Investigation of a Combination Treatment of Escitalopram and rTMS

Inclusion Criteria: Major Depressive Episode (according to DSM IV standards) HAMD > 20 Patient has an IQ > 70 based on the investigator´s judgement Patient is male or nonpregnant female adequately protected from conception Patient is able to comply with all testing and follow-up visit requirements defined by the study protocol Patient has voluntarily signed an informed consent in accordance with institutional policies Exclusion Criteria: Patient has a history of schizophrenia, schizoaffective disorder or delusional disorder Patient currently has a secondary diagnosis of, or signs of, delirium, dementia, amnestic or other cognitive disorder per DSM IV Patient is suicidal Patient has had an alcohol or substance dependence within the previous 12 month Patient is currently enrolled in another investigational study Patient has a history of, or evidence of, significant central nervous disease (especially seizures) Patient has previously been treated with escitalopram Contraindication against escitalopram or rTMS