The Effects Of Combining Antidepressants With Repetitive Transcranial Magnetic Stimulation For The Acute Treatment Of Depressive Patients

Background: Suicidal ideation is defined as thinking about,considering,or planning suicide.And it is common to view a patient with depression who has suicidal ideation.Repetitive transcranial magnetic stimulation(r TMS)has been proved that has remarkable effect in depression.However,there were a few of studies pay attention to if add-on r TMS for the acute treatment can be better in anti-suicide and improve depression.Aim: As we all know,no standard answer,clinical efficacy of anti-depression combined r TMS still is in dispute.The goal from this study was to investigate the effect of the acute treatment combined r TMS on depressed symptoms and suicidality in depressions.Methods: We analyzed the data of demographic characteristics,anti-depression drugs,dosage,r TMS sessions,r TMS protocol,Hamilton depression scale(HAMD),and Hamilton anxiety scale(HAMA)of 61 inpatients with depressive affective disorders in a third-class psychiatric hospital at admission.HAMD and HAMA were re-evaluated one week after admission and two week after admission.Patients were divided into three groups,group A(24 subjects): treated with antidepressants without r TMS or combined with less than 5 r TMS sessions,group B(19 subjects): treated with antidepressants combined with 5-9 r TMS sessions,group C(18 subjects): treated with antidepressants combined with equal or greater than 10 r TMS sessions.The difference of curative efficacy was embodied by comparing the difference of reduction rate of the Hamilton Depression Scale(HAMD),the reduction of HAMD-3,the reduction of HAMD every factor,the reduction of HAMA,and the reduction of HAMA every factor at T3 among the three groups.Results: There was no positive difference in HAMD deduction rate(?2=7.801,?=0.241),the reduction of HADM-3(F=0.468,?=0.629),or the reduction of Hamilton Anxiety Scale(HADA)(F=1.000,?=0.374)at T3 among three groups.The acute phase combined with a higher dose of r TMS(more than 10 sessions)could be more effective in improving sleep disturbances in patients with depressive disorder(F=3.433,?=0.039).Conclusion: The acute phase antidepressant therapy combined repetitive transcranial magnetic stimulation has not shown greater antidepressant efficacy,improved anxiety symptoms,or reduced suicidal ideation efficacy.That should be worthy of attention is more r TMS sessions in the acute phase of depression could be helpful in improving sleep disorders,and may promote recovery and reduce suicidal risk in patients with depressive disorder.Further,increasing pulses per session and sessions per day(multiple sessions per day)for the add-on treatment on the basis of anti-depression therapy in the acute phase of depression can or can not improve efficacy and relieve the symptoms more quickly.