Abstract
Objective: To explore the clinical efficacy of right low frequency repetitive transcranial magnetic stimulation (rTMS) therapy combined with escitalopram in treating outpatients with first-episode depression. Methods: Seventy-eight patients with depressive disorder of ICD-10 criteria were recruited for the trial. All subjects were randomly divided into the active rTMS group (receive active rTMS) and sham group (receive sham rTMS). Each group received low frequency active or sham rTMS combined with 10 mg escitalopram per day. Patients in the active rTMS group were treated with active rTMS for continuous two weeks, while the sham patients were treated with pseudo stimulation. HAMD, HAMA and TESS were used to assess the efficacy and side effects before the treatment and at the ends of the second week and the fourth week of treatment, respectively. Results: 1) At the end of 4 weeksâ treatment, patients in the active rTMS group had a response rate of 87.8 % while the patients in the sham group had 41.5 %; 2) patients in the active rTMS group showed a significant efficacy at the end of 2 weeks, which was significantly different from the patients in the sham group; 3) Patients in the active rTMS group got a significantly lower score in HAMA at the end of 2 weeks, and there was a significant difference from the sham group; 4) There was only a local pain response. Conclusion: The right low-frequency rTMS technique combined with escitalopram in treatment of depressive patients in general hospitals has a significant better effect than mono-pharmacotherapy and can shorten the time of treatment.
Highlights
Eighty-two outpatients with first-episode depression were recruited from the psychology department of the People’s Hospital of Guizhou Province from August 2016 to March 2017, 78 of which completed this study
The repetitive Transcranial Magnetic Stimulation, a safe, noninvasive and painless nerve stimulation technique that has been applied in the field of neuropsychiatry in recent years, showed a reliable effect on neuropsychiatric disorders [1]
A large number of clinical trials have confirmed that the efficacy of treating the depressive disorder using high frequency repetitive transcranial magnetic stimulation (rTMS) to stimulate dorsolateral prefrontal cortex (DLPFC) at right brain has been widely recognized . [2, 3] there are fewer studies on treatment of depressive patients using the right low frequency rTMS technique to stimulate DLPFC
Summary
Eighty-two outpatients with first-episode depression were recruited from the psychology department of the People’s Hospital of Guizhou Province from August 2016 to March 2017, 78 of which completed this study. The relevant information of the 78 outpatients was listed here. All subjects conformed to the psycholepsy diagnosis criteria of ICD-10 Mental and Behavioral Disorders; b. First-episode depression and no administration of any antidepressants and antipsychotic drug. Patients with severe physical illness or brain organic diseases; b. Patients with depression caused by psychoactive substances and non-dependent substances; c. Patients with an implanted metal object or cochlear; d. Exclusion criteria: a. patients with severe physical illness or brain organic diseases; b. patients with depression caused by psychoactive substances and non-dependent substances; c. patients with an implanted metal object or cochlear; d. patients previously treated with rTMS; e. patients with severe epilepsy; and f. patients with risk of suicide
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