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Transcranial DC Stimulation: Ready for Regular Use in Treating Major Depression?

By MedScape | Jan 30, 2017

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This is the Medscape Psychiatry Minute. I’m Dr Peter Yellowlees.

Studies of transcranial direct-current stimulation (tDCS), which is one of several emerging biological nonpharmacologic interventions proposed to treat depression, have had mixed results. Now a team of investigators[1] from the University of São Paulo, Brazil, have undertaken a systematic review and meta-analysis of individual patient data to assess tDCS efficacy and explore individual response predictors.

After gathering data from six randomized sham-controlled trials enrolling 289 patients, the researchers concluded that active tDCS was significantly superior to sham treatment for depression improvement and remission in patients with major depression. They noted that higher tDCS “doses” corresponded to increased tDCS efficacy, and that patients with treatment-resistant depression were less likely to respond to tDCS.

These results are of interest primarily to researchers in biological psychiatry and do not in any way suggest that tDCS is ready for clinical prime time. Before we can consider using this type of therapy with our patients, we need to see much more than trials of active tDCS compared with sham. Well-designed, head-to-head trials against other physical and drug treatments are needed, as there is minimal evidence that this treatment is as effective as the many other biological treatments for depression that we currently have at our disposal.

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