Abstract
OBJECTIVE: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.