Abstract: Objective · To investigate the effects and safety of accelerated repetitive transcranial magnetic stimulation (rTMS) on suicide ideation in depressive patients and to examine whether intensive rTMS has a rapid remission of suicidal ideations or not. Methods · A total of 14 depression out patients with severe suicidal ideations were enrolled in the study. All the participants were treated with rTMS (5 Hz) on the left dorsolateral prefrontal cortex. rTMS was delivered 3-4 times daily for 3 d (total 10 sessions, 20 000 stimuli). The participants were taking antidepressants at a fixed effective dose during rTMS treatment. Scale for Suicidal Ideation (SSI), Hamilton Depression Scale-17 (HAMD17) and Clinical Global Impression-Severity of Illness (CGI-SI) were assessed at baseline and 4 d, 2 weeks and 4 weeks after baseline. Results · rTMS of 5 Hz was safe and well-tolerated. The SSI scores decreased significantly at all follow-up timepoints after rTMS treatment (F15.788, P0.000), and the SSI score decreased the most significantly the day after the end of rTMS therapy. The effect of anti-suicide ideation could be maintained after 4 weeks. There was a significant correlation between the degree of decrease of suicidal ideation and the decrease of HAMD17 score (t5.658, P0.000), but not related with CGI-SI (t-1.058, P0.295). accelerated rTMS treatment improved depressive symptoms significantly, and the total effective rate reached 78.57% after 4 weeks the baseline. Conclusion · accelerated rTMS treatment may have the potential to quickly reduce suicide ideation in depressive patients, with good safety. The degree of decrease in suicide ideation is related to the antidepressant effect of rTMS, and its efficacy can be maintained.

Key words: repetitive transcranial magnetic stimulation (rTMS), depression, suicidal ideation, suicide