Electroconvulsive Therapy Augmented With Transcranial Magnetic Stimulation for Treatment Resistant Depression

This study is testing whether combining electroconvulsive therapy (ECT) — a well-established treatment for severe depression — with transcranial magnetic stimulation (TMS), a non-invasive brain stimulation technique, can produce better results than ECT alone for people with treatment-resistant depression. **You may be eligible if...** - You are 18 or older - You have been diagnosed with major depressive disorder (according to ICD-10 criteria) - Your depression score is 20 or higher on the MADRS scale (indicating moderate to severe depression) - Your depression has not responded to other treatments **You may NOT be eligible if...** - You have another major psychiatric diagnosis (like schizophrenia or substance addiction) - You have dementia - You have received ECT in the last 3 months - You have received TMS in the last 3 months - You have psychotic symptoms - You are pregnant or breastfeeding - You have epilepsy or another neurological condition - You have a physical condition that makes ECT unsafe - You have been in another clinical trial in the last 30 days Talk to your doctor to see if this trial is right for you.