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tDCS effective as add-on therapy in treating bipolar depression, finds study

01-17 | Rachael

tDCS effective as add-on therapy in treating bipolar depression, finds study

With the emergence of transcranial direct current stimulation (tDCS) as the mainstream treatment, many medical practitioners are actively using this approach for treating psychiatric disorders. As such, tDCS is a painless brain stimulation method that awakens certain regions of the brain using direct electric currents.

The increased popularity in neuromodulatory approaches like tDCS has led to discussion on the ethical challenges of using such methods. However, due to the absence of severe side effects, it is considered safe for mental health treatment.

Along the same lines, a new research supported by the Brain & Behavior Research Foundation has found that tDCS is a safe and effective add-on therapy for treating type I or II bipolar depression. Published in the JAMA Psychiatry in December 2017, the study findings are based on the analysis of 52 patients part of the randomized, double-blind, Bipolar Depression Electrical Treatment Trial (BETTER).

The analysis revealed that active tDCS causes comparatively more anti-depressive effects than any other traditional procedure. By highlighting the clinical effectiveness of tDCS, the study will assist the medical fraternity in developing a better understanding of such an innovative treatment.

The study was conducted as an additional trial on patients who had type I or II bipolar disorder and experienced major depression. With the Hamilton Depression Rating Scale-17 (HDRS-17) scores being as high as 17, each of them was receiving a stable pharmacologic treatment for depression.

Moreover, the high prevalence of comorbid anxiety disorders was found in the study sample. Along with this, a third of the patients had experienced an acute depressive episode unresponsive to a couple of treatment regimens. An additional parallel design was then used to assign the study patients randomly to either a sham treatment or active tDCS.

All 52 patients – 26 active and 26 sham – were given all 12 tDCS treatment sessions, which included 10 daily 30-minute sessions of active or sham tDCS on weekdays and then one session every two weeks until Week 6. During these sessions, the dorsolateral prefrontal cortex (DLPFC) region of the participants’ brains were exposed to the weak and direct currents. This region of the brain is responsible for regulating the cognitive and emotional functioning of the brain.

Some other findings are as follows:

• Around 19 patients in the active group and eight patients in the sham group achieved sustained response, with significantly greater results for the tDCS group.
• Approximately 10 patients in the active group and five in the sham group achieved sustained remission. However, the benefits of tDCS were not that great in further analyses.
• Adverse events that led to manic and hypomanic episodes were found to be similar between active and sham tDCS.
• Patients receiving active treatment were found to have more localized skin redness than those receiving sham. However, these were temporary effects that didn’t affect the study’s continuation.

Based on the above findings, the researchers concluded that tDCS is an “effective and tolerable add-on treatment in this subsample of patients with type I or II bipolar disorder who were in a major depressive episode” “Although preliminary, our results are promising and encourage further trials to examine the efficacy of tDCS in a large bipolar disorder sample.”

Additionally, they found that one can achieve greater effects by combining tDCS with other treatment options, such as pharmacotherapy, other brain stimulation therapies or psychotherapy. The researchers have highlighted that the next step will be to develop a better understanding of the mechanism of tDCS by using it in combination with various neuroimaging techniques, such as spectroscopy and resting-state MRI.

Recovery road map

Depression is one of the commonest forms of mental illness affecting a large population in the United States. While treatment options like medications and therapies are already available, scientists are constantly developing alternative approaches to assist patients lead a healthy life.

If you or someone you know is dealing with depression, contact the Depression Treatment Helpline of Colorado to find about the state-of-the-art depression treatment centers in Colorado. Call at our 24/7 helpline number 866-427-5668 or chat online with our medical advisers to know about the best depression treatment in Colorado.


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