Repetitive Transcranial Magnetic Stimulation as a Probe of Episodic Memory Neurocircuitry in Schizophrenia

Inclusion Criteria

1.    Between 18 and 40 years of age
2.    Within 10 years of illness onset as defined by entry into treatment for psychotic symptoms
3.    Able to give informed consent
4.    Willing and able to adhere to the study schedule
5.    Structured Clinical Interview for diagnosis of schizophrenia
6.    Clinical stability defined by:
a.    Subjects must not have experienced an exacerbation of their illness within 4 weeks prior to randomization, leading to an intensification of psychiatric care in the opinion of the investigator. Examples of intensification of care include, but are not limited to: inpatient hospitalization, day/partial hospitalization, outpatient crisis management, or psychiatric treatment in an emergency room AND
b.    Antipsychotic treatment stability for at least 4 weeks prior to randomization (no change in antipsychotic dosing or addition of new antipsychotic medication)

Exclusion Criteria

1.    Lifetime history of a seizure, excluding febrile seizures and those induced by substance withdrawal
2.    First degree relative with idiopathic epilepsy or other seizure disorder
3.    History of significant neurological illness
4.    History of head trauma as defined by a loss of consciousness or a post-concussive syndrome
5.    Pregnant or breast feeding
6.    Known IQ < 70
7.    Current acute, serious, or unstable medical conditions
8.    Metallic objects planted in or near the head, including implanted pacemaker, medication pump, vagal stimulator, deep brain stimulator, TENS unit, ventriculoperitoneal shunt, or cochlear implants
9.    Contraindications to MRI or otherwise unable to tolerate MRI procedures
10.    History of electroconvulsive therapy
11.    Subjects taking clozapine
12.    Subjects who have participated in a clinical trial with any pharmacological treatment intervention for which they received study-related medication in the 4 weeks prior to randomization
13.    Subjects considered a high risk for suicidal acts – active suicidal ideation as determined by clinical interview OR any suicide attempt in 90 days prior to screening
14.    Current diagnosis of alcohol or drug use disorder (excluding nicotine or caffeine)