Accelerated Versus Standard Intermittent Theta Burst Stimulation for Major Depressive Disorder

This randomized, rater‐blinded clinical trial aims to compare the effectiveness, safety,and tolerability of accelerated intermittent theta burst stimulation (iTBS) with standardiTBS in adults with major depressive disorder (MDD).Participants will be randomly assigned in a 1:1 ratio to receive either accelerated orstandard iTBS targeting the left dorsolateral prefrontal cortex. Participants may bepsychotropic‐medication naïve or may continue stable psychotropic medication according tothe protocol‐defined medication stability criteria. The accelerated iTBS group willreceive 45 treatment sessions over approximately 15 treatment days, while the standardiTBS group will receive 20 treatment sessions over 4 weeks.The primary objective is to compare changes in depressive symptom severity, measuredusing the 17‐item Hamilton Depression Rating Scale (HAM‐D17), from baseline to theend‐of‐treatment assessment. Secondary and exploratory assessments include treatmentresponse and remission, sleep quality, quality of life, cognitive measures, safety andtolerability, resting electroencephalography (EEG), and transcranial magnetic stimulationcombined with EEG (TMS‐EEG).