This study is being conducted to determine whether SAINT can safely and effectively reduce symptoms of postpartum depression compared to a sham treatment. Researchers are also evaluating how long any improvements last, whether participants find the treatment acceptable, and whether treatment may improve quality of life and mother-infant bonding.

You may be eligible for this study if you meet the following criteria.

Inclusion Criteria:

• Women ages 18-45
• Within 12 months after giving birth
• Currently experiencing moderate to severe postpartum depression
• If in therapy, have attended therapy regularly for at least 30 days
• Able to attend all study visits and treatment appointments, including 5 consecutive treatment days in Charleston, SC

Exclusion Criteria:

• Currently pregnant
• History of seizures or certain metal implants that prevent MRI/TMS participation
• Previously received TMS treatment

You will be involved in the study for about 6 months total, with a combination of in-person and virtual visits. The in-person treatment portion of the study lasts 1 week.

Screening

• A brief phone screening to gauge interest and general eligibility
• A longer virtual screening visit with the study clinician to formally determine eligibility, review medical/psychiatric history, and complete questionnaires

1 Pre-Treatment Visit (In-Person)

• An MRI visit to help identify the treatment target in the brain
• A baseline assessment visit, including a urine drug and pregnancy screening

5-Day Treatment Week (In-Person, Monday-Friday)

• Participants will be randomly assigned to receive either active SAINT treatment or a sham (placebo) treatment during this week. The treatment uses magnetic pulses delivered to specific brain areas involved in mood regulation and is guided by MRI imaging.
• Approximately 10 hours per day at the clinic
• 10 treatment sessions per day, each about 10 minutes, followed by a 50-minute break
• Time to rest, eat, work remotely, read, or relax between sessions

Follow-Up (Virtual)

• Visits at approximately 5 days, 14 days, 28 days, 3 months, and 6 months after treatment
• Biweekly questionnaires following the 28-day post-treatment visit

Participants who experience a return of symptoms during follow-up may be eligible for one additional course of active SAINT treatment.

Participants may receive up to $450 for completing study visits and assessments. Reimbursement may also be available for travel, meals, childcare/caregiver support, and lodging expenses when needed.

There is no cost for you to participate in our research study. Study-related evaluations, MRI scans, and access to the investigational SAINT treatment are provided at no cost to you.