognitive worsening on standardized measures.Kaster et al., Neuropsychopharmacology 2018
Who this is for.
- Adults ≥60 with MDD inadequately responsive to medications
- Older adults intolerant of medication side effects
- Patients for whom ECT is undesirable or contraindicated
Eligibility is finalized at consultation. We screen carefully for contraindications — see the Safety page.
Talk with the IPMG TMS team.
A consultation is the right next step. We will review your prior treatments, confirm whether you meet the FDA-cleared criteria for this indication, and walk you through what your insurance covers.