Efficacy and safety of adjunctive transcranial alternating current stimulation in bipolar depression: A randomized controlled trial.
Jinjie Xu, Dan Li, Yafei Liu et al.
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In 30 seconds
This randomized, double-blind, sham-controlled trial evaluated adjunctive transcranial alternating current stimulation (tACS) in 60 participants with bipolar depression receiving lithium. Participants received active 10-Hz tACS or sham stimulation twice daily for two weeks and were followed for six weeks. At week 2, antidepressant response—defined as at least a 50% reduction in HAMD-17 score—was higher with active tACS than sham (46.7 vs. 20.0%); response rates also favored active treatment at week 4 (70.0 vs. 43.3%). Active tACS was associated with greater improvement in anxiety and sleep symptoms, with comparable tolerability.
Key findings
- Week-2 antidepressant response was 46.7% with active tACS versus 20.0% with sham.
- At week 4, response rates were 70.0% with active tACS and 43.3% with sham.
- Active tACS was associated with greater reductions in anxiety and sleep symptoms and fewer manic symptoms; cognitive outcomes did not differ.
- Headache and dizziness were the most common treatment-related adverse events, and tolerability was comparable between groups.
Why it matters
The findings suggest that adjunctive tACS may offer an additional short-term symptom benefit for people with bipolar depression receiving lithium, while showing comparable tolerability to sham. The EEG observations also raise a possible relationship between delta-power changes and depressive symptom improvement. These results are preliminary and do not establish durable benefit or efficacy beyond the studied treatment context.
What to keep in mind
The authors describe the findings as hypothesis-generating and call for improved sham procedures, lithium-free designs, and longer follow-up.