(HealthDay News) – In antidepressant-free patients with major depressive disorder, treatment with transcranial direct current stimulation (tDCS) plus sertraline is more effective than either treatment alone, according to a study published online Feb. 6 in JAMA Psychiatry.

Andre R. Brunoni, MD, PhD, from University Hospital in São Paulo, Brazil, and colleagues randomly assigned 120 antidepressant-free patients with major depressive disorder to sham tDCS and placebo, sham tDCS and sertraline, active tDCS and placebo, or active tDCS and sertraline.

The researchers found that, as assessed by the Montgomery-Asberg Depression Rating Scale, the active tDCS and sertraline group scored significantly better than the other groups. The mean differences ranged from 5.9–11.5, with a difference of at least three points considered clinically relevant. The tDCS and placebo and sham tDCS and sertraline groups had similar efficacies, while the use of tDCS plus placebo (but not sham tDCS plus sertraline) was superior to sham tDCS plus placebo. However, five of the seven episodes of mania or hypomania occurred in the active tDCS and sertraline group. Skin redness on the scalp occurred significantly more in the active tDCS group; other common adverse effects did not differ significantly between the interventions.

“In addition to confirming the clinical efficacy of tDCS and demonstrating that tDCS has effects similar to those of sertraline in antidepressant-free patients with major depressive disorder, we observed that tDCS and sertraline combined have greater response compared with each intervention alone, although the increased risk of mania or hypomania should be considered,” Brunoni and colleagues conclude.

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