Synchronized Transcranial Magnetic Stimulation for PTSD

Inclusion Criteria

• Must be a Veteran;
• MRI safe;
• Meet Diagnostic and Statistical Manual, Fifth Edition (DSM 5) criterion for PTSD (acute or chronic, confirmed by the Clinician Administered PTSD Scale (CAPS) and at least moderate severity defined by a PCL-5 score > 33); AND at least moderate depressive symptom severity (defined by QIDS-SR score > or equal to 11) at baseline visit. Individuals with bipolar II or otherwise unspecified who are currently in a depressed episode are eligible;
• Baseline score of "moderately ill" or worse on the Clinical Global Impressions-Severity (CGI-S);
• Stable psychotropic regimen for at least 6 weeks prior to baseline and willing to maintain current dose and regimen throughout study, or no psychotropic medication at all;
• If female and of child bearing potential, must agree to use an acceptable method of birth control for the duration of the study treatment period;
• Be willing and able to comply with all study related procedures and visits;
• Be capable of independently reading and understanding all patient information materials and giving written informed consent.

Exclusion Criteria

• Pregnant or lactating, or planning on becoming pregnant within the next 3 months;
• Lifetime history of loss of consciousness (>10 minutes) due to head injury, or lifetime history of head injury with documented evidence of brain injury;
• Current (or past) significant neurological disorders (seizure disorder, primary or secondary central nervous system (CNS) tumors, stroke, cerebral aneurysm);
• Unstable medical illness, or significant absence of appropriate medical care;
• Current axis I primary psychotic disorder or Bipolar I disorder;
• Active (within the last month) moderate or severe substance (excluding nicotine/caffeine) abuse disorders. Individuals on stable (>3 months), monitored opiate agonist therapy may be included at investigator's discretion;
• Past failed treatment with rTMS or electroconvulsive therapy (ECT); any past treatment with deep brain stimulation or vagus nerve stimulation;
• Have an active suicidal intent or plan, or in the opinion of the investigator, is likely to attempt suicide in the next 6 months;
• Presence of condition or circumstance with potential to prevent study completion;
• Inability to obtain sufficient EEG to calibrate study device.