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Psychiatry Res. 2017 Aug;254:18-23. doi: 10.1016/j.psychres.2017.04.005. Epub 2017 Apr 8.

Randomized controlled trial of repetitive transcranial magnetic stimulation combined with paroxetine for the treatment of patients with first-episode major depressive disorder.

Author information

1
Institute of Mental Health, Brain Aging and Cognitive Neuroscience Laboratory, Hebei Medical University, Shijiazhuang 050030, China.
2
National Institute on Drug Dependence, Peking University, Beijing 100191, China; Institute of Mental Health/Peking University Sixth Hospital and Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing 100191, China.
3
Institute of Mental Health/Peking University Sixth Hospital and Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing 100191, China.
4
National Institute on Drug Dependence, Peking University, Beijing 100191, China. Electronic address: li313@bjmu.edu.cn.
5
Institute of Mental Health, Brain Aging and Cognitive Neuroscience Laboratory, Hebei Medical University, Shijiazhuang 050030, China. Electronic address: ydyywxy@163.com.

Abstract

Repetitive transcranial magnetic stimulation (rTMS) has been introduced as a new and effective treatment option for major depression. This paper examined the effectiveness of rTMS on first episode depressed patients when combined with antidepressant drugs. A random sample of forty-three first-episode depressed patients received active or sham rTMS to the left dorsolateral prefrontal cortex, and concomitantly took paroxetine for 4 weeks, and paroxetine monotherapy for 4 weeks afterwards. Response was defined as a ≥50% decrease on the total Hamilton Depression Rating Scale (HDRS) from the baseline, and remission was defined as an HDRS total residual score <8. The dosage of paroxetine was the average dose per day in each week. Repeated-measures ANOVA revealed a significant improvement in the HDRS with active compared with sham rTMS from the end of the 1st week to the 4th week. At the end of the 4th week, response rate was 95.5% with active and 71.4% with sham rTMS, remission rate was 68.2% with active and 38.1% with sham rTMS, while these significant differences disappeared at the endpoint of the study. These findings indicate that rTMS at 10-Hz accelerated the onset of action and augmented the response to paroxetine for first-episode depressed patients.

KEYWORDS:

First-episode depression; Onset of action; Paroxetine; Repetitive transcranial magnetic stimulation

PMID:
28441583
DOI:
10.1016/j.psychres.2017.04.005
[Indexed for MEDLINE]

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