Efficacy of sertraline combined with repetitive transcranial magnetic stimulation for depression in adolescents with a history of childhood trauma

Cheng Fang-shuo; Zhong Yi; Liu Xiao-yan

doi:10.3969/j.issn.1672-8157.2025.02.024

Abstract：Objective To evaluate the efficacy and safety of sertraline combined with repetitive transcranial magnetic stimu-lation(rTMS)in treating depression in adolescents with a history of childhood trauma.Methods Adolescent patients with depres-sion and a history of childhood trauma who were hospitalized in Hangzhou Seventh People's Hospital from January to August 2023 were selected and divided into two groups using a randomization table.The patients in the monotherapy group received sertraline treatment while those in the combination group received both sertraline and rTMS.For the rTMS treatment,left dorsolateral prefron-tal cortex(DLPFC)was targeted,with 5 sessions per week for 2 weeks,totaling 10 sessions.The primary outcome measure was the 17-item Hamilton depression rating scale(HAMD-17),and the secondary outcome measure was the Hamilton anxiety rating scale(HAMA).Both of them were used to assess changes in symptoms.Adverse events occurring during the treatment were documented and analyzed.Results Prior to treatment,there were no significant differences between the two groups in HAMD-17 and HAMA scores(both P>0.05).After treatment for 2 weeks,the HAMD-17 score(11.40±4.13)and HAMA score(12.71±3.58)in the combi-nation group were significantly lower than those in the monotherapy group((13.40±4.13)and(16.38±6.45)),showing statistically significant difference between the two groups(P<0.05).The treatment response rates for depressive symptoms and anxiety symptoms in the combination therapy group were 55.26%and 63.16%,respectively,which were significantly higher than those of 26.19%and 38.10%in the monotherapy group(P<0.05).However,no significant difference was observed in incidence of adverse events between the two groups(P>0.05).Conclusion Sertraline combined with rTMS is a safe and effective treatment for adolescents with de-pression and a history of childhood trauma,leading to significant improvements in depressive and anxiety symptoms.