Accelerated Transcranial Magnetic Stimulation for People With Schizophrenia Treated With Clozapine
Trial Parameters
Brief Summary
In this study, the investigators will examine whether a type of repetitive transcranial magnetic stimulation called accelerated intermittent theta burst stimulation (iTBS) can augment neurocognition in individuals who receive treatment with clozapine. Following a baseline evaluation and magnetic resonance imaging (MRI), participants will undergo a session of iTBS +MRI and session of sham delivery + MRI. The order for these sessions will be blinded and randomized. The investigators predict that accelerated iTBS will enhance neurocognition relative to sham delivery.
Eligibility Criteria
Inclusion Criteria: 1. A current Diagnostic and Statistical Manual of Mental Disorders 5 (DSM 5)-defined diagnosis of schizophrenia or schizoaffective disorder 2. age 18-50 years 3. at least 4 months of clozapine treatment 4. history of at least 2 failed antipsychotic trials 5. competency and willingness to sign informed consent 6. A clinically optimized dosage of clozapine, unchanged for at least 1 month, with a minimum of 150 mg/day Exclusion Criteria: 1. Serious neurologic or medical condition/treatment that impacts the brain 2. a significant risk of suicidal or homicidal behavior 3. cognitive or language limitations, or any other factor that would preclude subjects providing informed consent 4. pregnancy or postpartum (\<6 weeks after delivery or miscarriage) 5. history of treatment with electroconvulsive therapy 6. contraindications for magnetic resonance imaging (e.g., a pacemaker) 7. Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders 5 (DSM 5