REVIEW – November 2022

Use of non-invasive brain stimulation in combination with standard methods in treatment of depression

Authors: Ella Kivilo

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Depression is one of the most prevalent psychiatric disorders worldwide with a significant impact on quality of life. Approximately 20-30% of patients do not respond to standard pharmacological (including antidepressants) and/or evidence-based psychotherapeutic interventions, hence there is the need to find alternative treatment options for this specific subgroup. An emerging trend is use of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), which have proved their effective ness and have been included in depression treatment guidelines of several countries. In Estonia, tDCS has been financed by the Health Insurance Fund since 2022. However, the use of both methods in treatment of depression should increase in the upcoming years. The advantages of rTMS and tDCS are their safety and availability to use either as monotherapy or in combination with other treatment modalities (antidepressants and psychotherapy), which is often necessary in clinical practice. In the future, the goal is to develop personalized treatment protocols.