Schizophrenia is a severe mental disorder characterized by hallucinations, delusions and cognitive dysfunction, imposing a substantial burden on individuals and society. While antipsychotic medication Show more
Schizophrenia is a severe mental disorder characterized by hallucinations, delusions and cognitive dysfunction, imposing a substantial burden on individuals and society. While antipsychotic medications such as risperidone effectively control positive symptoms, their efficacy in ameliorating cognitive impairment and aggressive behavior remains limited. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive neuromodulation technique, has recently demonstrated potential in adjunctively improving cognitive and behavioral dimensional symptoms in schizophrenia patients. However, the effects of combined rTMS-risperidone therapy on these symptoms and associated serum biomarkers are not yet adequately supported by clinical evidence. This study aimed to evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) combined with risperidone on cognitive function, aggressive behavior and serum biomarkers in patients with schizophrenia. Eighty patients were randomly assigned to a risperidone monotherapy group or a combination therapy group (40 each) for a 4-week intervention. Results showed that the combination group achieved significantly greater reductions in cognitive factor scores (11.39±2.44 vs. 12.84±2.13) and aggressive behavior scores compared to the monotherapy group (all P<0.05). Serum analysis revealed that the combination group also demonstrated superior modulation of biomarkers, including greater reductions in pro-inflammatory factors (TNF-α, IL-8, IL-18) and greater increases in anti-inflammatory (IL-10) and neurotrophic factors (BDNF, VEGF-A, FGF-2) (all P<0.05), while no significant differences were observed in PDGF-BB and HGF between the two groups. These findings suggest that rTMS combined with risperidone more effectively improves cognitive and aggressive symptoms in schizophrenia and is associated with favorable changes in serum inflammatory and neurotrophic markers. Show less
Daniel Pustay, Vishal Patel, Krista Ulisse+1 more · 2026 · International journal of psychiatry in clinical practice · Taylor & Francis · added 2026-04-24
Treatment-resistant depression (TRD) remains a complex challenge, often requiring interventions beyond standard medications. This review explores factors that may predict positive response to electroc Show more
Treatment-resistant depression (TRD) remains a complex challenge, often requiring interventions beyond standard medications. This review explores factors that may predict positive response to electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS) and ketamine-based treatments to help guide clinical decision-making. A systematic review was conducted following PRISMA 2020 guidelines. English-language, peer-reviewed studies were identified through PubMed, Embase and Google Scholar using search terms such as 'treatment-resistant,' 'outcome,' 'prediction,' 'ECT,' 'rTMS,' and 'ketamine.' Studies were included if they examined clinical, biological or imaging predictors of response in adults with TRD. Case reports, reviews, editorials and non-English articles were excluded. A total of 42 studies were selected from 408 screened. Among these, 23 focused on ketamine/esketamine, 14 on rTMS, and 11 on ECT. Predictive factors were grouped into clinical (e.g., symptom profile, illness duration), biological (e.g., IL-6, CRP, BDNF) and imaging (e.g., cingulate cortex activity, connectivity). Inflammation markers and fronto-limbic network findings appeared across treatments, though findings were inconsistent. While some predictors show promise, clinical use remains limited by methodological differences and small sample sizes. Larger studies are required to identify clinically useful predictors. Additionally, for optimal treatment decision-making, comparative studies are necessary. Show less