 To ensure comparability with previous studies, the primary outcome variable will be the 17-item Hamilton Rating Scale for Depression HAMD. Other outcome measures will include the Montgomery-Asberg Depression Rating Scale MADRS, Beck Depression Questionnaire BDI, Brief Psychiatric Rating Scale BPRS and an interview to record the subjective experiences of TMS and any adverse events. Final response and remission rates will be measured using standard rating scale score criteria but the patients will need to achieve these scores at the study end and at the 2 week follow up assessment. 