Journal of International Psychiatry

Abstract Objective: To investigate whether repetitive Transcranial Magnetic Stimulation combined with mirtazapine not only has a beneficial effect on depressive symptoms, but also improves cognitive dysfunction. Methods: 80 patients with depression and sleep disorder were randomly divided into two groups. The control group was treated with mirtazapine only. Observation group was given 10HZ rTMS on the basis of control group. Depressive symptoms, sleep status and cognitive function were assessed before and after treatment using Hamilton Depression Scale-17, Pittsburgh Sleep Quality Index score and Montreal Cognitive Assessment Scale. The incidence of adverse reactions was assessed by the Treatment Emergent Symptom Scale. Results: After 4 weeks of treatment, the symptoms of both groups were significantly relieved. HAMD17 scores and PSQI scores in observation group were significantly lower than those in control group (P < 0.05). The total MoCA score and all dimension scores of the observation group were significantly higher than those of the control group (P < 0.05), and the differences were statistically significant. The incidence of adverse reactions in control group was higher than that in observation group, but the difference was not statistically significant (P > 0.05).Conclusions: Taken together, these results suggest that rTMS combined with mirtazapine for depression with sleep disorders has a beneficial effect on depressive symptoms, relief of sleep, and improvement of cognitive function.

Key words: depression; Sleep disorders; Cognitive function; Repeated transcranial magnetic stimulation; Mirtazapine;