Psilocybin rTMS for Treatment Resistant Depression

This trial combines two treatments — psilocybin (a psychedelic compound from mushrooms, used under medical supervision) and repetitive transcranial magnetic stimulation (rTMS, a non-invasive brain stimulation technique) — for people with treatment-resistant depression. The goal is to see whether this combination can help people whose depression has not responded to multiple medications. **You may be eligible if...** - You are 22 to 65 years old - You have moderate-to-severe major depressive disorder that has not responded to at least 2 antidepressant medications - You do not have psychotic features with your depression - You are willing to taper off antidepressants before the study - You are willing to attend daily sessions at the research site for about 2 weeks **You may NOT be eligible if...** - You have bipolar disorder, psychosis, PTSD, or an eating disorder - You have had a seizure or have epilepsy - You have metal implants in your head (such as a brain stimulator or cochlear implant) - You are pregnant or planning to become pregnant - You have significant active suicidal intent - You have used a serotonergic psychedelic (like LSD or psilocybin) in the past year Talk to your doctor to see if this trial is right for you.