The efficacy and safety of olanzapine combined with repetitive transcranial magnetic stimulation (rTMS) in patients with comorbid anxiety–depression and sleep disorders
- 1Department of Psychosomatic Medicine, Dazhou Central Hospital, Dazhou, Sichuan, China.
Abstract
This retrospective study non-randomized cohort study evaluated the efficacy and safety of adjunctive repetitive transcranial magnetic stimulation (rTMS) combined with olanzapine in adults with comorbid anxiety–depression and sleep disorders treated between April 2019 and March 2025. A total of 210 patients were included and allocated, according to the treatment actually received in routine clinical practice, to an olanzapine monotherapy group (n = 102) or a combined treatment group receiving olanzapine plus rTMS for 4 weeks (n = 108). Baseline demographic and clinical characteristics, including baseline sleep, anxiety, and depression severity, were comparable between groups. After 4 weeks, actigraphy-derived sleep parameters favored the combined group, including higher sleep efficiency (80.31% ± 9.85% vs 76.85% ± 10.53%), longer total sleep time (404.26 ± 14.52 vs 398.26 ± 13.52 minutes), and fewer nighttime awakenings (3.78 ± 0.94 vs 4.12 ± 0.85). Consistent with these objective findings, greater reductions were observed in patient-reported sleep scales, with lower posttreatment Pittsburgh Sleep Quality Index (8.49 ± 1.24 vs 9.05 ± 1.27) and ISI scores (11.47 ± 1.28 vs 11.91 ± 1.31). Both groups demonstrated improvement in mood and anxiety symptoms; however, reductions in Hamilton Depression Rating Scale (13.51 ± 1.85 vs 14.12 ± 1.49) and Hamilton Anxiety Rating Scale scores (12.61 ± 1.78 vs 13.37 ± 1.69) were greater with combined therapy, accompanied by higher overall clinical efficacy and improved World Health Organization Quality of Life – Brief Version physical and psychological domains. Metabolic indices (body mass index, fasting blood glucose, and lipids) were similar between groups at baseline and follow-up. Headache occurred more frequently with rTMS, whereas other adverse events were infrequent and comparable. These findings support the short-term effectiveness of olanzapine plus rTMS for improving sleep and affective symptoms without additional metabolic burden. However, the retrospective non-randomized design, potential residual confounding, and 4-week follow-up require cautious interpretation and confirmation in randomized long-term studies.
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BibTeX
@article{yin2026efficacy,
title = {{The efficacy and safety of olanzapine combined with repetitive transcranial magnetic stimulation (rTMS) in patients with comorbid anxiety–depression and sleep disorders}},
author = {Deyang Yin and Da Yang and Xuan Hou and Ying Liu},
journal = {Medicine},
year = {2026},
month = oct,
doi = {10.1097/md.0000000000050199},
url = {https://europepmc.org/article/PMC/PMC13727165},
note = {CC BY},
}
RIS
TY - JOUR
TI - The efficacy and safety of olanzapine combined with repetitive transcranial magnetic stimulation (rTMS) in patients with comorbid anxiety–depression and sleep disorders
AU - Deyang Yin
AU - Da Yang
AU - Xuan Hou
AU - Ying Liu
PY - 2026
DA - 2026/10/30
JO - Medicine
DO - 10.1097/md.0000000000050199
UR - https://europepmc.org/article/PMC/PMC13727165
AB - This retrospective study non-randomized cohort study evaluated the efficacy and safety of adjunctive repetitive transcranial magnetic stimulation (rTMS) combined with olanzapine in adults with comorbid anxiety–depression and sleep disorders treated between April 2019 and March 2025. A total of 210 patients were included and allocated, according to the treatment actually received in routine clinical practice, to an olanzapine monotherapy group (n = 102) or a combined treatment group receiving olanzapine plus rTMS for 4 weeks (n = 108). Baseline demographic and clinical characteristics, including baseline sleep, anxiety, and depression severity, were comparable between groups. After 4 weeks, actigraphy-derived sleep parameters favored the combined group, including higher sleep efficiency (80.31% ± 9.85% vs 76.85% ± 10.53%), longer total sleep time (404.26 ± 14.52 vs 398.26 ± 13.52 minutes), and fewer nighttime awakenings (3.78 ± 0.94 vs 4.12 ± 0.85). Consistent with these objective findings, greater reductions were observed in patient-reported sleep scales, with lower posttreatment Pittsburgh Sleep Quality Index (8.49 ± 1.24 vs 9.05 ± 1.27) and ISI scores (11.47 ± 1.28 vs 11.91 ± 1.31). Both groups demonstrated improvement in mood and anxiety symptoms; however, reductions in Hamilton Depression Rating Scale (13.51 ± 1.85 vs 14.12 ± 1.49) and Hamilton Anxiety Rating Scale scores (12.61 ± 1.78 vs 13.37 ± 1.69) were greater with combined therapy, accompanied by higher overall clinical efficacy and improved World Health Organization Quality of Life – Brief Version physical and psychological domains. Metabolic indices (body mass index, fasting blood glucose, and lipids) were similar between groups at baseline and follow-up. Headache occurred more frequently with rTMS, whereas other adverse events were infrequent and comparable. These findings support the short-term effectiveness of olanzapine plus rTMS for improving sleep and affective symptoms without additional metabolic burden. However, the retrospective non-randomized design, potential residual confounding, and 4-week follow-up require cautious interpretation and confirmation in randomized long-term studies.
SN - 0304-5412
SN - 1536-5964
SN - 0025-7974
ER -