Transcranial direct current stimulation for unipolar depression and risk of treatment emergent mania: an updated meta-analysis
Brain stimulation, 2019•Elsevier
Results Five RCTs of tDCS reported 13 cases of TEM. Twelve TEM cases were in the active
tDCS groups (12/367= 3.3%) and one was in a sham group (1/364= 0.27%). The fixed effect
MH method yielded an odds ratio of 5.01 ([1.37–18.26], p= 0.015) with higher risk of TEM in
the active tDCS groups (Fig. 1), and a significant pooled risk difference between active and
sham treatments (RD= 0.031 [0.011–0.050], p= 0.002). Sensitivity analyses adjusting for
method (MH, Inverse, Peto), and use of continuity Discussion This study demonstrates that …
tDCS groups (12/367= 3.3%) and one was in a sham group (1/364= 0.27%). The fixed effect
MH method yielded an odds ratio of 5.01 ([1.37–18.26], p= 0.015) with higher risk of TEM in
the active tDCS groups (Fig. 1), and a significant pooled risk difference between active and
sham treatments (RD= 0.031 [0.011–0.050], p= 0.002). Sensitivity analyses adjusting for
method (MH, Inverse, Peto), and use of continuity Discussion This study demonstrates that …
Results
Five RCTs of tDCS reported 13 cases of TEM. Twelve TEM cases were in the active tDCS groups (12/367= 3.3%) and one was in a sham group (1/364= 0.27%). The fixed effect MH method yielded an odds ratio of 5.01 ([1.37–18.26], p= 0.015) with higher risk of TEM in the active tDCS groups (Fig. 1), and a significant pooled risk difference between active and sham treatments (RD= 0.031 [0.011–0.050], p= 0.002). Sensitivity analyses adjusting for method (MH, Inverse, Peto), and use of continuity
Discussion
This study demonstrates that individuals receiving active tDCS for unipolar depression are at an increased risk of TEM compared to those receiving sham stimulation. Most treatments for depression carry a modest risk of inducing TEM, either from previously undiagnosed bipolar disorder or as a function of the treatment itself [11]; tDCS appears to be no different in this regard. While it is difficult to assess the severity of the TEM using meta analytic methods, at least one case of psychotic
Conclusion
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