Participants were aged 18 years or older, with a diagnosis of MDD by DSM-IV criteria and failure to respond to at least one adequate antidepressant treatment. Major exclusion criteria included: current treatment with electroconvulsive therapy; dementia, intellectual disability, or psychosis; current use of illicit drugs; and cardiovascular decompensation. Subjects were on oral antidepressant treatment and did not have to discontinue current medications, which should remain unchanged from 15 days before intervention until the end of the follow-up period.
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