Table 1.

Eligibility criteria.

Inclusion

Females who have completed delivery

>18 years old

Confirmed PPD diagnosis by DSM-5 criteria

Moderate to Severe Depression by score of >18 score on HAM-D17 scale

Exclusion

rtms contraindications

Previous Stroke, Seizure or CNS Disease

Previous or current drug or alcohol abuse

Ferromagnetic metallic implants

SSRI therapy contraindications

Bipolar Depression or previously diagnosed mental health disorder

Allergy to components of the medication

History of Liver or kidney Disease

Other exclusions

Previous 6 month treatment with SSRI or rTMS prior to randomization

Suicidal ideation and History of suicidal attempt

Puerperal blues

Secondary causes of Depression (e.g. Hypothyroidism, Sheehan Syndrome etc.)