Effects of Repeat Transcranial Magnetic Stimulation Combined with Escitalopram in Patients with Treatment-Resistant Depression
FENG Lianqi
LIU Jie
WANG Juan
Abstract：Objective To investigate the effects of repetitive transcranial magnetic stimulation(rTMS)combined with escitalopram in patients with treatment-resistant depression.Methods From September 2019 to September 2022,192 patients with refractory depression were admitted to Shangqiu Second People's Hospital.They were divided into two groups with 96 cases each by random number table method.Escitalopram therapy was used as a control group.rTMS combination with escitalopram therapy was used in observation group.There was evidence of cognitive impairment,sleep quality,depression,nerve injury-related variables,neurotransmitter levels,and therapy safety were observed.Results There was no difference in cognitive impairment between the two groups before intervention(P＞0.05).The cognitive impairment scores of the two groups were increased after intervention,and the scores of observation group were higher than those of control group(P＜0.05).Before intervention,there was no difference in sleep quality between the two groups(P＞0.05).After intervention,the sleep quality scores of both groups decreased,and the sleep quality scores of observation group were lower than that of control group(P＜0.05).There was no difference in the contents of brain derived neurotrophic factor(BDNF),norepinephrine,5-hydroxytryptamine,neuron-specific enolase(NSE)and S-100B protein between the two groups before intervention(P＞0.05).After intervention,the contents of BDNF,norepinephrine and 5-hydroxytryptamine in both groups increased,while NSE and S-100B protein decreased.The contents of BDNF,norepinephrine and 5-hydroxy tryptamine in observation group were higher than those in control group,while the contents of NSE and S-100B protein in observation group were lower than those in control group(P＜0.05).There was no difference in the depression score of the two groups before intervention(P＞0.05).The depression score of the two groups was decreased after intervention,and the depression score of observation group was lower than that of control group(P＜0.05).There was no difference in incidence of adverse reactions between control group and observation group(P＞0.05).Conclusion rTMS in combination with escitalopram can improve cognitive impairment,sleep quality,and depression severity in patients with refractory depression,reduce nerve damage,and inhibit disease progression by regulating neurotransmitter and nerve cell damage factors,and it is safe and effective in clinical use.
Keywords：treatment-resistant depressionrepetitive transcranial magnetic stimulationescitalopramnerve injurycognitive functionsleep
Publication Date：2025-02-14
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：4( 452-455 )