Zhang Zhengyu, Luo Ting, Yu Jianying
Sichuan University, West China Hospital, Mental Health Center - Chengdu, China.
Sichuan University, West China Hospital, Department of Radiology - Chengdu, China.
Rev Assoc Med Bras (1992). 2025 Jun 2;71(4):e20241001. doi: 10.1590/1806-9282.20241001. eCollection 2025.
Postpartum depression significantly affects maternal mental health and family dynamics. Effective and safe treatments are crucial to enhance the quality of life for affected women. This study assesses the effectiveness and safety of combining sertraline with repetitive transcranial magnetic stimulation in treating postpartum depression.
We recruited 152 postpartum depression patients at West China Hospital between May 2020 and October 2023, dividing them into sertraline-only (n=61) and combined treatment (n=91) groups. We evaluated treatment outcomes after 8 weeks, comparing effectiveness, quality of life, neurotransmitter levels, and estrogen levels, while monitoring for adverse reactions.
After 8 weeks, the combined treatment group exhibited a significantly higher effectiveness rate (95.6%) compared to the sertraline-only group (78.7%; p=0.001). Factors such as age, marital status, and treatment regimen significantly influenced treatment outcomes, with women under 30 and married women showing superior results. Post-treatment, both groups showed improvements in physical, psychological, social, and environmental aspects of life, with the combined group achieving notably higher scores. Improvements in neurotransmitter levels (5-hydroxytryptamine and plasma norepinephrine) and hormonal balances (luteinizing hormone, follicle-stimulating hormone, progesterone, and estradiol) were more substantial in the combined treatment group. Both groups had similar rates of adverse reactions, indicating that combining treatments did not significantly increase adverse events (11.0% in the combined group vs. 4.9% in the sertraline group; p=0.190).
Combining sertraline with repetitive transcranial magnetic stimulation significantly enhances treatment effectiveness and improves neurotransmitter and hormone levels, contributing to better quality of life outcomes for postpartum depression patients without increasing adverse reactions.
产后抑郁症严重影响产妇心理健康和家庭关系。有效且安全的治疗对于提高受影响女性的生活质量至关重要。本研究评估舍曲林联合重复经颅磁刺激治疗产后抑郁症的有效性和安全性。
我们于2020年5月至2023年10月在华西医院招募了152例产后抑郁症患者，将其分为单纯舍曲林组（n = 61）和联合治疗组（n = 91）。我们在8周后评估治疗结果，比较有效性、生活质量、神经递质水平和雌激素水平，同时监测不良反应。
8周后，联合治疗组的有效率（95.6%）显著高于单纯舍曲林组（78.7%；p = 0.001）。年龄、婚姻状况和治疗方案等因素对治疗结果有显著影响，30岁以下女性和已婚女性的治疗效果更佳。治疗后，两组在生活的身体、心理、社会和环境方面均有改善，联合组得分显著更高。联合治疗组神经递质水平（5-羟色胺和血浆去甲肾上腺素）和激素平衡（促黄体生成素、促卵泡生成素、孕酮和雌二醇）的改善更为显著。两组的不良反应发生率相似，表示联合治疗并未显著增加不良事件（联合组为11.0%，舍曲林组为4.9%；p = 0.190）。
舍曲林联合重复经颅磁刺激可显著提高治疗效果，改善神经递质和激素水平，有助于产后抑郁症患者获得更好的生活质量，且不增加不良反应。
