TMS Devices Compared: NeuroStar, BrainsWay, MagVenture, Magstim and Magnus

The five best-known TMS systems for depression in the U.S. are NeuroStar (Neuronetics), BrainsWay Deep TMS, MagVenture, Magstim Horizon and the Magnus system that delivers SAINT. All are Class II devices that FDA cleared or granted through the 510(k) or De Novo pathways, not "approved". All are cleared for adult major depression; they differ mainly in coil design, which protocols and additional indications (OCD, adolescents, smoking cessation, accelerated schedules) their labels include, and how long a session takes.

This page compares them on those facts, without ranking them. The coil and protocol matter more to outcomes than the brand name on the cart, and head-to-head comparisons between manufacturers are essentially absent from the trial literature.

How to read a device's FDA status

FDA "clears" a device through a 510(k) by finding it substantially equivalent to one already on the market, and "grants" a De Novo request for a novel device type. Premarket approval is reserved for Class III devices, and every TMS system in this comparison is Class II. So the accurate phrase is "FDA-cleared". Each clearance carries an indication statement, and a later clearance can widen it. That is why the same machine can have a list of dates beside it. The patient guide to TMS and the FDA explains the vocabulary in plain terms.

The comparison at a glance

Cells summarize FDA device summaries and trial reports, so some nuance is lost. Session times are stimulation times and exclude setup.

System by system

NeuroStar

NeuroStar was the first TMS device authorized for depression in the U.S., through De Novo DEN070003 in October 2008. Its pivotal sham-controlled trial was O'Reardon 2007, which used a figure-of-eight coil at 120% MT. The current label keeps a 3,000-pulse 10 Hz session but allows an inter-train interval as short as 11 seconds, cutting session time to as little as 18.75 minutes. The labeled course is 36 sessions: 30 daily treatments over 6 weeks plus a 3-week taper. Its 2024 adolescent clearance, as an adjunct for ages 15-21, was the first for that age group and was based on open-label registry data; the one large sham-controlled trial in adolescents was negative.

BrainsWay Deep TMS

BrainsWay's H-coil is designed to stimulate a broader and deeper volume than a figure-8 coil. Its pivotal depression trial (Levkovitz 2015, 233 enrolled) is discussed in the landmark trials. Among the five systems compared here it has the most non-depression indications: adjunct treatment of adult OCD by De Novo in 2018 and an aid to short-term smoking cessation in 2020. Its accelerated protocol, cleared in 2025, runs 30 sessions over 6 treatment days within 2 weeks, then 8 maintenance sessions, so it is not a one-week course. In a 2018 member survey, seizures were reported at 5.56 per 1,000 patients with the H-coil versus 0.14 per 1,000 for the three most-used figure-8 devices; the authors called the absolute risk low and the relative risk higher. For the physics and evidence, see deep TMS vs standard TMS.

MagVenture

MagVenture's MagVita system received the first FDA clearance for intermittent theta-burst stimulation in August 2018, on the strength of the THREE-D trial. That cut active stimulation to just over 3 minutes. In 2026 it was cleared for accelerated schedules of 2 to 10 sessions a day, with or without MRI-based neuronavigation. MagVenture hardware also sits inside two other cleared systems: the Magnus SAINT system and Wave Neuroscience's MeRT system for PTSD. The theta-burst explainer covers iTBS in depth.

Magstim Horizon

Magstim's Horizon line has a series of depression clearances beginning in 2017, including a version "with Navigation" in 2019. Horizon 3.0, cleared in March 2025, carries adult MDD, adjunct adult OCD and adjunct adolescent MDD (ages 15-21) in one label.

Magnus (SAINT)

Magnus Medical's system is cleared specifically to deliver SAINT: an individualized target chosen from structural and functional MRI, then 10 sessions a day for 5 days, 90,000 pulses in total. It was cleared by 510(k) in September 2022, not by De Novo, and no later label expansion has been found. FDA's summary notes effectiveness was evaluated only to four weeks after treatment, and that all 70 patients came from studies at a single site. See the SAINT guide for its trial data.

Other cleared systems

The market is wider than five names. Nexstim (NBS 6), CloudTMS, Apollo (Mag & More), Soterix SPRY, BTL-699 and several others hold FDA clearances for adult MDD, and several also carry OCD or adolescent labels. At least seven systems now carry an adjunct adolescent (15-21) MDD label, so "first and only" claims from 2024 are out of date. In June 2026, Wave Neuroscience's MeRT system became the first TMS-based device cleared as an adjunct for adult PTSD; it uses an EEG-derived algorithm to set a personal pulse rate between 8 and 13 Hz. Separately, small single-pulse devices from eNeura are cleared for migraine; they belong to a different regulatory category and are not used for depression.

How the clearances build on each other

Because most TMS clearances are 510(k)s, each new label leans on an earlier device, called a predicate. Following those links shows how closely the systems are related. MagVenture's 2025 adolescent clearance named NeuroStar's 2024 adolescent clearance as its primary predicate. MagVenture's 2026 accelerated clearance named SAINT as its primary predicate. Wave Neuroscience's PTSD system, in turn, named a MagVenture system as its predicate. BrainsWay's smoking-cessation clearance used its own OCD De Novo as the predicate.

The practical lesson is that a new indication on one brand often follows quickly on others, and that the evidence behind a later clearance may be the same evidence, or the same kind of evidence, as behind the first. When a label is new, it is worth asking what data supported it; the adolescent clearances, for example, rest on registry data rather than positive sham-controlled trials.

What actually differs between machines

• Coil geometry. Figure-8 coils give a focal field; the H1 coil reaches a broader, deeper area. The 2018 consensus recommendations state that strong evidence supports the figure-of-eight and H1 coils, but not other coils, for depression.
• Protocols on the label. iTBS, accelerated and adolescent use depend on what each manufacturer has cleared, not on whether the hardware could physically deliver it.
• Targeting tools. Some systems include scalp-measurement kits (NeuroStar ships both 5-cm and Beam F3 head-strap packs) and others offer neuronavigation; see finding the TMS target.
• Motor-threshold tools. Dosing is individualized in every system, but the hardware used to measure it varies; see motor threshold and dosing.
• Session length. A standard 10 Hz session takes roughly 19 to 37.5 minutes, deep TMS about 20 minutes of stimulation, and iTBS about 3 minutes.

What a device label does not tell you

A clearance shows that FDA found the device acceptably safe and effective for the stated use, often by comparison with an earlier device. It does not mean one brand outperforms another. Network meta-analyses compare stimulation types (high-frequency, theta-burst, bilateral and so on), not manufacturers. The quality of mapping, dosing, monitoring and follow-up is not on any label at all, which is why the question of who delivers TMS matters as much as the hardware.

Coverage usually follows the label. Medicare's Downstate New York policy, for example, requires an FDA-approved or -cleared device and states that deep TMS for OCD is not considered reasonable and necessary. Commercial plans vary; see the payer guides such as UnitedHealthcare and Optum TMS coverage.

Questions to ask about the device

1. Which system and coil will be used, and which protocol on its label fits my diagnosis and age?
2. Is the planned schedule (standard, theta-burst, accelerated) within that device's clearance?
3. How is my target located, and how is my motor threshold measured on this system?
4. If I have OCD or anxiety along with depression, does the device's label cover that use?
5. Will my insurer cover this protocol on this device?

For the broader picture, see the TMS guide; to talk through whether TMS fits your situation, see the TMS therapy page.

Frequently asked questions

Which TMS machine is the best?

No trial has shown one manufacturer's machine to be better than another. Evidence attaches to coil types and protocols, so the better question is which protocol suits your diagnosis and which team will deliver it carefully.

Is deep TMS stronger than NeuroStar?

The H-coil reaches a broader and deeper area than a figure-8 coil, but that is not the same as being more effective. Direct comparisons are limited, and seizure reports per patient were higher with the H-coil in one large survey, though still rare.

Can any TMS machine deliver SAINT?

SAINT as cleared by FDA is delivered with the Magnus system, which uses MagVenture stimulator hardware and MRI-derived targeting. Clinics advertising SAINT-like or SAINT-inspired schedules on other devices are offering something different.

Which devices are cleared for teenagers?

Several systems, including NeuroStar, BrainsWay, MagVenture, Magstim Horizon 3.0 and others, carry an adjunct label for major depression in patients aged 15 to 21. Younger adolescents are not covered by any of these labels.

Does the device affect what TMS feels like?

Somewhat. Coil design, pulse pattern and intensity all change the sensation, and theta-burst was rated slightly more painful than 10 Hz in one large trial. Most people find discomfort eases during the first week.

Sources

1. Premarket Notification 510(k); De Novo Classification Request; Premarket Approval (PMA). U.S. FDA, 2026. fda.gov
2. De Novo Classification Request DEN070003 (NeuroStar TMS System). U.S. FDA, 2008. accessdata.fda.gov
3. 510(k) K212289 – NeuroStar Advanced Therapy for OCD. U.S. FDA, 2022. accessdata.fda.gov
4. 510(k) K220127 – NeuroStar anxious-depression indication. U.S. FDA, 2022. accessdata.fda.gov
5. 510(k) Summary K231926 – NeuroStar Advanced Therapy System. U.S. FDA, 2024. accessdata.fda.gov
6. 510(k) K122288 – BrainsWay Deep TMS System. U.S. FDA, 2013. accessdata.fda.gov
7. De Novo Summary DEN170078 – BrainsWay Deep TMS for OCD. U.S. FDA, 2018. accessdata.fda.gov
8. 510(k) K200957 and K203616 – BrainsWay smoking cessation. U.S. FDA, 2020. accessdata.fda.gov
9. 510(k) K210201 – BrainsWay comorbid anxiety indication. U.S. FDA, 2021. accessdata.fda.gov
10. 510(k) Summary K251449 – BrainsWay accelerated Deep TMS. U.S. FDA, 2025. accessdata.fda.gov
11. 510(k) Summary K251391 – BrainsWay adolescent indication. U.S. FDA, 2025. accessdata.fda.gov
12. 510(k) Summary K173620 – MagVita TMS Therapy System w/Theta Burst Stimulation. U.S. FDA, 2018. accessdata.fda.gov
13. 510(k) K251119 – MagVenture TMS Therapy System (OCD history via openFDA). U.S. FDA, 2025. accessdata.fda.gov
14. 510(k) K251125 – MagVenture adolescent indication. U.S. FDA, 2025. accessdata.fda.gov
15. 510(k) Summary K260189 – MagVenture Accelerated TMS (aTMS) Therapy System. U.S. FDA, 2026. accessdata.fda.gov
16. MagVenture Receives FDA Clearance for Accelerated TMS Protocols, Expanding Flexibility for Clinics and Patients. MagVenture, 2026. magventure.com
17. 510(k) K243869 – Magstim Horizon 3.0. U.S. FDA, 2025. accessdata.fda.gov
18. 510(k) Summary K220177 – Magnus Neuromodulation System with SAINT Technology. U.S. FDA, 2022. accessdata.fda.gov
19. openFDA 510(k) records: Magnus Medical, Nexstim, CloudTMS, Apollo, Soterix and other OBP clearances. U.S. FDA (openFDA), 2026. api.fda.gov
20. 510(k) K260402 – MeRT System (Wave Neuroscience). U.S. FDA, 2026. accessdata.fda.gov
21. 21 CFR 882.5808; De Novo DEN130022 and 510(k) K182976 – eNeura migraine devices. U.S. FDA / eCFR, 2013. accessdata.fda.gov
22. Efficacy and safety of deep transcranial magnetic stimulation for major depression: a prospective multicenter randomized controlled trial. World Psychiatry, 2015. pmc.ncbi.nlm.nih.gov
23. Seizure risk with repetitive TMS: Survey results from over a half-million treatment sessions. Brain Stimulation, 2021. europepmc.org
24. Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial. Biological Psychiatry, 2007. pubmed.ncbi.nlm.nih.gov
25. Consensus Recommendations for the Clinical Application of Repetitive Transcranial Magnetic Stimulation (rTMS) in the Treatment of Depression. Journal of Clinical Psychiatry, 2018. pmc.ncbi.nlm.nih.gov
26. Repetitive Transcranial Magnetic Stimulation for the Acute Treatment of Major Depressive Episodes: A Systematic Review With Network Meta-analysis. JAMA Psychiatry, 2017. pubmed.ncbi.nlm.nih.gov
27. Repetitive Transcranial Magnetic Stimulation for Major Depressive Disorder: A Systematic Review and Network Meta-Analysis. Journal of Evidence-Based Medicine, 2026. pubmed.ncbi.nlm.nih.gov
28. Transcranial Magnetic Stimulation LCD L33398 (v40). CMS, 2026. cms.gov

Educational information, not medical advice. Whether TMS or any treatment fits you is a decision to make with a psychiatrist who knows your history.