Efficacy of H7-Coil DTMS Compared to H1-Coil DTMS in Subjects With Major Depression Disorder (MDD)

Inclusion Criteria:

• Outpatients

• Men and women 22-68 years of age

• Primary DSM-IV diagnosis of Major Depression, single or recurrent episode.

• Current depressive episode is less than 5 years duration

• The patient did not respond to at least one but not more than four antidepressanttreatments in the current episode or Patients who have not completed antidepressanttrials due to intolerance to therapy of 2 or more anti-depressant medications in thecurrent episode

• Satisfactory safety screening questionnaire for transcranial magnetic stimulation

• Patients not suffering from hypo or hyper-thyroidism based on pre-study TSH level ormedically stabilized

• Capable and willing to provide informed consent and able to adhere to the treatmentschedule

• Patient is stable on medication for 2 month and is not expected to change medicationduring all study period

Exclusion Criteria:

• Individuals diagnosed by the Investigator with the following conditions (currentunless otherwise stated):

• Depression secondary to a general medical condition, or substance-induced

• History of substance abuse or dependence within the past 6 month (except nicotineand caffeine)

• Any psychotic disorder (lifetime), including schizoaffective disorder, or majordepression with psychotic features, Bipolar disorder, Eating disorder, Obsessivecompulsive disorder

• Post-traumatic stress disorder (current or within the past year)

• Current generalized anxiety disorder, panic disorder or social anxiety disorder

• Presence of a personality disorder (such as antisocial, schizotypal, histrionic,borderline, narcissistic)

• Individuals with a significant neurological disorder or insult including, but notlimited to:

• Any condition likely to be associated with increased intracranial pressure

• Space occupying brain lesion

• Any history of seizure EXCEPT those therapeutically induced by ECT

• History of cerebrovascular accident

• Transient ischemic attack within two years

• Cerebral aneurysm

• Dementia

• Mini Mental State Exam score of less than or equal to 24

• Parkinson's disease

• Huntington's chorea

• Multiple sclerosis

• Increased risk of seizure for any reason

• Individuals with hearing loss

• ECT treatment within 3 months prior to the screening visit

• History of treatment with Vagus Nerve Stimulation (VNS)

• History of treatment with Deep Brain Stimulation (DBS)

• Use of any investigational drug within 4 weeks of the randomization visit

• Use of any prohibited study medication(s)

• Present suicidal risk as assessed by the investigator or significant suicide risk

• Any self-inflicted harm in the past 3 months not in the context of suicidal ideation

• Cardiac pacemakers, implanted medication pumps, intracardiac lines, or acute, unstablecardiac disease

• Intracranial implant (e.g., aneurysm clips, shunts, stimulators, cochlear implants, orelectrodes) or any other metal object within or near the head, excluding the mouth,that cannot be safely removed

• Implanted neurostimulators

• History of abnormal MRI

• Known or suspected pregnancy

• If participating in psychotherapy, must have been in stable treatment for at least 3months prior to entry into the study, with no anticipation of change in the frequencyof therapeutic sessions, or the therapeutic focus over the duration of the rTMS trial

• Clinically significant laboratory abnormality, in the opinion of the Investigatorbased on CBC and biochemistry

• Women of childbearing potential and not using a medically accepted form ofcontraception when engaging in sexual intercourse

• Women: if pregnant, planning on becoming pregnant, or currently nursing