Efficacy Of Agomelatine Combined With RTMS In Treatment Of First-Episode Depression

Objective: To study the remission degree and therapeutic effect of agomelatine on depression and anxiety in patients with depression,and to determine the improvement of agomelatine on sleep disorders.At the same time,its safety was observed and analyzed.Further study on the effect of agomelatine in combination with repetitive transcranial magnetic stimulation(r TMS),expecting that provides new thinking and methods for the treatment of depression.Methods: Choose 90 depression patients who visits Lanzhou University Second Hospita for the first time from April 2019 to December 2019,and divided them into three groups randomly.Group A was given paroxetine to treat,group B was given agomelatine,and C was given agomelatine combined with r TMS.HAMD,HAMA and PSQI scales were evaluated for the three groups of patients before treatment,at the end of the 2nd week,the 4th week and the 8th week respectively.Clinical efficacy was evaluated according to the changes in the total score of the scales and the score reduction rate.And the total score of TESS was used to evaluate the adverse reactions at the end of the 8th week.The object of statistical analysis was FAS set data,and statistical methods such as t test,variance analysis and chi-square test were used.Results: A total of 88 patients were included in the FAS set,group A and B has 29 patients,and 30 in group C.There was no significant difference in general conditions and baseline conditions among the three groups(P>0.05).After treatment,the scale scores of patients in the three groups were analyzed,and the following results were obtained: 1.After treatment,the scores of HAMD and HAMA scales in the three groups at different observation time(at the end of the 2nd,4th and 8th weekends)showed statistically significant differences compared with the baseline scores(P<0.05).At the end of the 8th week,the PSQI scores of the three groups also decreased significantly(P< 0.05).And scores on the depression and anxiety scales declined the most in the first two weeks of treatment.2.Comparison between paroxetine treatment group and agomelatine treatment group showed no significant difference in the scores of HAMD and HAMA scales between the two groups at any stage of observation(P>0.05).There was no difference between the effective rate of depression and anxiety symptoms at the end of the 2nd week and the clinical cure rate at the end of the 8th week(P>0.05).At the end of the 8th week,the PSQI score of agomelatine treatment group was significantly lower than that of paroxetine treatment group,and the number of people with improved sleep quality was significantly higher than that of paroxetine group,with statistically significant differences(P<0.05).3.The comparison results between agomelatine treatment group and agomelatine combined with r TMS treatment group showed that HAMD and HAMA scores of agomelatine+r TMS treatment group were lower at the end of the 2nd and the 4th weekend,with statistically significant differences(P<0.05).At the end of the 8th week,there was no significant difference in scores between the two groups(P>0.05).At the end of the2 nd week,there was no difference in the effective number and effective rate of depression and anxiety symptoms between the two groups(P>0.05).At the end of the8 th week,the HAMD scale analysis showed that the number of patients cured and the cure rate of the two groups were equal(P>0.05),but the HAMA scale showed that the number of patients cured was higher in agomelatine+r TMS treatment group,with a statistically significant difference(P<0.05).4.At the end of the 8th week of treatment,there was no significant difference in TESS scale scores between groups A,B and C,nor was there any difference in the number of patients with adverse reactions(P>0.05).Conclusions: 1.Agomelatine is effective in treating depression and anxiety in patients with depression,and its efficacy is comparable to that of paroxetine;2.Agomelatine can play its role after 2 weeks of apply;3.Agomelatine can improve the sleep quality of patients with depression;4.The combination of agomelatine and r TMS can control patients' symptoms more quickly and effectively;5.Agomelatine is as safe as paroxetine and has less impact on sexual function,but patients need to be regularly monitored for liver function.