Depression is a common and highly debilitating psychiatric disorder. The treatment for depression varies from talking therapies such as cognitive behavioural therapy to drug treatment and in severe cases use of electroconvulsive therapy (ECT). Unfortunately ECT, despite its effectiveness and safety, remains unpopular among the public because of its negative history, with associated stigma. In this short paper, we explore the non-invasive neurostimulation techniques, repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), as well as an invasive technique known as deep brain stimulation (DBS). These neurostimulation techniques are gaining a broad evidence base and, after years of research, are being utilized in clinical practice, particularly rTMS. Though rTMS has received NICE approval, it is still seldom used in the NHS in the UK. However, this has not stopped an increasing number of private clinics offering rTMS, and in some cases tDCS, to many patients who do not want to take medication, cannot tolerate medication or indeed, in a number of cases, fail to respond to medication. DBS requires initial neurosurgery; because this is invasive, DBS is seldom used and is mainly offered in a research setting. More research and a broader evidence base are needed before these neurostimulation treatments become much more widely used.
Ransfield et al. (Mon,) studied this question.
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