Intensive TMS for Bipolar Depression

Exclusion Criteria

• •No current substance abuse disorder for the past 6 months (previous substance abuse not exclusionary)
• •Any psychotic disorder or current active psychotic symptoms (personality disorders not exclusionary unless in the opinion of the referring psychiatrist it would jeopardize participation)
• •No dementia or other major neurological disorders
• •Not having depression as primary disorder
• •No major medical illness, for example metastatic cancer, end stage renal disease
• •Not able to verify contact information. Participants must be able to follow through with the study \& must have verified contact information and at least one verified contact
• •Pregnancy. While there are no known risks to a fetus this is a new use of TMS, which has not been tested, thus pregnancy is exclusionary
• •Score on Young Mania Rating Scale (YMRS) greater than 12 (patients with mixed features have been shown not to respond well to TMS treatment)
• •Rapid cycling Bipolar illness (patients with \> 4 mood episodes within the past year will be excluded, as they have a higher risk of switch to mania)
• •Any implants, conditions, or contraindications that would be deemed unsafe for TMS or MRI
• •Currently using benzodiazepines (such as lorazepam) with a dose \>1 mg per day or equivalent.