AUTHOR=Liu Zhang , Yu Sijia , Hu Youfan , Wang Ding , Wang Shuyu , Tang Zhaohui , Li Weihong 

TITLE=Efficacy and safety of repeated transcranial magnetic stimulation combined with escitalopram in the treatment of major depressive disorder: a meta-analysis

JOURNAL=Frontiers in Psychiatry

VOLUME=14

YEAR=2024

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2023.1275839

DOI=10.3389/fpsyt.2023.1275839

ISSN=1664-0640

ABSTRACT=<sec id="sec1"><title>Objective</title><p>This study was designed to systematically review the efficacy and safety of repeated transcranial magnetic stimulation (rTMS) combined with escitalopram in treating major depressive disorder (MDD).</p></sec><sec id="sec2"><title>Methods</title><p>Databases including PubMed, Embase, Cochrane, Web of Science, CNKI, Wanfang, VIP Journal, and China Biomedical Literature databases were electronically searched for randomized controlled trials of rTMS combined with escitalopram intervention for MDD treatment from the inception of these databases to 27 May 2023. Two reviewers independently screened the studies, extracted the data, and assessed the quality of the included studies. R 4.2.2 was then used for a meta-analysis.</p></sec><sec id="sec3"><title>Results</title><p>In total, 19 articles involving 1,032 patients were included. The results of the meta-analysis showed that Hamilton Depression Rating Scale (HAMD) scores were significantly lower in the group receiving rTMS combined with escitalopram (experimental group) than that in the control group [weighted mean difference (WMD) = −5.30, 95% confidence interval (95% CI): −6.44 to −4.17, <italic>p</italic> &lt; 0.01]. The response rate of the experimental group was significantly higher than that of the control group [odds ratio (OR): 5.48; 95% CI: 3.72 to 8.07; <italic>p</italic> &lt; 0.01]. No significant difference in the adverse reaction rate was observed between the two groups (OR: 1.04, 95% CI: 0.71 to 1.52, <italic>p</italic> = 0.82).</p></sec><sec id="sec4"><title>Conclusion</title><p>Our findings suggest that rTMS combined with escitalopram can benefit patients with MDD in a safe manner, which may help in guiding clinical practice.</p></sec><sec id="sec04"><title>Systematic review registration</title><p>DOI number: <ext-link xlink:href="http://dx.doi.org/10.37766/inplasy2023.11.0114" ext-link-type="uri" xmlns:xlink="http://www.w3.org/1999/xlink">10.37766/inplasy2023.11.0114</ext-link>, INPLASY2023110114.</p></sec>