tDCS for the treatment of depression: a comprehensive review
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Transcranial direct current stimulation (tDCS) has been investigated for the treatment of major depressive disorders in recent years. Here, we review the implications of current research for the clinical use of tDCS in the treatment of major depressive disorder. Meta-analyses, randomized, placebo-controlled clinical trials, open-label trials, case reports and review articles were identified through a systematic search of the literature database of the National Institutes of Health (USA). Available articles were evaluated with regard to their clinical relevance. Results of tDCS efficacy are inconsistent due to the small sample sizes, the heterogeneous patient samples and the partially high treatment resistance in some studies. Overall, tDCS has very low side effects. Meta-analyses suggest some efficacy of tDCS in the treatment of acute depressive disorder with moderate effect size, and low efficacy in treatment-resistant depression. A general statement about the efficacy of tDCS as a therapeutic tool in major depression seems to be premature. tDCS is considered as a safe therapeutic option and is associated with only minor side effects. The effectiveness of tDCS decreases with resistance to treatment. Psychotropic drugs may attenuate or amplify its effects. The use of 2 mA current strength over 20 min per day over a short time span can be considered as safe.
KeywordsNoninvasive brain stimulation tDCS Major depressive disorder Treatment resistance
This work has been supported by the German Center for Brain Stimulation (GCBS) research consortium (FKZ 01EE1403) funded by the Federal Ministry of Education and Research. The authors are members of the Munich Center for Brain Stimulation, funded in 2015 at the Department of Psychiatry and Psychotherapy of the Ludwig Maximilian University Munich as a part of the German Center for Brain Stimulation (GCBS), a multi-centric consortium funded by the German Ministry of Education and Research (BMBF; FKZ 01EE1403).
Conflict of interest
F.P. received research support from NeuroConn GmbH and Brainsway Inc. as well as speaker’s honorarium from Mag&More GmbH. A. H. has been invited to scientific meetings by Lundbeck, Janssen-Cilag and Pfizer, and he received a paid speakership from Desitin, Otsuka and Lundbeck. He was a member of the advisory board of Roche. The other authors declare no conflict of interest.
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