Journal of International Psychiatry

【Abstrat】Objective The aim of this study was to prospectively evaluate the effectiveness and safety of high-frequency Repetitive transcranial magnetic stimulation(rTMS) over the left dorsolateral prefrontal cortex(DLPFC)concomitant antidepressants use in patients with treatment-resistant depressive(TRD）.Method The authors conducted a 4 to 6 week double-blind, randomized, sham-controlled trial in 100 patients with treatment-resistant depression episode.100TRD inpatients or outpatient in our hospital from December 2021 to August 2023 were randomly divided into 50 cases in study group and 50 control group according to the number table method. The study group received systematic rTMS treatment High-frequency left-side dorsolateral prefrontal cortex repetitive transcranial magnetic stimulation (rTMS) and the control group received sham-stimulation,and the patients reveived concurrently antidepressants，for a total of 4-6W.The primary outcome variable was the score on the 17-item Hamilton Depression Rating Scale(HAMD-17). Results There was no significant difference in HAMD-17 score between the two groups before treatment;The HAMD-17 score reduce rates (%)of the study group were 25.93、59.70、69.30 at weekend 2、4、6 respectively.There was a significant difference in the HAMD-17 score reduce rates between the two groups at weekend 2、4、6(F=101.341，P<0.01). A significant proportion of the study group met response rate (22 of550[44.0%]) or remission rate (15 of 50[30.0%]) criteria by weekend 6 compared to the contral group (2 of 50 [4.0%] and none of50[0.00%] respectively). There were significant differences in response rate and remission rate between the two groups at weekend 6（P =0.000）.Conclusions high-frequency Repetitive transcranial magnetic stimulation(rTMS) over the left dorsolateral prefrontal cortex concomitant antidepressants use has substantial treatment efficacy and safety in patients with treatment-resistant major depression.

high‐frequency； left dorsolateral prefrontal cortex； repetitive transcranial magnetic stimulation ；antidepressants；treatment- resistant depression