Tolerance of transcranial direct current stimulation in psychiatric disorders: An analysis of 2000+ sessions

Psychiatry Res. 2020 Feb:284:112744. doi: 10.1016/j.psychres.2020.112744. Epub 2020 Jan 2.

Abstract

Transcranial direct current stimulation (tDCS), a non-invasive, neuromodulatory technique, is being increasingly applied to several psychiatric disorders. In this study, we describe the side-effect profile of repeated tDCS sessions (N = 2005) that were administered to 171 patients (156 adults and 15 adolescents) with different psychiatric disorders [schizophrenia [N = 109], obsessive-compulsive disorder [N = 28], alcohol dependence syndrome [N = 13], mild cognitive impairment [N = 10], depression [N = 6], dementia [N = 2] and other disorders [N = 3]]. tDCS was administered at a constant current strength of 2 mA with additional ramp-up and ramp-down phase of 20 s each at the beginning and end of the session, respectively. Other tDCS protocol parameters were: schizophrenia and obsessive-compulsive disorder: 5-days of twice-daily 20-min sessions with an inter-session interval of 3-h; Mild cognitive impairment/dementia and alcohol dependence syndrome: at least 5-days of once-daily 20-min session; Depression: 10-days of once-daily 30 min session. At the end of each tDCS session, any adverse event observed by the administrator and/or reported by the patient was systematically assessed using a comprehensive questionnaire. The commonly reported adverse events during tDCS included burning sensations (16.2%), skin redness (12.3%), scalp pain (10.1%), itching (6.7%), and tingling (6.3%). Most of the adverse events were noted to be mild, transient and well-tolerated. In summary, our observations suggest that tDCS is a safe mode for therapeutic non-invasive neuromodulation in psychiatric disorders in adults as well as the adolescent population.

Keywords: Alcohol dependence syndrome; Depression; Mild cognitive impairment; Obsessive compulsive disorder; Schizophrenia; Tolerance; tDCS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / psychology*
  • Mental Disorders / therapy*
  • Middle Aged
  • Pain / diagnosis
  • Pain / etiology
  • Pain / psychology
  • Pruritus / diagnosis
  • Pruritus / etiology
  • Pruritus / psychology
  • Surveys and Questionnaires
  • Transcranial Direct Current Stimulation / adverse effects
  • Transcranial Direct Current Stimulation / methods*
  • Transcranial Direct Current Stimulation / trends
  • Young Adult