Not every treatment works for every person. If you’ve been through antidepressants, therapy, or even one of the advanced treatments — and you’re still struggling — that doesn’t mean you’ve run out of options. It means the right combination may not have been tried yet.
Not every treatment works for every person. If you’ve been through antidepressants, therapy, or even one of the advanced treatments — and you’re still struggling — that doesn’t mean you’ve run out of options. It means the right combination may not have been tried yet.
At Interventional Psychiatry of Philadelphia, we offer a full range of advanced psychiatric treatments and, where evidence supports it, we use them in combination. That approach is what separates an interventional psychiatry practice from a clinic that offers one or two standalone procedures.
What is interventional psychiatry? Interventional psychiatry is a subspecialty within psychiatry focused on procedural and device-based treatments for mental health conditions — particularly those that have not responded to medication or therapy alone. It integrates neuromodulation methods with targeted pharmacological interventions, providing options for patients who have not found relief through conventional care.
For patients who have tried TMS or ketamine individually without full relief, using both in a coordinated protocol may produce results that neither achieves alone. TMS and ketamine work through different but complementary pathways — and the timing of how they are sequenced matters clinically. This is the right conversation to have if you’ve had a partial response, or no response, to either treatment on its own.
tDCS is a low-level electrical stimulation technique that can be delivered in the same session as TMS, with no additional appointments. A 2024 randomized clinical trial published in JAMA Network Open (Zhou et al., 240 participants) found that combining tDCS with TMS produced significantly better outcomes than either treatment alone in patients with major depressive disorder. If you are planning a TMS course, this is worth discussing before you start.
D-cycloserine (DCS) is a medication that amplifies the brain’s plasticity response to TMS stimulation. Taken approximately 30 minutes before each session, it targets the NMDA receptor mechanism that determines whether TMS produces lasting circuit change — or simply temporary stimulation. In a 2022 JAMA Psychiatry randomized controlled trial (Cole et al., 50 participants), adding DCS more than doubled both response and remission rates compared to TMS with placebo: 74% versus 29% response, and 39% versus 4% remission.
Standard TMS runs over six weeks. Accelerated TMS condenses the same treatment into days — not weeks. For patients who need faster results or cannot maintain a months-long daily schedule, this is a clinically supported alternative with a growing research base that includes the FDA-cleared SAINT protocol and the University of Toronto’s ONE-D single-day protocol.
Most practices that offer TMS also offer ketamine. Fewer offer both in an integrated clinical setting. Fewer still use them together as a deliberate treatment strategy supported by clinical evidence.
At Interventional Psychiatry of Philadelphia, our treatment pathways include TMS combined with ketamine, TMS combined with tDCS, and DCS-augmented TMS for both depression and OCD. Each combination has a distinct clinical rationale, a different patient population it suits best, and a growing research base supporting its use.
Combination treatment is particularly relevant when:
We offer advanced combination protocols such as TMS with ketamine or DCS augmentation for cases that haven’t responded to standard treatment.
TMS can be paired with tDCS in the same session to target the circuits involved in anxiety.
We offer FDA cleared deep TMS protocols for OCD, with accelerated scheduling available.
TMS addresses the circuit level dysregulation seen in PTSD and can be combined with ketamine when needed.
We offer TMS for bipolar depression with protocols adjusted to reduce the risk of triggering mania.
We offer combination therapies such as TMS with tDCS for patients whose pain and mood symptoms are linked.
Interventional psychiatry is a subspecialty of psychiatry that uses device-based and procedural treatments — including TMS, ketamine, and tDCS — to treat mental health conditions, particularly those that haven’t responded to medications or therapy alone. It targets brain circuits directly rather than relying solely on systemic medication.
Standard TMS is delivered once daily, five days per week, over approximately six weeks. Accelerated TMS delivers multiple sessions per day over a compressed timeline — in some protocols, as few as five days or a single day. Both use the same magnetic stimulation technology. The difference is pacing and intensity, not mechanism. Accelerated TMS is suited for patients who need faster results or can’t sustain a six-week daily schedule.
Yes, in many cases. The scientific rationale for combining treatments like TMS and ketamine, or TMS and tDCS, is that they work through different but complementary pathways. A 2023 peer-reviewed review in Frontiers in Neuroscience found that TMS and ketamine promote neuroplasticity through overlapping but distinct mechanisms — NMDA receptor activity, BDNF, and glutamate signaling — and may be synergistic when used together. Whether combination treatment is right for you depends on your clinical history and is determined through evaluation.
That depends on your diagnosis, treatment history, how urgently you need relief, and practical factors like your schedule and insurance coverage. The right starting point is a consultation. Our team will review your history and recommend a treatment pathway — or combination of pathways — tailored to you.
Interventional Psychiatry of Philadelphia is located at 2401 Pennsylvania Ave, Suite 1C44-45, Philadelphia, PA 19130. We serve patients throughout Philadelphia, including Center City, Fairmount, Spring Garden, Northern Liberties, Fishtown, South Philadelphia, West Philadelphia, and the surrounding region.
If you’re researching what’s available — or if you’ve already tried treatments that didn’t work — a consultation is the right next step. We’ll review your history, answer your questions, and help you understand what makes sense for your situation.
Call 215-222-0310 or request an appointment online.
