Effect of left anodal transcranial direct current stimulation on hypothalamic-pituitary-adrenal axis (HPAA) activity in patients with depressive episodes: a randomized, triple-blind, pilot trial

Zentralinstitut für Seelische Gesundheit0 个研究点目标入组 47 人开始时间: 2022年8月16日最近更新: 2024年8月19日

适应症

试验速览

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•To be included in the study participants had to meet the DSM-V criteria, evaluated through SCID-I interviews, for a depressive episode or major depression and sign the informed consent form. The interviews were carried out by Central Institute of Mental Health clinical experts, who were not involved in the study. Included patients had a Hamilton Depression Rating Scale (HDRS) of at least 18 points with baseline stability (i.e., less than 25% improvement one week before the beginning of stimulation). Before starting the study, we checked that the participants had an ECG sinus rhythm. Therapy-naïve status was not an inclusion criterion for this pilot trial so that the study participants could continue their prescribed treatments at the inpatient unit. During the trial medication was not changed but the doses were adjusted slightly if needed. We chose a three-week trial interval (21 days) to try to avoid the occurrence of essential changes in the pharmacological treatment. Finally, patients taking benzodiazepines as a pro re nata (PRN) treatment could participate with doses no greater than 1.5 mg/d of Lorazepam or equivalent, to keep additional pharmacological effects as low as possible. Participants taking sleep inducers such as Zopiclone and Zolpidem as a PRN treatment were not excluded from this pilot trial.

•Patients with psychotic disorders, post-traumatic stress disorders, panic disorders, and borderline personality disorders were excluded from the study. We also excluded females with current pregnancies, participants with a conservatorship or with legal protectors, and patients who could not give their consent because of severe mental illness. Finally, we excluded patients complying with the following criteria: with metal implants or medical devices (e.g., pacemakers), illegal drug and alcohol dependency at the time of the study, acute suicide crisis, medical conditions that alter adrenal functions, use of glucocorticoids, intake of medication that changes the heart rate and its variability (e.g., beta-blockers), arrhythmias of any type, dementia syndrome (DSM-V/ICD-10 criteria), past medical history of severe cranioencephalic trauma, neurological diseases of any kind, severe decompensated medical conditions (e.g., therapy-resistant arterial hypertension, heart insufficiency, respiratory insufficiency), neoplastic diseases of any kind and infectious diseases of any kind.

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