Transcranial Magnetic Stimulation Treatment for Generalized Anxiety Disorder

Approximately five patients with GAD who failed to respond to a sham (placebo) TMS
intervention will be enrolled. TMS sessions will occur twice a week for five weeks.
Assessments will occur at pretreatment, weekly during treatment, and at posttreatment.
Approximately five nonanxious control volunteers will also be recruited to complete
pretreatment assessments for baseline comparison purposes.

Inclusion Criteria:

- Participated in the study DIEF003523.1, received sham "placebo" TMS and achieved <
50% improvement in HARS at 3 month follow-up.

- Fluency in English

- Capacity to understand the nature of the study and willingness to sign informed
consent form

Exclusion Criteria:

- History of epilepsy or head trauma (LOC > 5 minutes) within the past 6 months

- Lifetime history of increased intracranial pressure, seizure disorder, stroke, brain
tumor, multiple sclerosis, or brain surgery

- A review of patient medications by the study physician indicates an increased risk of
seizure

- An active autoimmune, endocrine, viral, or vascular disorder affecting the brain; any
unstable cardiac disease; hypertension; or severe renal or liver insufficiency

- Substance use disorder or PTSD within the past 6 months

- Lifetime bipolar disorder, obsessive-compulsive disorder (OCD), psychotic disorder,
mental retardation, or pervasive developmental disorder

- Any psychotic features, including dementia or delirium

- Concurrent psychotherapy and unwillingness to discontinue

- Medication change within the past 4 weeks

- Current serious suicidal or homicidal ideation, and/or serious suicidal attempt
within the past 6 months

- Serious, unstable, or terminal medical condition or clinically judged too
psychiatrically unstable to participate in the study

- Any contraindication for participation in MRI scan