Efficacy of low-frequency repetitive transcranial magnetic stimulation combined with risperidone in the treatment of schizophrenia patients with auditory verbal hallucinations

Abstract

Objective: This study aimed to determine the efficacy and safety of low-frequency (1 Hz) repetitive transcranial magnetic stimulation (rTMS) combined with risperidone in the treatment of schizophrenia patients with auditory verbal hallucinations (AVH).

Methodology: This retrospective cohort study was conducted in Wenzhou Seventh People’s Hospital and included data from 100 schizophrenia patients with AVH, treated from May 2022 to May 2024. Among them, 50 patients who received low-frequency rTMS combined with risperidone were matched with the cohort of patients who received risperidone alone in a ratio of 1:1. The scores of the Psychotic Symptom Rating Scale (PSYRATS), Auditory Hallucination Rating Scale (AHRS) and Positive and Negative Syndrome Scale (PANNS) were compared between the two groups at baseline, at the end of treatment (five weeks) and after one month of follow-up.

Results: PSYRATS, AHRS, and PANSS scores of the two groups decreased with time (p<0.05). After treatment, the general psychopathological symptoms, positive symptom scores, and PANSS total scores of the rTMS/risperidone group were lower than those of the risperidone group (p < 0.05). There was no difference between the two groups at one-month follow-up (p > 0.05). The incidence of adverse reactions during treatment was comparable in the two groups (p > 0.05).

Conclusions: The results of this study showed that risperidone, combined with 1Hz rTMS, showed no benefit in improving the auditory hallucination symptoms of schizophrenia patients with AVH. However, the combined regimen could significantly improve the positive symptom scores of patients during treatment.