This article is more than 5 years old. Information may no longer be current.

Electrical current therapy plus sertraline effective in treating MDD

The combination of electrical current therapy and sertraline use increased the efficacy of each treatment in major depressive disorder, researchers from Brazil reported in JAMA Psychiatry.

“There is tremendous need for effective, safe, affordable therapies for major depressive disorder (MDD), a disabling, highly prevalent condition,” the researchers wrote.

Andre R. Brunoni, MD, PhD, of the University of San Paulo, and colleagues performed a double blind, controlled trial to assess the efficacy of transcranial direct current stimulation (tDCS) compared with a common pharmacological treatment using sertraline hydrochloride in 120 antidepressant-free patients with moderate to severe, nonpsychotic, unipolar MDD. Patients were divided into groups using sertraline/placebo and active/sham tDCS.

The combined treatment group consisted of a 6-week treatment with 12 30-minute sessions of tDCS and sertraline 50 mg. For sham conditions, the device was turned off after 1 minute of use, enough to simulate the common adverse effects of mild scratching and discomfort. Treatment outcomes were measured based on scores on the Montgomery-Asberg Depression Rating Scale (MADRS) at 6 weeks. The researchers considered the difference of three points on the MADRS to be clinically relevant. Patients also reported on treatment safety using questionnaires.

Results indicated a significant difference in MADRS scores comparing the combined treatment group with those who received sertraline only (mean difference=8.5 points; 95% CI, 2.96-14.03), tDCS only (mean difference=5.9 points; 95% CI, 0.36-11.43), and placebo/sham tDCS (mean difference=11.5 points; 95% CI, 6.03-17.1). The efficacies of tDCS-only treatment vs. sertraline-only treatment were comparable (mean difference=2.6 points; 95% CI, –2.9 to 8.13).

According to Brunoni and colleagues, using tDCS only for MDD treatment was superior to placebo/sham tDCS combination. Common adverse effects did not differ between the treatments, except for scalp redness specific to active tDCS use (P=.03). Seven episodes of treatment-emergent mania or hypomania occurred, five of which occurred in the combined treatment group.

“Noninvasive brain stimulation is becoming an established therapy for the treatment of depression,” the researchers wrote. “Because tDCS devices are relatively inexpensive, further health economics studies should analyze whether it would be a cost-effective alternative for regions with low resources where the prevalence of MDD is high, such as most developing nations.”

Disclosure: The researchers report no relevant financial disclosures.