Accelerated Neuromodulation of Anterior Cingulate Cortex for Depression

Prior treatment

• have a metal plate in your head (such as an ear implant, implanted brain stimulators, aneurysm clips). Dental devices and implants that are non-magnetic are safe
• have an implanted medication pump
• are on unstable doses of any psychotropic medication such as - antidepressants, antipsychotic, mood stabilizers or memory enhancing medications

Other illness

• have known increased pressure or a history of increased pressure in their brain, which may increase their risk for having seizures
• have a cardiac pacemaker
• have a history of any psychotic disorder, bipolar disorder, eating disorder, obsessive compulsive disorder, post-traumatic stress disorder, or dementia
• have a history of substance abuse in the last 6 months
• have a history of stroke or other brain lesions
• have a personal history of epilepsy
• have a family history of epilepsy
• have a history of abnormal MRI of the brain
• have unstable medical condition(s)

Other

• have a central venous line
• are a pregnant or breast-feeding woman
• have untreated hypo- or hyper-thyroidism
• have any other known contraindications to TMS
• require daily doses of benzodiazepines or hypnotics within two weeks of randomization

• are between 60- 85 years old (on the day of randomization)
• have been diagnosed with DSM5 Major Depressive Disorder, with the current episode longer than 4 weeks but less than 5 years
• did not respond to/did not tolerate, or failed to achieve remission with at least one antidepressant trial of 8 week minimum duration
• are willing to provide informed consent
• are able to follow the treatment schedule
• are stable on medications for 2 months and are not expected to change medication during the entire study period (if they are taking medications)
• have a satisfactory safety screening questionnaire for TMS