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Psychiatry Res. 2018 Apr;262:363-372. doi: 10.1016/j.psychres.2017.09.009. Epub 2017 Sep 19.
Major depressive disorder is a highly prevalent condition with significant morbidity and mortality. Recurrent episodes occur in greater than 50% of patients within a one year period despite treatment with antidepressant medications, electroconvulsive therapy and psychotherapy. Longer antidepressant treatment may prevent relapses and recurrences. Urgent therapeutic alternatives are needed such as maintenance repetitive transcranial magnetic stimulation. The purpose of this review is to describe and discuss studies that have evaluated the safety and efficacy of this technique in the long-term treatment and relapse prevention of depression. The electronic literature on maintenance repetitive transcranial magnetic stimulation for depression was reviewed. A limited number of controlled, open-label studies as well as case series have been published on maintenance rTMS after successful response to acute rTMS. In the majority of these studies, most patients with treatment-resistant unipolar or bipolar depression with or without medications experienced either moderate or marked benefit with maintenance rTMS, sometimes remission for three months and up to eight years. Many of the reviewed studies have shown promising results, however, future well-designed sham-controlled studies are needed to confirm the long-term safety and efficacy of maintenance rTMS in the relapse prevention of depression.
重度抑郁症是一种高发病率的疾病，具有显著的发病率和死亡率。尽管采用抗抑郁药物、电惊厥疗法和心理疗法治疗，在一年内仍有超过 50%的患者反复发作。延长抗抑郁治疗可能预防复发和再发。因此，需要紧急的治疗替代方法，如维持重复经颅磁刺激。本综述的目的是描述和讨论评估该技术在抑郁症的长期治疗和复发预防中的安全性和有效性的研究。对维持重复经颅磁刺激治疗抑郁症的电子文献进行了回顾。在急性 rTMS 治疗成功后，已经发表了一些关于维持 rTMS 的有限数量的对照、开放标签研究以及病例系列研究。在这些研究中的大多数，大多数伴有或不伴有药物治疗的抗药性单相或双相抑郁症患者，维持 rTMS 治疗后，大多数患者都有中度或显著的益处，有时缓解期为三个月至八年。许多已审查的研究显示出有希望的结果，然而，未来需要进行精心设计的假对照研究，以确认维持 rTMS 在预防抑郁症复发方面的长期安全性和有效性。
