Efficacy of fluvoxamine combined with rTMS in the treatment of patients with post-stroke depression and sleep disorders
Li Dan
Kang Xia
Li Yuanyuan
Abstract：Objective To explore the clinical efficacy of fluvoxamine combined with repetitive transcranial magnetic stim-ulation(rTMS)in the treatment of patients with post-stroke depression and sleep disorders.Methods This study prospectively enrolled 78 patients with post-stroke depression and sleep disorders who were admitted to Zhumadian Center Hospital between December 2022 and December 2024 and randomly assigned them to the control group(n=39)and the observation group(n=39)using a random number.The control group was treated with fluvoxamine monotherapy,and the observation group was treated with fluvoxamine combined with rTMS.The levels of 17 items of the Hamilton Depression Scale(HAMD-17),Pittsburgh Sleep Quality Index(PSQI),inflammatory factors and neurobiochemical indicators before and after treatment were compared between the control group and the observation group.Results After treatment,the observation group showed significantly lower HAMD-17 and PSQI scores compared to the control group((17.34±3.11)points vs(19.75±3.55)points,(7.13±1.33)points vs(7.88±1.56)points)(t=3.198,2.285,both P<0.05).After treatment,the levels of high-sensitivity C-reactive protein,tumor necrosis factor-α and serum interleukin-6 were significantly reduced in the observation group compared to the control group((7.44±1.33)mg·L-1 vs(8.08±1.23)mg·L-1,(37.99±10.53)mg·L-1 vs(45.22±7.93)mg·L-1,(7.88±1.23)pg·L-1 vs(8.68±1.62)pg·L-1)(t=2.206,3.425,2.456,all P<0.05).After treatment,the level of 5-hydroxytryptamine was increased in the observation group compared to the control group((445.78±18.91)pg·L-1 vs(411.89±23.88)pg·L-1)(t=6.937,P<0.05),and the level of homocysteine was decreased in the observation group compared to the control group((11.67±1.78)μmol·mL-1 vs(12.78±1.66)μmol·mL-1)(t=2.848,P<0.05).Conclusion Fluvoxamine combined with rTMS in the treatment of post-stroke depression with sleep disorders can effectively improve the degree of depression and sleep quality of the patients,inhibit the inflammatory response,regulate the levels of serum 5-hydroxytryptamine and homocyste-ine,and have a positive effect on them.
Keywords：FluvoxamineRepetitive transcranial magnetic stimulationPost-stroke depressionSleep disordersClinical efficacy
Publication Date：2025-09-25
Online Publishing Date：2025-10-10(First online date of this platform, not the publication date of the document)
Pages：5( 1009-1013 )