| Objective To investigate the efficacy, safety and cost-effectiveness of Transcranial magnetic stimulation (rTMS) and Modified electroconvulsive therapy (MECT) combined with antidepressants in the early stage treatment of patients with major depressive disorder (MDD). Methods 335 discharged patients with MDD were divided into MECT + drug group (n=141 cases) and rTMS + drug group (n=194 cases). Hamilton Depression Scale (HAMD) reduction rate and recovery rate were used to evaluate the efficacy, the safety of adverse reactions and the cost-effectiveness of this treatment phase were compared. Results There was no significant difference in the reduction rate and recovery rate between rTMS + drug group and MECT + drug group at the 1st, 2nd, 3rd and 4th weekend after treatment (P>0.05). After MECT treatment, 41% of patients had near memory impairment and 52% had head and neck muscle pain. Headache or local skin discomfort occurred in 13.9% of patients after rTMS treatment. The treatment cost of MECT was higher than that of rTMS, and the difference was statistically significant［(18614.25±2078.85)vs.(14334.10±1845.53)， P＜0. 05］. Conclusion rTMS + drug group has the same efficacy, higher safety and more cost-effectiveness as MECT + drug group in the early stage treatment of patients with major depressive disorder. |