Brain zaps synced to your brain waves may boost depression treatment

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. Diagnosis of unipolar major depressive disorder, in a current major depressive episode, without psychotic features 2. Pretreatment Hamilton score ≥ 20 3. Age between 21 and 70 years 4. Fixed and stable antidepressant medications for 3 weeks prior and during the rTMS trial. Limit on benzodiazapenes to lorazepam (or equivalent) up to 3 mg every day 5. Moderate level of resistance to antidepressant treatment in the current episode, defined as failure of 1-4 adequate medication trials or intolerance to at least 3 trials, and duration of current episode ≤ 3 years 6. No history of schizophrenia, schizoaffective disorder, other \[non mood disorder\] psychosis, depression secondary to a medical condition, mental retardation, substance dependence or abuse within the past year (except nicotine), bipolar disorder, psychotic features in this or previous episodes, amnestic disorder, dementia or MMSE ≤24, delirium, obsessive compulsive disorder, post-traumatic stress disorder, panic disorder 7. No current Vagus Nerve Stimulation 8. No history of failing to respond to an adequate course of ECT in this or any episode, and no ECT within the past 3 months 9. No contraindication to MRI 10. No contraindication to rTMS (history of neurological disorder or seizure (except induced by ECT), increased intracranial pressure, brain surgery, or head trauma with loss of consciousness for \>15 minutes, implanted electronic device, metal in the head, or pregnancy) 11. No history of autoimmune, endocrine, viral, or vascular disorder. No unstable cardiac disease, uncontrolled hypertension, or sleep apnea 12. No active suicidal intent or plan, or history of attempt within the past 12 months 13. Willing to provide informed consent Exclusion Criteria: 1. To ensure that baseline levels of depression severity are stable at the time of study enrollment, patients will be dropped if they show \> 30% improvement in the HRSD score from the time of initial intake (e.g., screening) to the baseline assessment. 2. Patients must have a recordable alpha frequency.