Maintenance rTMS for Depression (Maitr-De)

Inclusion Criteria

• •1. They met criteria for a DSM-5 diagnosis of a Major Depressive Episode (MDE) during the index episode of depression for which they have received an acute rTMS treatment course.
• •2. Meet criteria for either response or remission from their initial depressive illness. The MINI assessment timeline will be adjusted to allow scoring of illness symptoms prior to rTMS response. Response to acute course of treatment is defined as either a MADRS score of \<10, or a MADRS score of 10-19, plus evidence of having met response criteria on either the MADRS or another structured depression rating scale. The response is defined as a \>50% reduction in the total score from the start to the end of treatment.
• •3. Their initial rTMS treatment course must have consisted of at least 15 rTMS treatment sessions.
• •4. People between the ages of 18 and 80 at the time of screening. A written statement from the referring physician will be required to confirm that the participant demonstrates the capacity to consent.
• •5. Able to read, understand, and provide written, dated informed consent prior to screening. Proficiency in English sufficient to complete questionnaires / follow instructions during TMS-EEG assessments and iTBS interventions. Stated willingness to comply with all study procedures, including availability for the duration of the study, and to communicate with study personnel about adverse events and other clinically important information.
• •6. In good general health, as evidenced by medical history.
• •7. Agreement to adhere to Lifestyle Considerations throughout study duration.
• •8. If a person of child-bearing potential is: must take a pregnancy test at the screening visit, with results confirmed as negative by study staff