Does tDCS treat Depression?

Transcranial Direct Current Stimulation (tDCS) is a wearable brain stimulation device that can deliver therapeutic electricity to brain regions that regulate mood and other brain functions related to depression. There is a long history of using electrical therapy for depression including the FDA approved Transcranial Magnetic Stimulation (TMS) and ElectroConvulsive Therapy (ECT), but tDCS is of special interest because it can be used comfortably at home, as well as in clinics. So the question is, does tDCS work for Depression? reviews what the experts and best doctors say.

A recent review by Dr. Felipe Fregni of Harvard Medical School (and the inventor of tDCS for Depression) and the Neuromodulation Center Working Group of world experts concludes: “some of the indications analyzed in this review can be considered as definitely effective (Level A) such as depression…”

Bottom line: tDCS recommended for depression

This major trial of tDCS run by Dr. Andre Brunoni was published in the prestigious New England Journal of Medicine, using the Soterix Medical tDCS LTE approach, found “Escitalopram and tDCS were both superior to placebo (difference vs. placebo, 5.5 points [95% CI, 3.1 to 7.8; P<0.001] and 3.2 points [95% CI, 0.7 to 5.5; P=0.01], respectively). Patients receiving tDCS had higher rates of skin redness, tinnitus, and nervousness than did those in the other two groups, and new-onset mania developed in 2 patients in the tDCS group. Patients receiving escitalopram had more frequent sleepiness and obstipation than did those in the other two groups.” What that means is tDCS and a common drug worked better then sham (sugar pill). Some patients responded better to tDCS and some better to drugs. As a whole, most patients has better benefit in depression symptoms in respond to drugs, but the side-effects were much better for tDCS.

Bottom line: tDCS worked for depression in pivotal controlled trial

A major review of all trials of tDCS for Depression including by Dr. Andrea Brunoni and Dr. Colleen Loo who ran most of the major trials. They conclude “We included 23 RCTs (25 datasets, 1,092 participants), most (57%) presenting a low risk of bias. Active tDCS was superior to sham regarding endpoint depression scores (k  = 25, g  = 0.46, 95% confidence interval [CI]: 0.22–0.70), and also achieved superior response (k  = 18, 33.3% vs. 16.56%, OR = 2.28 [1.52–3.42], NNT = 6) and remission (k  = 18, 19.12% vs. 9.78%, OR = 2.12 [1.42–3.16], NNT = 10.7) rates. Moreover, active tDCS was as acceptable as sham. No risk of publication bias was identified. Cumulative meta‐analysis showed that effect sizes are basically unchanged since total sample reached 439 participants. TDCS is modestly effective in treating depressive episodes.”

Bottom line: Different tDCS approach work better than others, but overall tDCS is effective. Note to say tDCS is modestly effective across a group, does not mean tDCS is not very effective for some people who respond very well. And side-effects are minor.

Safety reviews show again and again that the expert and doctor consider tDCS safe and tolerated. Tolerated means little of no discomfort, with any sensation going away after the tDCS is over. Let’s not forget tDCS is considered safe enough to use on healthy people all the time.

Bottom line: tDCS is safe *This safety depend on using good equipment and sticking to established protocols.

So according to world experts on tDCS, does it treat depression? The answer seems to be yes again and again. With Soterix Medical recently getting its IDE for tDCS-LTE Depression after already having tDCS approved around the world, it seems patients in the USA should get better access to tDCS soon.

As a general disclaimer, does not give medical advice and out summary of the tDCS field are based on publicly available information in published papers and other sources.


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