OBJECTIVETo assess the efficacy of repetitive transcranial magnetic stimulation (rTMS) for alleviating the clinical symptoms and suicidal ideation in elderly patients with depression.

METHODSA total of 178 elderly depressive patients with suicidal ideation were randomized into rTMS treatment group (n=80) and control group (n=98) and treated with rTMS or sham rTMS treatment for 4 weeks in addition to conventional therapy with medications. The 24-item Hamilton Depression Scales (HAMD) and Self-rating Idea of Suicide Scale (SIOSS) were used to assess the severity of depression and the risk of suicide at the baseline and after 2 and 4 weeks of treatment. The treatment response was defined as a 25% reduction in HAMD scores from baseline, and an early improvement as 20% reduction in HAMD scores after 2 weeks of treatment.

RESULTSThe two groups of patients were comparable for baseline socio-demographic characteristics and baseline SIOSS and HAMD scores (P>0.05). After 2 and 4 weeks of treatment, both SIOSS and HAMD scores were improved in the two groups, but the patients in rTMS group showed a significantly faster score reduction. A significantly higher rate of early improvement at 2 weeks (52.5% vs 28.6%; χ=10.569, P<0.01) and a higher response rate at 4 weeks (77.5% vs 53.1%; χ=15.470, P<0.05) were observed in rTMS group.

CONCLUSIONSrTMS combined with medications can effectively improve sleep quality, cognitive impairment and somatization symptom and reduce suicidal ideation in elderly patients with depression.