Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Jul 19, 2023; 13(7): 453-460
Published online Jul 19, 2023. doi: 10.5498/wjp.v13.i7.453
Repetitive transcranial magnetic stimulation combined with olanzapine and amisulpride for treatment-refractory schizophrenia
Jin-Ling Liu, Zhi-Mei Tan, Shu-Jie Jiao
Jin-Ling Liu, Shu-Jie Jiao, Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
Zhi-Mei Tan, Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
Author contributions: Liu JL and Jiao SJ contributed to the study conception and design, drafting the manuscript, and data analysis and interpretation; Liu JL and Tan ZM contributed to the study conception and critical revision of the article for important intellectual content; Liu JL contributed to the study conception and design and critical revision of the article for important intellectual content.
Institutional review board statement: This study was approved by the Institutional Review Board of the First Affiliated Hospital of Zhengzhou University.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare having no conflicts of interest.
Data sharing statement: The data for this study can be obtained from the corresponding author upon request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shu-Jie Jiao, PhD, Doctor, Department of Neurology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Erqi District, Zhengzhou 450000, Henan Province, China. jsj331253@126.com
Received: May 4, 2023
Peer-review started: May 4, 2023
First decision: May 15, 2023
Revised: May 31, 2023
Accepted: June 21, 2023
Article in press: June 21, 2023
Published online: July 19, 2023
Abstract
BACKGROUND

Treatment-refractory schizophrenia (TRS), accounting for approximately 30% of all schizophrenia cases, has poor treatment response and prognosis despite treatment with antipsychotic drugs.

AIM

To analyze the therapeutic effectiveness of repetitive transcranial magnetic stimulation (rTMS) combined with olanzapine (OLZ) and amisulpride (AMI) for TRS and its influence on the patient’s cognitive function.

METHODS

This study enrolled 114 TRS patients who received treatment at the First Affiliated Hospital of Zhengzhou University between July 2019 and July 2022. In addition to the basic OLZ + AMI therapy, 54 cases of the control group (Con group) received modified electroconvulsive therapy, while 60 cases of the research group (Res group) received rTMS. Data on therapeutic effectiveness, safety (incidence of drowsiness, headache, nausea, vomiting, or memory impairment), Positive and Negative Symptom Scale, Montreal Cognitive Assessment Scale, and Schizophrenia Quality of Life Scale were collected from both cohorts for comparative analyses.

RESULTS

The Res group elicited a higher overall response rate and better safety profile when compared with the Con group. Additionally, a significant reduction was observed in the post-treatment Positive and Negative Symptom Scale and Schizophrenia Quality of Life Scale scores of the Res group, presenting lower scores than those of the Con group. Furthermore, a significant increase in the Montreal Cognitive Assessment Scale score was reported in the Res group, with higher scores than those of the Con group.

CONCLUSION

The treatment of TRS with rTMS and OLZ + AMI is effective and safe. Moreover, it can alleviate the patients’ mental symptoms, improve their cognitive function and quality of life, and has a high clinical application value.

Keywords: Repetitive transcranial magnetic stimulation, Olanzapine, Amisulpride, Treatment-refractory schizophrenia, Therapeutic effectiveness, Cognitive function

Core Tip: Patients with treatment-refractory schizophrenia always have an unsatisfactory treatment response and prognosis despite antipsychotic therapy, which poses significant challenges to clinical management. Therefore, it is necessary to continuously explore and validate effective treatments for treatment-refractory schizophrenia.