Objective To explore the efficacy of combination therapy with brainwave synchronization,repetitive transcranial magnetic stimulation (r TMS) and fluoxetine in the treatment of postpartum depression.
Methods Forty-eight cases of postpartum depression in Hangzhou Seventh People's Hospital between June,2013 and June,2015 were randomized into two groups.The combined treatment group (25 cases) received the combination therapy with brainwave synchronization,r TMS and fluoxetine,while the simple drug group (23 cases) only received fluoxetine treatment.The curative effect and adverse reactions were evaluated between the two groups by Hemilton depression scale (HAMD),Edinburgh postnatal depression scale (EPDS),clinical global impression (CGI) and treatment emergent symptom scale (TESS) before the treatment and 1,2,4 and 6 weeks after the treatment.The levels of serum cortisol (COR),three iodine thyroid glycine (T3),four iodine glycine (T4),thyroid-stimulating hormone (TSH) and estradiol were tested before the treatment and 6 weeks after the treatment.
Results HAMD and EPDS score on the end of 2,4 and 6 weeks decreased obviously in the combined treatment group as compared with the fluoxetine group (
P<0.01);CGI-EI on the end of 2 weeks in the combined treatment group was higher than that in the fluoxetine group (
P<0.05);The difference in (CGI-GI and CGI-EI at 6 weeks after the treatment was statistically significant (
P<0.05);TESS score on the end of 4 and 6 weeks in the combined treatment group was obviously lower than that in the fluoxetine group (
P<0.01);After 6 weeks treatment,the difference in the levels of serum TSH,COR and estradiol was significant between the two groups (
P<0.05).
Conclusion The combination therapy with brainwave synchronization,r TMS and fluoxetine for postpartum depression is effective with less sideeffect.The small drug dosage can improve the compliance of patients.