A randomize controlled trial of early response between repetitive transcranial magnetic stimulation and modified electroconvulsive therapy in patients with first-episode depression
10.3969/j.issn.1000-6729.2015.09.006
- VernacularTitle:重复经颅磁刺激与改良电休克治疗首发抑郁症起效时间的随机对照试验
- Author:
Ning LI
;
Xueyi WANG
;
Xiaoqian LI
;
Ming YU
- Publication Type:Journal Article
- Keywords:
repetitive transcranial magnetic stimulation;
modified electroconvulsive therapy;
escitalopram;
first-episode depression;
randomize controlled trial
- From:
Chinese Mental Health Journal
2015;(9):667-671
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the differences of the early response time between transcranial magnetic stimulation (rTMS ) and modified electroconvulsive therapy (MECT )in patients with first-episode depression.Methods:Totally 65 first-episode patients aged 18 -45 year were enrolled in the study.The diagnoses were made according tothe Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-Ⅳ)criteria for depression.The patients randomly received rTMS(n =33)or MECT (n =32).All patients received co-therapy of escitalopram (10 -20 mg /day).Stimulation (20 Hz)was performed five times a week for four weeks and,a total of 20 consecutive working days over the left dorsolateral prefrontal cortex(DLPFC).MECT group received MECT treatment 3 times a week for 3 weeks,a total of eight times.The Hamilton Depression Rating Scale-24 items (HAMD)was used to assess the severity of clinical symptoms and reduction rates.Results:Compared with the pa-tients in MECT group,the patients in rTMS group showed a less reduction rates [(25.0.±3.1),(34.4 ±7.7), (52.2 ±7.8),(69.1 ±8.3),vs(28.2 ±5.4),(38.8 ±5.1 ),(57.7 ±6.8),(75.4 ±8.6),Ps <0.05]in the first four weeks and the suicidal behavior scores reduced less in rTMS group in the first two weeks (P <0.05).Conclu-sion:It suggests that both rTMS at 20 Hz and MECT combined with escitalopram could improve the first-episode depression within a week.While the efficacy of rTMS combined with escitaloprm slightly less than MECT com-bined with essitaloprm in rapid response and reducing the suicide risk of acut period.
