Meta-analysis of Therapeutic Effect in Depression Treatment of Repetitive Transcranial Magnetic Stimulation Combined Paroxetine

Objective:To evaluate the therapeutic effect of repetitive transcranial magnetic stimulation(TMS)combined with paroxetine in the treatment of depression, provide reference for the clinical treatment and related research of depression.Methods:We electronically searched databases, including CNKI Chine...

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Main Authors: Xinyi GUO, Guo YU, Xiaokuo HE
Format: Article
Language:English
Published: Editorial Office of Rehabilitation Medicine 2019-04-01
Series:康复学报
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Online Access:http://kfxb.publish.founderss.cn/thesisDetails#10.3724/SP.J.1329.2019.02067
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author Xinyi GUO
Guo YU
Xiaokuo HE
author_facet Xinyi GUO
Guo YU
Xiaokuo HE
author_sort Xinyi GUO
collection DOAJ
description Objective:To evaluate the therapeutic effect of repetitive transcranial magnetic stimulation(TMS)combined with paroxetine in the treatment of depression, provide reference for the clinical treatment and related research of depression.Methods:We electronically searched databases, including CNKI Chinese Journal Full-text Database, Wanfang Database, VIP Database, PubMed, the Cochrane Library and EMbase, to collect randomized controlled trials(RCTs)about depression treated by repetitive TMS combined with paroxetine. The time limitation was from the establishment of each database to 31st August 2017.Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Then, Meta-analysis was performed by using RevMan 5.3 software.Results:A total of sixteen related articles and 1 150 patients were retrieved. The effective rate was selected as primary outcome measure in five articles, and Meta analysis showed that compared with control group, pooled <italic>RR</italic> was 1.35 with 95%<italic>CI</italic> [1.11, 1.65], <italic>Z</italic>=3.00, <italic>P</italic>&lt;0.01, in the test for overall effect, implying the significant effective rate difference between the two groups was in the treatment of first-episode depressive. The adverse reaction rate was selected as primary outcome measure in five articles. Meta analysis showed that compared with control groups, pooled <italic>RR</italic> was 0.83 with 95%<italic>CI</italic> [0.56, 1.24], <italic>Z</italic>=0.92, <italic>P</italic>&gt;0.05, in the test for overall effect, implying that the adverse reaction rate difference of two groups was not significant. The HAMD scores was selected as secondary outcome measure in three articles, and Meta analysis showed that compared with control groups, pooled <italic>MD</italic> was-1.71 with 95%<italic>CI</italic> [-4.82, 1.40], <italic>Z</italic>=1.08, <italic>P</italic>&gt;0.05, in the test for overall effect, implying that the HAMD scores difference of two groups was not significant. The effective rate was selected as primary outcome measure in five articles. Meta-analysis showed that compared with control groups, pooled <italic>RR</italic> was 1.20 with 95%<italic>CI</italic> [0.96, 1.52], <italic>Z</italic>=1.58, <italic>P</italic>&gt;0.05, in the test for overall effect, implying the effective rate difference of two groups was not significant in the treatment of depressive. The adverse reaction rate was selected as primary outcome measure in four articles, and Meta-analysis showed that compared with control groups, pooled <italic>RR</italic> was 0.96 with 95%<italic>CI</italic> [0.68, 1.34], <italic>Z</italic>=0.26, <italic>P</italic>&gt;0.05, in the test for overall effect, implying the adverse reaction rate difference of two groups was not significant in the treatment of depressive. The HAMD scores were selected as secondary outcome measure in eight articles, and Meta analysis showed that compared with the control group, pooled <italic>MD</italic> was-3.26 with 95%<italic>CI</italic> [-3.83, -2.69], <italic>Z</italic>=11.20, <italic>P</italic>&lt;0.01, in the test for overall effect, implying that the HAMD scores difference of two groups was significant in the treatment of depressive.Conclusion:The effect of repeated TMS combined Paroxetine in the treatment of first-episode depressive disorder and depression is better than Paroxetine with and without pseudo stimulus, but there is no difference in side effects. Therefore, repeated TMS combined paroxetine may be more suitable for clinical use in the treatment of first-episode depression and depression. However, the above conclusion still needs to be verified by large sample and high quality RCTs.
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spelling doaj-art-b875ef3bfc0c4c989b5360432219334f2025-01-14T10:04:38ZengEditorial Office of Rehabilitation Medicine康复学报2096-03282019-04-0129677423129053Meta-analysis of Therapeutic Effect in Depression Treatment of Repetitive Transcranial Magnetic Stimulation Combined ParoxetineXinyi GUOGuo YUXiaokuo HEObjective:To evaluate the therapeutic effect of repetitive transcranial magnetic stimulation(TMS)combined with paroxetine in the treatment of depression, provide reference for the clinical treatment and related research of depression.Methods:We electronically searched databases, including CNKI Chinese Journal Full-text Database, Wanfang Database, VIP Database, PubMed, the Cochrane Library and EMbase, to collect randomized controlled trials(RCTs)about depression treated by repetitive TMS combined with paroxetine. The time limitation was from the establishment of each database to 31st August 2017.Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Then, Meta-analysis was performed by using RevMan 5.3 software.Results:A total of sixteen related articles and 1 150 patients were retrieved. The effective rate was selected as primary outcome measure in five articles, and Meta analysis showed that compared with control group, pooled <italic>RR</italic> was 1.35 with 95%<italic>CI</italic> [1.11, 1.65], <italic>Z</italic>=3.00, <italic>P</italic>&lt;0.01, in the test for overall effect, implying the significant effective rate difference between the two groups was in the treatment of first-episode depressive. The adverse reaction rate was selected as primary outcome measure in five articles. Meta analysis showed that compared with control groups, pooled <italic>RR</italic> was 0.83 with 95%<italic>CI</italic> [0.56, 1.24], <italic>Z</italic>=0.92, <italic>P</italic>&gt;0.05, in the test for overall effect, implying that the adverse reaction rate difference of two groups was not significant. The HAMD scores was selected as secondary outcome measure in three articles, and Meta analysis showed that compared with control groups, pooled <italic>MD</italic> was-1.71 with 95%<italic>CI</italic> [-4.82, 1.40], <italic>Z</italic>=1.08, <italic>P</italic>&gt;0.05, in the test for overall effect, implying that the HAMD scores difference of two groups was not significant. The effective rate was selected as primary outcome measure in five articles. Meta-analysis showed that compared with control groups, pooled <italic>RR</italic> was 1.20 with 95%<italic>CI</italic> [0.96, 1.52], <italic>Z</italic>=1.58, <italic>P</italic>&gt;0.05, in the test for overall effect, implying the effective rate difference of two groups was not significant in the treatment of depressive. The adverse reaction rate was selected as primary outcome measure in four articles, and Meta-analysis showed that compared with control groups, pooled <italic>RR</italic> was 0.96 with 95%<italic>CI</italic> [0.68, 1.34], <italic>Z</italic>=0.26, <italic>P</italic>&gt;0.05, in the test for overall effect, implying the adverse reaction rate difference of two groups was not significant in the treatment of depressive. The HAMD scores were selected as secondary outcome measure in eight articles, and Meta analysis showed that compared with the control group, pooled <italic>MD</italic> was-3.26 with 95%<italic>CI</italic> [-3.83, -2.69], <italic>Z</italic>=11.20, <italic>P</italic>&lt;0.01, in the test for overall effect, implying that the HAMD scores difference of two groups was significant in the treatment of depressive.Conclusion:The effect of repeated TMS combined Paroxetine in the treatment of first-episode depressive disorder and depression is better than Paroxetine with and without pseudo stimulus, but there is no difference in side effects. Therefore, repeated TMS combined paroxetine may be more suitable for clinical use in the treatment of first-episode depression and depression. However, the above conclusion still needs to be verified by large sample and high quality RCTs.http://kfxb.publish.founderss.cn/thesisDetails#10.3724/SP.J.1329.2019.02067depressionrepetitive transcranial magnetic stimulationparoxetineMeta-analysis
spellingShingle Xinyi GUO
Guo YU
Xiaokuo HE
Meta-analysis of Therapeutic Effect in Depression Treatment of Repetitive Transcranial Magnetic Stimulation Combined Paroxetine
康复学报
depression
repetitive transcranial magnetic stimulation
paroxetine
Meta-analysis
title Meta-analysis of Therapeutic Effect in Depression Treatment of Repetitive Transcranial Magnetic Stimulation Combined Paroxetine
title_full Meta-analysis of Therapeutic Effect in Depression Treatment of Repetitive Transcranial Magnetic Stimulation Combined Paroxetine
title_fullStr Meta-analysis of Therapeutic Effect in Depression Treatment of Repetitive Transcranial Magnetic Stimulation Combined Paroxetine
title_full_unstemmed Meta-analysis of Therapeutic Effect in Depression Treatment of Repetitive Transcranial Magnetic Stimulation Combined Paroxetine
title_short Meta-analysis of Therapeutic Effect in Depression Treatment of Repetitive Transcranial Magnetic Stimulation Combined Paroxetine
title_sort meta analysis of therapeutic effect in depression treatment of repetitive transcranial magnetic stimulation combined paroxetine
topic depression
repetitive transcranial magnetic stimulation
paroxetine
Meta-analysis
url http://kfxb.publish.founderss.cn/thesisDetails#10.3724/SP.J.1329.2019.02067
work_keys_str_mv AT xinyiguo metaanalysisoftherapeuticeffectindepressiontreatmentofrepetitivetranscranialmagneticstimulationcombinedparoxetine
AT guoyu metaanalysisoftherapeuticeffectindepressiontreatmentofrepetitivetranscranialmagneticstimulationcombinedparoxetine
AT xiaokuohe metaanalysisoftherapeuticeffectindepressiontreatmentofrepetitivetranscranialmagneticstimulationcombinedparoxetine