Transcranial direct current stimulation in treatment – resistance unipolar major depressive disorder

Abstract

Objective

MDD is a common, chronic and recurrent illness .it is essential to reach full remission in acute treatment. tDCS is a non-invasive brain stimulation that uses direct electrical currents to stimulate specific parts of the brain.

Aim

Is to assess the effectiveness of tDCS in patients with treatment resistance MDD.

Method

Eighty outpatients of a psychiatric clinic were selected. Subjects meet (DSM-IV) diagnostic criteria for MDD. All patients had failed to respond to at least two standard antidepressant medication, in the current episode. Patients with bipolar depressive disorder, MDD with psychotic and atypical features, other psychiatric disorders, sever medical condition, acute suicidality and pregnancy were excluded. All patients received stable drug regimens for at least two weeks before enrollment and drug dosages remained unchanged throughout the study. They revised 8 stimulation sessions, using a 2 mA current, for 20 minutes, in 8 consecutive days. The anodal electrode was placed over the left DLPFC. Cathode electrode over the right supraorbital region. Mood was evaluated with 21-item Hamilton Rating Depression Scale and the Beck Depression Inventory.

We designed a pretest–posttest study and evaluate depression at baseline (pre-intervention), immediately after 8 sessions (post-intervention) and two months after treatment onset (follow-up).

Results

There is a significant difference between Pre- vs. post-intervention (F_BDI = 246.58, P < 0.001; F_HRSD = 214.56, P < 0.001) and pre vs. Follow-up intervention (F_BDI = 323.10, P < 0.001; F_HRSD = 150.96, P < 0.001).

Conclusion

It can be said that tDCS had effective and enduring variation (P _{post vs. follow-up} > 0.05) in improving the clinical symptoms of MDD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.