Transcranial Magnetic Stimulation in Bipolar Depression

A Randomized, Sham Controlled, Crossover Trial of rTMS for Bipolar Depression

To compare antidepressant efficacy of left or right to sham Repetitive Transcranial Magnetic Stimulation (rTMS)

to determine if non-responders can become responders if treated on the other side of the hemisphere

(rTMS)

Patients will be assigned to one of 3 treatment arms for 10 days of treatment with either left high frequency or right high frequency, or sham rTMS. After 10 days of treatment, and no improvement, another 10 days of treatment follows, this time with the coil placed on the other hemisphere. Subjects will be followed for 2 months respectively with unrestricted treatment provided by their regular physician. Mood stabilizers will be continued throughout this trial.

Inclusion Criteria:

• Bipolar Depression
• no physical health problems

Exclusion Criteria:

• Metal in head/neck or skull
• History of Epilepsy
• Pregnancy
• Pacemaker