Study to Assess the Effects of Intranasal Ketamine Along With rTMS for Patients With Treatment-resistant Major Depressive Disorder (TRD)

Open-label, single-group study (n=20) assessing a single sub-anesthetic intranasal ketamine dose (0.5 mg/kg, max 40 mg) given prior to a standard 6-week course of rTMS in patients with treatment-resistant depression.

Primary outcome is response to rTMS as measured by the IDS-SR; safety and tolerability assessed throughout. Screening excludes prior ketamine use, significant suicidality, and conditions contraindicating rTMS or ketamine.