Theta Burst Stimulation for Refractory Depression in Autism Spectrum Disorder

Eligibility Criteria

• 1. Fluent in English and able to volunteer in the informed consent process and provide spontaneous narrative description of key elements, risks, and benefits of the study.
• 2. Aged 13-26, inclusive.
• 3. Full-scale intelligence quotient ≥ 70.
• 4. Diagnosis of ASD using criteria from Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Diagnosis will be confirmed by study psychologist/social worker and supported by scoring in the ASD on the Autism Diagnostic Observation Schedule (ADOS-2).
• 5. Diagnosis of MDD based on psychologist diagnosis and DSM-5-based structural diagnostic interview determine via KSADS
• 6. Exhibiting treatment resistance to at least one antidepressant drug treatment of adequate dose and duration.
• 7. Symptoms of moderate to severe depression according to Hamilton Depression Rating Scale ≥ 20 which must be maintained through lead-in period.
• 8. Participants are not required to discontinue current interventions but must agree to attempt to keep medications and other interventions stable during the study.
• 1. Participation in an investigational drug trial within the past three months.
• 2. Active substance use disorder (excluding tobacco use) within the past 6 months.
• 3. Contraindications to Transcranial Magnetic Stimulation including, but not limited to, a history of epilepsy, the presence of metallic foreign bodies, or implanted medical devices (e.g. pacemaker, medical pump).
• 4. Actively suicidal (i.e., suicidal ideation with plan and intent) or deemed at high risk for suicide.
• 5. Current use of anticonvulsant, barbiturate, lithium, or benzodiazepine medications.
• 6. Prior rTMS treatment.
• 7. For female subjects of childbearing potential, a positive urine pregnancy test.