Can brain stimulation benefit depression?
New research from the Institute of Psychiatry Psychology and Neuroscience (IoPPN) at King’s College London provides clarification about the benefits of non-surgical brain stimulation for depression.
The study, published in The BMJ, suggests brain stimulation techniques, should be considered as alternative or add-on treatments for adults with severe forms of depression. The findings also suggest that more established techniques should take priority over new treatments with a more limited evidence base.
Depression is a common and debilitating illness that is usually treated with drugs and psychological therapies. But these treatments do not work for every patient and some patients experience undesired side effects.
Non-surgical brain stimulation techniques, such as electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS), use electrical currents or magnetic fields to change brain activity. No-one is entirely sure how these treatments work, but for example rTMS is thought to change activity in areas of the brain that are under or overactive in depression.
Although guidelines support the use of these techniques, they tend to be used too little and too late, and previous research into their effectiveness has been limited.
A team led by Julian Mutz, from the Social Genetic and Developmental Psychiatry Centre at King’s College London, set out to compare response (clinical efficacy) and all cause discontinuation (acceptability) of non-surgical brain stimulation for the treatment of major depressive episodes in adults.
They analysed the results of 113 clinical trials involving 6,750 patients (average age 48 years, 59% women) with major depressive disorder or bipolar depression, randomised to 18 active treatment strategies or inactive (“sham”) therapy.
The researchers found that bitemporal ECT, high dose right unilateral ECT, high frequency left rTMS and transcranial direct current stimulation (tDCS), were more effective than sham therapy across all outcome measures.
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Read more on the King’s College London website.