<p>Transcranial Direct-Current Stimulation (tDCS) Versus Venlafaxine ER In The Treatment Of Depression: A Randomized, Double-Blind, Single-Center Study With Open-Label, Follow-Up</p>

Abstract

ObjectiveTranscranial direct-current stimulation (tDCS), a relatively new neuromodulation approach, provides some evidence of an antidepressant effect. This randomized, 4-week, double-blind study with 8-week, open-label, follow-up compared the efficacy and tolerability of left anodal tDCS with venlafaxine ER (VNF) in the treatment of depression and prevention of early relapse.MethodsSubjects (n = 57) received tDCS (2 mA, 20 sessions, 30 mins) plus placebo (n = 29) or VNF plus sham tDCS (n = 28). Responders to both interventions entered the open-label follow-up. The primary outcome was score change in the Montgomery–Åsberg Depression Rating Scale (MADRS) at week 4 of the study. Secondary outcomes were response, remission, dropout rates and relapse rates within the follow-up.The mean change in the MADRS score from baseline to week for patients treated with tDCS was 7.69 (95% CI, 5.09–10.29) points and 9.64 (95% CI, 6.20–13.09) points for patients from the VNF group, a nonsignificant difference (1.95, 95% CI −2.25–6.16; t (55) = 0.93, p= 0.36, Cohen´s d = 0.24). There were no significant between-group differences in the MADRS scores from baseline to endpoint (intention-to-treat analysis). The response/remission rate for tDCS (24%/17%) and VNF (43%/32%) as well as the dropout rate (tDCS/VNF; 6/6) did not differ significantly between groups. In the follow-up, relapse (tDCS/VNF; 1/2) and dropout (tDCS/VNF; 2/3) rates were low and comparable. LimitationsA relatively small sample size and short duration of the antidepressant treatment; no placebo arm.ConclusionOverall, this study found a similar efficacy of tDCS and VNF in the acute treatment of depression and prevention of early relapse. The real clinical usefulness of tDCS and its optimal parameters in the treatment of depression should be further validated.

Neurostimulation Methods in the Treatment of Depression: A Comparison of rTMS, tDCS, and Venlafaxine Using a Pooled Analysis of Two Studies

“…At the endpoint, similar antidepressant effects were reported in all three groups, thus supporting the use of LF rTMS in the treatment of treatment-resistant depression. 31 With the exception of our study, 21 tDCS has not been compared with VNF in any other RCT. The efficacy and acceptability of tDCS compared with ADs (fluoxetine 20mg, sertraline 50mg, and escitalopram 20mg) were evaluated in three studies.…”

“…The application of sham stimulations (tDCS, rTMS) and placebo capsules is described in detail in the original articles. 20 , 21 …”

“…Briefly, two 4-week, single-centered, two-armed, double-blind, randomized studies (EUDRACT n. 2005-000826-22 and EUDRACT n. 2015-001639- 19) were conducted in Prague Psychiatric Centre (PCP)/ National Institute of Mental Health (NIMH-CZ), Czech Republic, between 2005-2009 and 2015-2019. 20,21 The design of both studies adhered to the latest version of the Declaration of Helsinki and ICH/Good Clinical Practice guidelines, both trials were regulated by the State Institute for Drug Control of Czech Republic (SUKL). PCP Independent Ethics Committee (IEC) (for the first trial) and NIMH-CZ IEC (for the second trial) reviewed and approved the study and written consent to participate in the research was obtained from all subjects.…”

“…In our study, we display an analysis of our original data from two randomized controlled trials (RCTs) with almost identical designs comparing efficacy and tolerability of rTMS, tDCS, and venlafaxine. 20 , 21 Both studies were carried out in one center, on the same department, and by almost the same research team.…”

A Novel Highly Durable Carbon/Silver/Silver Chloride Composite Electrode for High-Definition Transcranial Direct Current Stimulation

“…Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique that uses a constant low-intensity direct current (1~2 mA) to regulate the activity of cortical neurons [ 1 , 2 , 3 , 4 ]. In recent years, tDCS has been widely used in the clinical intervention and treatment of epilepsy [ 5 , 6 , 7 , 8 ], depression [ 9 , 10 ] stroke [ 11 , 12 ], and other neurological or psychiatric disorders [ 13 , 14 , 15 , 16 , 17 , 18 ]. Compared with other non-invasive brain stimulation techniques, tDCS has the advantages of high safety, good tolerance, convenient use, and less side effects [ 19 , 20 , 21 , 22 , 23 ].…”