Maintenance rTMS for Depression (Maitr-De)

Launched by UNIVERSITY OF CALIFORNIA, SAN DIEGO · Apr 14, 2025

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ClinConnect Summary

The Maintenance rTMS for Depression (Maitr-De) clinical trial is studying a treatment called repetitive transcranial magnetic stimulation (rTMS) for people who have major depressive disorder and have not found relief from other treatments. Specifically, the trial aims to see if continuing rTMS after an initial successful treatment can help maintain improvement in mood and brain function. Researchers will enroll 75 participants aged 18 to 80 who have previously responded well to rTMS. Participants will be randomly assigned to receive either standard rTMS, a different type called clustered rTMS, or a placebo treatment (sham rTMS) over six months.

To be eligible, participants must have been diagnosed with depression, have shown improvement after an acute rTMS treatment, and be in good general health. During the trial, participants will undergo regular assessments to track their mood and brain activity. This study is important because it explores whether ongoing rTMS can help prevent depression from returning in those who have already benefited from it. If you're interested in joining, it’s crucial to understand the requirements and that you’ll need to commit to the study procedures for the entire duration.

Gender

ALL

Eligibility criteria

• 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 \<7, or a MADRS score of 7-19, 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
• Exclusion Criteria:
• • 1. Pregnancy 2. History of or current psychotic disorder or depression with psychotic features 3. Severe borderline personality disorder based on clinical assessment. 4. Diagnosis of Intellectual Disability or Autism Spectrum Disorder 5. Current moderate or severe substance use disorder or demonstrating signs of acute substance withdrawal 6. Clinically significant suicidal ideation with plan 7. Any history of ECT (greater than 8 sessions) without a clinical meaningful response in the current episode.
• • 8. Recent (during the current depressive episode) or concurrent use of rapid-acting antidepressant agent (i.e., ketamine or a course of ECT) in the last 30 days 9. History of significant neurologic disease, including dementia, Parkinson's or Huntington's disease, brain tumor, seizure disorder, subdural hematoma, multiple sclerosis, or history of significant head trauma 10. Untreated or insufficiently treated endocrine disorder. 11. Contraindications to receiving rTMS (e.g., metal in head, history of seizure, known brain lesion) 12. Treatment with an investigational drug or other intervention within the study period 13. Unstable symptoms between screening and baseline as defined by a ≥ 30% change in MADRS score.
• • 14. Require a benzodiazepine with a dose \> lorazepam 2 mg/day or equivalent or any anticonvulsant (with the exception of Gabapentin).