| Objective Repetitive transcranial magnetic stimulation（rTMS）has been proved to be an effective method for the treatment of depressive disorders.Atypical antipsychotics as an enhanced antidepressant therapy are also gradually used in clinical and rTMS.However,previous studies have disputed the efficacy of rTMS in depressive patients taking atypical antipsychotics.Therefore,this study reviews a large sample of real data to evaluate whether atypical antipsychotic adjuvant therapy affects the antidepressant effect of rTMS,and to provide a basis for clinical treatment of depressive disorders.Methods This study is a retrospective study.According to the inclusion and exclusion criteria,135 inpatients diagnosed with recurrent depressive disorder according to ICD-10 clinical diagnostic criteria from January 2021 to December 2021 were selected,including atypical antipsychotics and patients who did not use atypical antipsychotics,including 42 patients who did not use atypical antipsychotics and 93 patients who used atypical antipsychotics.There was no significant difference in baseline（HAMD-24 scale score）between the two groups before treatment.In this retrospective study,135 patients were treated with transcranial magnetic stimulation for at least one week.Taking the reduction rate of HAMD-24 scale and the effective rate of treatment before and after transcranial magnetic therapy（TMS）as the curative effect evaluation indexes,this paper compares whether there is a certain difference in the curative effect between patients who use atypical antipsychotics and those who do not use TMS.In terms of baseline data,two groups of basic demographic and clinical variables,including general demographic data such as age and sex,were collected.Types and severity of depressive disorders;Clinical data such as the types and dosages of atypical antipsychotics currently taken,and the types and dosages of other drugs combined;And the related parameters of repetitive transcranial magnetic stimulation,such as stimulation target,frequency,intensity,threshold,total pulse number and treatment times;Summarize the data,statistically analyze the differences and draw a conclusion.Results A total of 135 patients with depressive disorder were included in this study,including 37 males（27.4%）and 98 females（72.6%）.42 cases（31.1%）were not treated with atypical antipsychotics and 93 cases（68.9%）were treated with atypical antipsychotics.There was no significant difference in baseline HAMD,age,sex,psychiatric symptoms,rTMS target,total pulse number,intensity,frequency,frequency,threshold and baseline of rTMS between the atypical antipsychotic group and the non-atypical antipsychotic group.There were significant differences in the absolute changes of HAMD,HAMD and the relative change of HAMD between the two groups after treatment.Among them,the effective rate of the group without atypical antipsychotics was 73.8%,which was higher than that of the group with atypical antipsychotics（67.7%）.Multivariate correlation analysis showed that there was significant difference in the effect of antidepressant therapy with atypical antipsychotics（P<0.05）.Conclusion Atypical antipsychotics can weaken the antidepressant effect of rTMS,which is not related to confounding factors.This effect is statistically significant and has potential clinical significance.Its exact mechanism remains to be clarified and needs to be further studied. |
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