Open AccessRepetitive Transcranial Magnetic Stimulation Combined with Antidepressants for the First Episode of Major Depressive Disorder
Author(s) -
Benchalak Maneeton,
Narong Maneeton,
Pakapan Woottiluk,
Surinporn Likhitsathian
Publication year - 2020
Publication title -
current neuropharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.955
H-Index - 73
eISSN - 1875-6190
pISSN - 1570-159X
DOI - 10.2174/1570159x18666200221113134
Subject(s) - discontinuation , tolerability , major depressive disorder , transcranial magnetic stimulation , medicine , hamd , adverse effect , randomized controlled trial , antidepressant , major depressive episode , psychiatry , mood , stimulation , significant difference , hippocampus
Objectives: The aims of this study were to systematically review the efficacy, acceptability,and tolerability of repetitive transcranial magnetic stimulation (rTMS) combined with antidepressantsin the treatment of the first major depressive disorder (MDD) episode. Materials and Methods: The primary efficacious outcome was the pooled mean-endpoint scores ofthe Hamilton Depression Rating Scale (HAMD). Rates of response, remission rate, overall discontinuationand discontinuation due to adverse events were also evaluated. Search in the Scopus,PubMed, CINAHL, and Cochrane Controlled Trials Register databases for interesting outcomeswas carried out in March 2018. Results: A total of 108 randomized patients of two randomized controlled trials were included inthis study. The pooled mean- endpoint scores of the HAMD in one, two, and four weeks for rTMSplus antidepressants (citalopram or paroxetine) were greater than that of sham plus the antidepressants.The pooled rates of overall discontinuation and discontinuation rates due to adverse eventswere not different between the two groups. Conclusion: According to a piece of limited evidence, the high-frequency repetitive transcranialmagnetic stimulation (HF-rTMS) could accelerate the antidepressant effect of SSRIs in young patientswith a first-episode major depressive disorder. However, the acceptability and tolerability ofHF-rTMS in the treatment of such patients are no better than an antidepressant alone. However,further well-defined and large sample-size studies of HF-rTMS combined with an antidepressant inMDD should be carried out to warrant these results.