Transcranial Direct Current Stimulation in Treatment-Resistant Major Depression

Despite the progress made in the field of drug therapy, a large part of patients with Major Depressive Disorder (MDD) (up to 60%) do not respond to current pharmacologic interventions and developed a Treatment-Resistant Depression (TRD). Transcranial Direct Current Stimulation (tDCS) is a noninvasive and non-convulsive form of brain stimulation recently used as treatment TRD with encouraging results. The present study aimed to explore the efficacy and tolerability of tDCS on TRD. Twenty-two patients with TRD have received 15 tDCS treatments over the course of 3 weeks (one treatment per week day), and a clinical evaluation with the 17-item Hamilton Rating Scale for Depression (HRSD-17) at baseline and at the end of the study. At the end of the study the patients have shown statistically significant improvement on HDRS scores, in particular on melancholic features and feelings of guilt, and have improved their sleep-wake rhythm; a decrease in anxious levels has also been reported. Our results in favour of antidepressant efficacy enabled us to propose tDCS as a valid therapeutic strategy for treatment of drug-resistant depression. In this perspective, further researches and clinical trials are needed to better elaborate and improved tDCS protocols towards an efficacious antidepressant intervention in therapy-resistant depression.