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    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Kekic, Maria Boysen, Elena Campbell, Iain C. and Schmidt, Ulrike 2016. A systematic review of the clinical efficacy of transcranial direct current stimulation (tDCS) in psychiatric disorders. Journal of Psychiatric Research, Vol. 74, p. 70.

    Palm, Ulrich Hasan, Alkomiet Strube, Wolfgang and Padberg, Frank 2016. tDCS for the treatment of depression: a comprehensive review. European Archives of Psychiatry and Clinical Neuroscience,

    Manosso, Luana M. Moretti, Morgana and Rodrigues, Ana Lúcia S. 2013. Nutritional strategies for dealing with depression. Food & Function, Vol. 4, Issue. 12, p. 1776.


Augmentative transcranial direct current stimulation (tDCS) in poor responder depressed patients: a follow-up study

  • Bernardo Dell'Osso (a1), Cristina Dobrea (a1), Chiara Arici (a1), Beatrice Benatti (a1), Roberta Ferrucci (a2), Maurizio Vergari (a2), Alberto Priori (a2) and A. Carlo Altamura (a1)
  • DOI:
  • Published online: 20 August 2013

Transcranial direct current stimulation (tDCS) is a non-invasive neurostimulation technique that has received increasing interest in the area of mood disorders over the last several years. While acute, double-blind, sham-controlled studies have already reported positive findings in terms of efficacy and safety for tDCS, follow-up data are lacking. This need prompted the present follow-up study, which assesses post-acute effects of tDCS (no maintenance stimulation was performed), in the mid-term, in a sample of major depressives.


After completing an acute, open trial of tDCS, 23 outpatients with either major depressive disorder or bipolar disorder entered a naturalistic follow-up (T1) with clinical evaluations at one week (T2), 1 month (T3), and 3 months (T4). A quantitative analysis of Hamilton Depression Rating Scale (HAM-D), Montgomery–Asberg Depression Rating Scale (MADRS), and Young Mania Rating Scale (YMRS) total scores, through repeated measures analysis of variance (ANOVA) (T1–T4) and paired t-test for comparing specific time points (T1–T2, T2–T3, and T3–T4), was performed. In addition, a qualitative analysis on the basis of treatment response and remission (HAM-D) was performed.


Even though a progressive reduction of follow-up completers was observed from T2 to T4 (95.6% at T2, 65.2% at T3, and 47.8% at T4), the antidepressant effects of acute tDCS persisted over 3 months in almost half of the sample. Of note, no post-acute side effects emerged during the follow-up observation. The most frequent causes of drop-out from this study included major modifications in therapeutic regimen (30%) and poor adherence to follow-up visits (17%).


In this mid-term, open, follow-up study, tDCS showed mixed results. Further controlled studies are urgently needed to assess its effects beyond the acute phase.

Corresponding author
*Address for correspondence: Dr. Bernardo Dell'Osso, MD, Assistant Professor of Psychiatry, Department of Psychiatry, University of Milan; Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milano, Italy. (Email
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The authors thank Dr. Filippo Castellano, MD, and Dr. Massimiliano Buoli, MD, for their support.

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