A preliminary study of repetitive transcranial magnetic stimulation combined with antidepressants in the treatment of first-episode late-life depression
10.3760/cma.j.cn113661-20210129-00044
- VernacularTitle:重复经颅磁刺激联合抗抑郁药治疗首次发病老年抑郁症的初步研究
- Author:
Xiaoyue HU
1
;
Weigang PAN
1
;
Xin MA
1
;
Li REN
1
;
Dandi ZHU
1
;
Peixian MAO
1
Author Information
1. 首都医科大学附属北京安定医院老年科 精神疾病诊断与治疗北京市重点实验室 100088
- Publication Type:Journal Article
- Keywords:
Depressive disorder;
Aged;
Transcranial magnetic stimulation;
Randomized controlled trial
- From:
Chinese Journal of Psychiatry
2021;54(4):265-270
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) combined with selective serotonin reuptake inhibitors (SSRIs) in the treatment of first-episode late-life depression.Methods:From June 2019 to January 2020, first-episode elderly patients with depression in Beijing Anding Hospital affiliated to Capital Medical University were screened and randomly divided into test group (true rTMS+SSRIs, n=26) and control group (rTMS sham+SSRIs, n=25) according to the random number table method. All the patients were treated for 4 weeks and followed up for 4 weeks after treatment. The test group received 20 sessions (5 sessions per week) of 10 Hz rTMS (120% of motor threshold). Hamilton Depression Scale (HAMD 17) and The Patient Health Questionnaire-9 (PHQ-9) were used to assess the clinical symptoms at the end of the 1st, 2nd, 3rd and 4th week of treatment and at the end of the 4th week of the follow-up after treatment, and the response rate and the rate of recovery were compared between the two groups,analyzed by the χ 2 test and repeated measurement analysis of variance. Results:(1) At the end of the 4th week of treatment 69.23% (18/26) subjects in the test group and 36.00% (9/25) in the control group significantly improved their depressive condition, which was defined as a more than 50% HAMD 17 reduction (χ 2=5.649, P=0.017). However, there was no significant difference between the two groups when compared the rate of recovery,which was defined as a HAMD 17 ≤7 ( P>0.05). (2) At the end of the 4th week of the follow-up, there was no significant difference in the response rate nor the rate of recovery between the two groups ( P>0.05). (3) During the entire observation period, there was an interaction between the time point and the group in HAMD 17 total score and PHQ-9 total score ( F=66.313, P=0.008; F=8.571, P<0.01). Conclusion:There might be potential advantages in the combination treatments by rTMS at 120% MT and SSRIs antidepressants for the elderly depressive patients, and the onset of efficacy is faster than that of pharmacotherapy alone, while the large sample clinical studies are still needed to confirm the benefits.
