Low-frequency repetitive transcranial magnetic stimulation for adjuvant treatment of depression with different characteristics: a controlled study
Objective:To evaluate the efficacy and safety of low-frequency repetitive transcranial magnetic stimulation (rTMS) in the adjuvant treatment of depression with different characteristics.Methods:A total of 80 depressed patients who visited the psychiatric department of Changshu Third People's Hospital from June 2018 to June 2022, met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) with melancholic features, anxious distress, or atypical features, and had poor response to 8 weeks of antidepressant treatment were divided into three groups and treated with original antidepressants combined with low-frequency rTMS to the right dorsolateral prefrontal cortex (DLPFC) for 6 weeks. The 17-item Hamilton Depression Scale (HAMD-17), Self-rating Idea of Suicide Scale (SIOSS), and Treatment Emergent Symptoms Scale (TESS) were used to assess the efficacy and safety at baseline and the 2nd, 4th, and 6th weekends after treatment.Results:The main effects of time and group and the interaction of time and group were significant in the total score of HAMD-17, the scores of anxiety, block, and sleep disorder dimensions of HAMD-17, the scores of despair, optimism, and sleep disorder dimensions of SIOSS in the three groups (P＜0.05 or P＜0.01). The main effect of time and the interaction of time and group were significant in the total score of SIOSS in the three groups (P＜0.01). Findings from the single effect analysis showed that there were no significant differences in the scores of HAMD-17 and SIOSS at baseline among the three groups (P＞0.05). From the 2nd weekend after treatment, the total scores of HAMD-17 and SIOSS in the anxious distress group decreased compared with those in the other groups (P＜0.05). There was no significant difference in the incidence rates of adverse reactions among the three groups (P＞0.05).Conclusion:Low-frequency rTMS to the right DLPFC is effective and safe in treating depression with different characteristics, and it especially has faster onset and better efficacy for depression with anxiety distress.
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