| To explore the efficacy and safety of right-sided low-frequency repetitive transcranial
magnetic stimulation (rTMS) in treating depression comorbid with anxiety in elderly patients. Methods: A total
of 72 elderly patients with depression comorbid with anxiety, hospitalized in the Department of Psychiatry of
Liyuan Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from
January 2021 to June 2021, were selected and randomly divided into a control group (35 cases) and a
low-frequency group (37 cases) using a random number table. Both groups received antidepressant medication.
Additionally, the low-frequency group was treated with rTMS (1.0 Hz) on the right dorsolateral prefrontal
cortex, 20 minutes per session, once daily, five times per week, for a total of 20 sessions over 4 weeks. The
control group received sham stimulation with the same duration and frequency. The Hamilton Depression Rating
Scale-24 (HAMD-24) and the Hamilton Anxiety Rating Scale-14 (HAMA-14) were used to evaluate anxiety and
depression symptoms and treatment efficacy at baseline and at the end of weeks 1, 2, 3, 4, 6, and 8. Adverse
reactions were recorded, and repeated measures ANOVA was used to compare the scores of anxiety and
depression between the two groups at different time points. Results: The main effects of time, group, and
time-group interaction for HAMD-24 and HAMA-14 scores were statistically significant (P<0.05). Further
analysis showed that HAMD-24 scores in both groups were significantly lower than baseline at weeks 1, 2, 3, 4,
6, and 8 (P<0.01). There was no significant difference in HAMD-24 scores between the two groups at weeks 1,
2, 3, and 4 (P>0.05), but the low-frequency group had significantly lower HAMD-24 scores than the control
group at week 6 (P<0.01) and week 8 (P<0.05). For HAMA-14 scores, both groups showed significant
reductions compared to baseline at weeks 1, 2, 3, 4, 6, and week 8 (P<0.01). The low-frequency group had significantly lower HAMA-14
scores than the control group at weeks 1 and 2 (P<0.05) and at weeks 3, 4, 6, and 8 (P<0.01). After 4 weeks of treatment, the overall
response rate in the low-frequency group was higher than that in the control group (P<0.05). After 6 weeks, the marked improvement rate
in the low-frequency group was significantly higher (P<0.05), but there was no significant difference in marked improvement rates
between the two groups after 8 weeks (P>0.05). No severe adverse reactions were observed in either group. Conclusion: Combined
antidepressant and right-sided rTMS therapy effectively alleviates both depressive and anxiety symptoms in elderly patients with
comorbid depression and anxiety, demonstrating superiority to antidepressant medication alone while maintaining a favorable safety
profile. |