Open Label Optimization Study

This is a prospective, multi-center, open-label study. Up to 1000 adult subjects, in a major depressive episode, who have failed to receive satisfactory improvement from a prior antidepressant medication in the current episode, are eligible to participate in this study if they are deemed to be appropriate candidates for TMS. Overall study duration is expected to be approximately 4 years. The study duration per subject is anticipated to be approximately 1 year. Hypothesis: The SAINT® Neuromodulation System will demonstrate effectiveness in the treatment of MDD as measured by CGI-I at the end of the treatment (cessation of stimulation).