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
ARTICLE HIGHLIGHTS
Research background

Treatment-refractory schizophrenia (TRS) accounts for approximately 30% of all patients with schizophrenia, with unsatisfactory treatment response and poor patient prognosis despite antipsychotic therapy.

Research motivation

The treatment of TRS is difficult and challenging, but it is still the responsibility of doctors to explore effective treatment options for the disease.

Research objectives

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 patients’ cognitive function (CF).

Research methods

First, 114 TRS patients who received treatment between July 2019 and July 2022 were selected. On the basis of OLZ + AMI therapy, 54 cases in the control group (Con group) received modified electroconvulsive therapy, and 60 cases in the research group (Res group) were given rTMS. Information on the therapeutic effectiveness, safety (drowsiness, headache, nausea, vomiting, and memory impairment), Positive and Negative Symptom Scale, Montreal Cognitive Assessment Scale, and Schizophrenia Quality of Life Scale were collected from both patient cohorts for competitive analyses.

Research results

A higher overall response rate and a better safety profile of treatment were determined in the Res group compared with the Con group. In addition, marked reductions in the Positive and Negative Symptom Scale and Schizophrenia Quality of Life Scale scores were found in the Res group after treatment, which were lower compared with the Con group. A significant increase in the Montreal Cognitive Assessment Scale score was observed in the Res group, with higher scores than the Con group.

Research conclusions

rTMS plus OLZ + AMI was effective and safe in the treatment of TRS, which can alleviate the patients’ mental symptoms and improve their CF and quality of life, with clinical promotion value.

Research perspectives

rTMS plus OLZ + AMI, with both clinical efficacy and safety, may be more suitable for TRS patients than modified electroconvulsive therapy plus OLZ + AMI. This therapy has significant advantages in relieving psychiatric symptoms and improving CF and quality of life, which is worth promoting clinically.