The Clinical Apply Research Of Repetitive Transcranial Magnetic Stimulation Combined With Single Fluoxetine In Post-stroke Depression

Objective:By comparing the efficacy between fluoxetine combined with low-frequency repetitive transcranial magnetic stimulation (rTMS) and simple fluoxetine treatment alone for post-stroke depression(PSD), We attempt to evaluate the tolerability and safety in PSD treatment with rTMS.Methods:40 patients meeting the standards were randomly assigned into two groups, treatment group and control group.There were 20 patients in each group.Patients in the control group were treated with fluoxetine 20mg/day, while those in the treatment group treated with fluoxetine combined with (rTMS). The stimulation site of rTMS is the right side dorsolateral prefrontal(DLPFC). Stimulating frequency is 1Hz, strength 80%MT,1500 times per treatment,5 times per week, and a total course was 4 weeks. All patients were treated for a period of four weeks and assessed with Hamilton Depression amount (HAMD), the US National Institutes of Health Stroke Scale (NIHSS), Activities of Daily Living Scale (ADL) at 0,2,4 weeks.Results:1 The HAMD scale score,NIHSS scores and ADL scores of two groups of patients before treatment was no significant difference (P> 0.05).2.There is a significant improvement (P<0.05) of HAMD scale score,NIHSS scores and ADL scores both in treatment group and control group before and after 4 weeks of treatment.3.There is a significant difference (P<0.05) of HAMD scores, NIHSS scores between the treatment group and the control group after treatment,while there is no difference of ADL scores between the treatment group and the control group after treatment.Conclusion:1.The efficacy of rTMS combine with fluoxetine in the treatment of PSD is better than fluoxetine alone.2.Comparing with single fluoxetine, the rTMS ombine with fluoxetine could accelerate the recovery in patients of the depressive symptoms.3.Low-frequency rTMS for depression after stroke patients is a safe and effective treatment, which is with no significant adverse reactions, Well tolerated, easy to accept for patients and their families.