Patients with major depressive disorder who received a combination of transcranial direct current stimulation and repetitive transcranial magnetic stimulation showed nearly twice the reduction in depressive symptoms after two weeks compared to those receiving single or sham treatments, according to a double-blind, randomized clinical trial conducted in China.

The trial, published in JAMA Network Open, included 240 patients randomized into four groups: active transcranial direct current stimulation (tDCS) + active repetitive transcranial magnetic stimulation (rTMS), active tDCS + sham rTMS, sham tDCS + active rTMS, and dual-sham (sham tDCS + sham rTMS). Over two weeks, participants received ten treatment sessions. Outcomes were assessed using the 24-item Hamilton Depression Rating Scale (HDRS-24).

Patients in the active tDCS + rTMS group demonstrated the most significant reduction in HDRS-24 scores, with a mean decrease of 18.33 (SD 5.39) compared to 14.86 (SD 5.59) for sham tDCS + active rTMS, 9.21 (SD 4.61) for active tDCS + sham rTMS, and 10.77 (SD 5.67) for the dual-sham group (P < .001). Response rates at week 2 were 85% for the combined therapy versus 31.7% for dual-sham. Remission rates were 50% for combined therapy, significantly higher than 13.3% for dual-sham (P < .001).

Safety profiles were comparable across groups, with mild adverse events such as headaches, skin redness, and dizziness reported. No serious adverse effects were observed. The authors emphasized that while the combined approach yielded faster symptom reduction, longer treatment durations may be needed to fully realize its antidepressant potential.

This study highlights the promise of combined tDCS and rTMS in major depressive disorder treatment and suggests future research to optimize stimulation parameters and investigate long-term outcomes. Full disclosures and methods are available in the original publication.

Full disclosures can be found in the published study.