Trial of Electrical Direct-Current Therapy versus Escitalopram for Depression

Brunoni, André R.; Moffa, Adriano H.; Sampaio-Júnior, Bernardo; Borrione, Lucas; Moreno, María Alejandra; Fernandes, Rodolfo Castanho; Veronezi, Beatriz P.; Nogueira, Barbara Schwair; Aparicio, Luana V Marotti; Razza, Laís B.; Chamorro, Renan; Tort, Luara C.; Fráguas, Renério; Lotufo, Paulo A; Gattaz, Wagner F.; Fregni, Felipe; Benseñor, Isabela M.

doi:10.1056/nejmoa1612999

Cited by 302 publications

(219 citation statements)

References 30 publications

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“…Generally, it has to be stated that tDCS is a safe and promising treatment option for major depression, as shown in a variety of studies over the past decade [25] including large-scale trials with positive results showing the superiority of tDCS over the placebo [26,42]. Recent meta-analysis has also showed positive results on the safety and acceptability of tDCS in depression [43], and on the cognitive effects [24].…”

Section: Discussionmentioning

confidence: 99%

Transcranial Direct Current Stimulation (tDCS) for Depression during Pregnancy: Scientific Evidence and What Is Being Said in the Media—A Systematic Review

et al. 2018

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Major depression is the most frequent morbidity in pregnancy. The first-line therapies, psychopharmacologic treatment and psychotherapy, are either insufficient or may cause severe or teratogenic adverse events. As a result of its local limitation to the patient’s brain, transcranial direct current stimulation (tDCS) could potentially be an ideal treatment for pregnant women with depression. A literature search was conducted in medical databases, globally published newspapers, search engines, and clinical trial registers to collect all articles on tDCS for the treatment of depression during pregnancy. The aim of this review was to investigate the scientific evidence of tDCS use for depression during pregnancy and to compare these results with the textual and emotional perception in the media as interventions during pregnancy are under particular surveillance. We detected 13 medical articles dealing with tDCS for depression in pregnancy. Overall, the scientific evidence as well as articles in the media for tDCS in pregnancy are sparse, but promising. Further studies are required in this specifically vulnerable population of pregnant women to generate evidence. It is likely that public interest will increase when the results of a pilot study in Canada are published.

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Section: Discussionmentioning

confidence: 99%

Transcranial Direct Current Stimulation (tDCS) for Depression during Pregnancy: Scientific Evidence and What Is Being Said in the Media—A Systematic Review

et al. 2018

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“…Recent clinical trials in depression have typically administered tDCS at between 1 and 2.5 mA current intensity, 10–30 min per session, either once or twice daily over several weeks (Brunoni et al., ). Current evidence suggests that tDCS has some antidepressant efficacy, as a large randomized clinical trial showed that tDCS, although not noninferior to escitalopram, is superior to placebo for the acute depressive episode (Brunoni et al., ). Nonetheless, negative findings were also reported in recent trials (Meron, Hedger, Garner, & Baldwin, ; Loo et al.…”

Section: Introductionmentioning

confidence: 99%

“…Considering the importance of the maintenance phase of the depressive episode, it is critical to better explore tDCS regimens that could induce greater efficacy. We report the relapse rates of a 6‐month follow‐up data from our two randomized clinical trials that examined tDCS efficacy for unipolar (Brunoni et al., ) and bipolar (Sampaio‐Junior et al., ) depression. All patients were tDCS responders at follow‐up onset and underwent tDCS twice a week for 6 months.…”

Section: Introductionmentioning

confidence: 99%

Transcranial direct current stimulation (tDCS) for preventing major depressive disorder relapse: Results of a 6-month follow-up

et al. 2019

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Background The efficacy of transcranial direct current stimulation (tDCS) as a continuation therapy for the maintenance phase of the depressive episode is low and insufficiently investigated in literature. We investigated whether it could be enhanced by using a more intensive treatment regimen compared to previous reports. Methods Twenty‐four patients (16 with unipolar depression and eight with bipolar depression) who presented acute tDCS response (≥50% depression improvement in the Hamilton Depression Rating Scale [HDRS]) after receiving 15 tDCS sessions were followed for up to 6 months or until relapse, defined as clinical worsening and/or HDRS > 15. Sessions were performed twice a week (maximum of 48 sessions) over 24 weeks. The anode and the cathode were positioned over the left and right dorsolateral prefrontal cortex (2 mA current, 30 min sessions were delivered). We performed Kaplan–Meier survival analysis and Cox proportional hazards ratios to evaluate predictors of relapse. Results Out of 24 patients, 18 completed the follow‐up period. tDCS treatment was well tolerated. The mean survival duration was 17.5 weeks (122 days). The survival rate at the end of follow‐up was 73.5% (95% confidence interval, 50–87). A trend (P = 0.09) was observed for lower relapse rates in nontreatment‐ vs. antidepressant treatment‐resistant patients (7.7% vs. 45.5%, respectively). No differences in efficacy between unipolar and bipolar depression were observed. Conclusion An intensive tDCS treatment regimen consisting of sessions twice a week achieved relatively low relapse rates after a 6‐month follow up of tDCS responders, particularly for nontreatment‐resistant patients.

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“…Safe, tolerable, inexpensive, and suitable for home use, tDCS could be implemented even more widely than medications if proven effective. Although some studies have questioned its therapeutic efficacy, tDCS nonetheless now seems to outperform sham stimulation in meta‐analyses and in the recent large ELECT‐tDCS trial published in the New England Journal of Medicine . Although this technique requires further optimization, DBS could help to inform the development of new targets and new protocols to improve its success rates.…”

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confidence: 99%

Deep Brain Stimulation in Depression: Even if Successful, Will It Ever Be Scalable?

Downar

2019

Clin Pharma and Therapeutics

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Trial of Electrical Direct-Current Therapy versus Escitalopram for Depression

Cited by 302 publications

References 30 publications

Transcranial Direct Current Stimulation (tDCS) for Depression during Pregnancy: Scientific Evidence and What Is Being Said in the Media—A Systematic Review

Transcranial Direct Current Stimulation (tDCS) for Depression during Pregnancy: Scientific Evidence and What Is Being Said in the Media—A Systematic Review

Transcranial direct current stimulation (tDCS) for preventing major depressive disorder relapse: Results of a 6-month follow-up

Deep Brain Stimulation in Depression: Even if Successful, Will It Ever Be Scalable?

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