Twice-daily rTMS for Depressed Youth in Hospital
Seamless Integration of Repetitive Transcranial Magnetic Stimulation (rTMS) for Youth Inpatients With Depression: A Feasibility Study
This project will test whether giving twice-daily repetitive transcranial magnetic stimulation (rTMS) to hospitalized adolescents with moderate-to-severe depression is feasible while they attend on-unit schooling and receive therapeutic support.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 30 (estimated) |
| Ages | 14 Years to 19 Years |
| Sex | All |
| Sponsor | Sunnybrook Health Sciences Centre Academic / other |
| Locations | 1 site (Toronto, Ontario) |
| Trial ID | NCT07140575 on ClinicalTrials.gov |
What this trial studies
This single-center feasibility project offers an accelerated rTMS pathway for adolescents admitted with major depressive episodes, delivering rTMS twice daily while participants engage in inpatient schooling and therapeutic programming. Eligible participants are typically aged 14–19 with moderate-to-severe depression (GRID-HAMD-17 ≥16) who have not responded to at least one evidence-based psychotherapy or antidepressant. The study will monitor feasibility, tolerability, safety, and depressive symptom change using standard rating scales and clinical observation. The protocol is informed by prior rTMS work in youth and accelerated rTMS pilots in adults, but focuses specifically on the inpatient setting to address access and logistical barriers.
Who should consider this trial
Good fit: Ideal candidates are adolescents (about 14–19 years) hospitalized or eligible for elective admission with a primary major depressive episode (or bipolar depression without psychotic/mixed features), a current episode of at least 4 weeks, GRID-HAMD-17 ≥16, and prior nonresponse to at least one evidence-based psychotherapy or antidepressant.
Not a fit: Patients with a history of psychotic disorders, recent substance use disorder, active mania or psychosis, epilepsy or other seizure disorders, pregnancy or nursing, eating disorders as the primary diagnosis, or taking medications that lower the seizure threshold are unlikely to be eligible or benefit from this pathway.
Why it matters
Potential benefit: If successful, this pathway could let hospitalized youth receive accelerated rTMS with fewer travel and schooling disruptions and faster access to neuromodulation for difficult-to-treat depression.
How similar studies have performed: rTMS has shown benefit in adolescents and young adults with treatment-resistant depression, and accelerated twice-daily protocols have been piloted in adults with encouraging safety and similar effectiveness, but data specifically for inpatient youth remain limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * age 14-19 years * primary diagnosis of major depressive disorder or of bipolar I or II disorder, current episode depressed with no psychotic or mixed features * current episode of depression lasting at least 4 weeks * failed ≥1 evidence-based psychotherapy or antidepressant * have a GRID-HAMD-17 (17-item Hamilton Depression Rating Scale) score of ≥16 (moderate-severe range) * currently an inpatient or suitable for an elective inpatient admission Exclusion Criteria: * lifetime diagnosis of a psychotic disorder, anorexia nervosa, bulimia nervosa diagnosis of a substance use disorder (except caffeine and tobacco) within the past year * obsessive compulsive disorder or personality disorder that is the main source and driver of distress * active psychosis and/or mania * history of epilepsy or any other neurologic condition that includes a history of seizures * use of medications that lower the seizure threshold * pregnancy or nursing * history of severe headaches within the previous year * improvement in depressive symptom severity between screening and baseline by 25% or more * inability to adhere to the protocol
Where this trial is running
Toronto, Ontario
- Sunnybrook Health Sciences Centre — Toronto, Ontario, Canada (Recruiting)
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.