• Home
  • Store
    • Newsletter Subscriptions
    • Multimedia Subscriptions
    • Books
    • eBooks
    • ABPN SA Courses
  • CME Center
  • Multimedia
    • Podcast
    • Webinars
    • Blog
  • Newsletters
    • General Psychiatry
    • Child Psychiatry
    • Addiction Treatment
    • Hospital Psychiatry
    • Geriatric Psychiatry
    • Psychotherapy and Social Work
  • Log In
  • Register
  • Welcome
  • Sign Out
  • Subscribe
Home » Transcranial Direct-Current Stimul­ation: Not Ready for Prime Time Yet

Transcranial Direct-Current Stimul­ation: Not Ready for Prime Time Yet

December 1, 2017
Michael Posternak, MD.
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Michael Posternak, MD. Dr. Posternak has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
Review of: Brunoni AR et al, N Engl J Med 2018;376(26):2523–2533

Transcranial magnetic stimulation (TMS) was approved by the FDA in 2009 for the treatment of major depression, but TMS is costly and has so far produced only mixed results. A novel method, transcranial direct-current stimulation (tDCS), applies a weak electrical current to the brain by placing electrodes on the scalp. tDCS would be less expensive than TMS, and previous research has shown that it can enhance the effects of antidepressant pharmacotherapy (see TCPR, July 2015 for extensive coverage of various electrical devices in psychiatry).

Researchers in a new study sought to determine whether tDCS would be an effective treatment for depression all by itself. In this study, 245 subjects with depression were randomized to tDCS (n = 94), escitalopram (n = 91; dosage was 10 mg for 3 weeks and 20 mg thereafter), or placebo (n = 60). There were no baseline differences between these groups regarding their age, gender, depression severity, or degree of treatment resistance. tDCS treatment consisted of 22 30-minute sessions, and all treatments were delivered over the course of 10 weeks. tDCS was generally well tolerated (though 2 patients developed a new-onset mania compared to none in the other two cohorts), and patients were unable to guess whether they were receiving tDCS or sham treatment—suggesting that patients were truly blind to the treatment they were receiving.

The primary outcome of interest was decrease in Hamilton Depression Rating Scale (HAMD) scores. Patients receiving escitalopram (-11.3 points) and tDCS (-9.0 points) both fared better than placebo (-5.8 points) in this regard, but tDCS was less effective than escitalopram (p = 0.02). Response rates to escitalopram, tDCS, and placebo were 47%, 41%, and 22%, respectively, with both active treatments superior to placebo.

TCPR’s Take
tDCS appears to work for depression, but unless it can be tweaked to work as well as, if not better than, antidepressant medications, it is hard to envision much of a niche for it within our antidepressant armamentarium.
General Psychiatry
KEYWORDS brain_devices research-update
    Michael Posternak, MD.

    Psychological Benefits of Abstaining from Social Media

    More from this author
    www.thecarlatreport.com
    Issue Date: December 1, 2017
    SUBSCRIBE NOW
    Table Of Contents
    CME Post-Test - PTSD, TCPR, December 2017
    Note From the Editor-in-Chief
    Update on Medications for PTSD
    Assessing Complex PTSD
    Transcranial Direct-Current Stimul­ation: Not Ready for Prime Time Yet
    Can Mindfulness-Based Stress Reduction Affect Symptom Outcomes in Older Adults?
    DOWNLOAD NOW
    Featured Book
    • PB4e_Cover2.png

      Psychiatry Practice Boosters, Fourth Edition (2023)

      Teaches you the key points of 63 of the most clinically relevant studies in psychiatry.
      READ MORE
    Featured Video
    • therapist_canstockphoto9201097.jpg
      General Psychiatry

      Using SAMe In Clinical Practice with Garrett Rossi, MD

      Read More
    Featured Podcast
    • canstockphoto6759394.jpg
      General Psychiatry

      Throwback Thursday: Brief Therapy for ADHD

      You started a stimulant medication for a young woman with ADHD. When she returns her symptoms are 70% better, but what can we do about the rest? Today a conversation with...

      Listen now
    Recommended
    • Approaches to Autism Intervention

      January 31, 2022
      canstockphoto2240982_child-bubbles_thumb.jpg
    • Currently Available Cannabis Products

      September 1, 2022
    • Interpreting Assessment Discrepancies from Multiple Sources

      October 17, 2022
      ChildAssessment.png
    • Approaches to Autism Intervention

      January 31, 2022
      canstockphoto2240982_child-bubbles_thumb.jpg
    • Currently Available Cannabis Products

      September 1, 2022
    • Interpreting Assessment Discrepancies from Multiple Sources

      October 17, 2022
      ChildAssessment.png
    • Approaches to Autism Intervention

      January 31, 2022
      canstockphoto2240982_child-bubbles_thumb.jpg
    • Currently Available Cannabis Products

      September 1, 2022
    • Interpreting Assessment Discrepancies from Multiple Sources

      October 17, 2022
      ChildAssessment.png

    About

    • About Us
    • CME Center
    • FAQ
    • Contact Us

    Shop Online

    • Newsletters
    • Multimedia Subscriptions
    • Books
    • eBooks
    • ABPN Self-Assessment Courses

    Newsletters

    • The Carlat Psychiatry Report
    • The Carlat Child Psychiatry Report
    • The Carlat Addiction Treatment Report
    • The Carlat Hospital Psychiatry Report
    • The Carlat Geriatric Psychiatry Report
    • The Carlat Psychotherapy Report

    Contact

    info@thecarlatreport.com

    866-348-9279

    PO Box 626, Newburyport MA 01950

    Follow Us

    Please see our Terms and Conditions, Privacy Policy, Subscription Agreement, Use of Cookies, and Hardware/Software Requirements to view our website.

    © 2023 Carlat Publishing, LLC and Affiliates, All Rights Reserved.