The safety and efficacy of transcranial direct current stimulation as add-on therapy to fluoxetine in obsessive-compulsive disorder: a randomized, double-blind, sham-controlled, clinical trial
Abstract Background Obsessive-compulsive disorder (OCD) is an anxiety disorder that causes impairment in daily activities. This study aimed to assess the safety and efficacy of transcranial direct current stimulation (tDCS) as adjunctive therapy with fluoxetine in individuals diagnosed with moderate...
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doaj-40d3681e60104c2eaacbb576008652512020-12-06T12:50:43ZengBMCBMC Psychiatry1471-244X2020-11-012011910.1186/s12888-020-02979-1The safety and efficacy of transcranial direct current stimulation as add-on therapy to fluoxetine in obsessive-compulsive disorder: a randomized, double-blind, sham-controlled, clinical trialSadegh Yoosefee0Man Amanat1Mona Salehi2Seyed Vahid Mousavi3Jamshid Behzadmanesh4Victoria Safary5Ali Yoonesi6Bahman Salehi7Neurosciences Research Center, Qom University of Medical SciencesFaculty of Medicine, Students’ Scientific Research Center, Tehran University of Medical SciencesFaculty of Medicine, Students’ Scientific Research Center, Tehran University of Medical SciencesNeuroImmunology Research Association (NIRA), Universal Scientific Education and Research Network (USERN)Department of Psychiatry, Arak University of Medical SciencesDepartment of Psychiatry, Arak University of Medical SciencesDepartment of Neurosciences, School of Advanced Technologies in Medicine, Tehran University of Medical SciencesDepartment of Psychiatry, Arak University of Medical SciencesAbstract Background Obsessive-compulsive disorder (OCD) is an anxiety disorder that causes impairment in daily activities. This study aimed to assess the safety and efficacy of transcranial direct current stimulation (tDCS) as adjunctive therapy with fluoxetine in individuals diagnosed with moderate to severe OCD. Methods This is a randomized, double-blind sham-controlled trial. Individuals with OCD who had baseline Yale-Brown obsessive-compulsive scale (Y-BOCS) of > 15 were enrolled. Eligible cases were randomly assigned in 1:1 ratio to receive either 20-min-period of stimulation with tDCS and fluoxetine (experimental arm) or fluoxetine only (sham control arm). The anodal electrode of tDCS was placed over the left dorsolateral prefrontal cortex (Fp3) and the cathodal electrode was placed over the right orbitofrontal cortex (F8). Two mA electrical stimulation with the tDCS was used for 20 min in individuals of experimental group. In the control group, electrodes were placed and stimulation was administered for 30 s to induce the same skin sensation as in experimental group. This procedure was performed three times per week for 8 weeks. Y-BOCS test was assessed at baseline, week 4 (after 12th stimulation), week 8 (after 24th stimulation), and 1 month after the last stimulation. The primary endpoints were the mean changes in Y-BOCS total score from baseline to the last visit. The secondary endpoints were the mean changes in obsession and compulsion sub-scores from baseline to the last visit. Adverse events were also assessed. Mixed design repeated measures analysis of variance assessed the endpoints. Results Sixty individuals (30 in each group) were participated. All individuals in control group and 28 cases in experimental arm completed the trial. The mean Y-BOCS (F(1.85) = 30.83; P < 0.001), OCD obsession (F(2.23) = 25.01; P < 0.001), and compulsion (F(2.06) = 10.81; P < 0.001) scores decreased significantly during the study. No statistical differences were, however, detected between experimental and control groups (P > 0.05). The tDCS was well tolerated and no major adverse events were reported. Conclusion This study showed that among individuals with moderate to severe OCD, there was no significant difference regarding OC symptoms between cases used tDCS as adjunctive therapy with fluoxetine and individuals used fluoxetine only. Trial registration IRCT2017030632904N1 . Registered 14 July 2017, http://irct.ir/user/trial/44193/viewhttps://doi.org/10.1186/s12888-020-02979-1Obsessive-compulsive disorderTranscranial direct current stimulationFluoxetineYale-Brown obsessive-compulsive scaleAnxiety |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sadegh Yoosefee Man Amanat Mona Salehi Seyed Vahid Mousavi Jamshid Behzadmanesh Victoria Safary Ali Yoonesi Bahman Salehi |
spellingShingle |
Sadegh Yoosefee Man Amanat Mona Salehi Seyed Vahid Mousavi Jamshid Behzadmanesh Victoria Safary Ali Yoonesi Bahman Salehi The safety and efficacy of transcranial direct current stimulation as add-on therapy to fluoxetine in obsessive-compulsive disorder: a randomized, double-blind, sham-controlled, clinical trial BMC Psychiatry Obsessive-compulsive disorder Transcranial direct current stimulation Fluoxetine Yale-Brown obsessive-compulsive scale Anxiety |
author_facet |
Sadegh Yoosefee Man Amanat Mona Salehi Seyed Vahid Mousavi Jamshid Behzadmanesh Victoria Safary Ali Yoonesi Bahman Salehi |
author_sort |
Sadegh Yoosefee |
title |
The safety and efficacy of transcranial direct current stimulation as add-on therapy to fluoxetine in obsessive-compulsive disorder: a randomized, double-blind, sham-controlled, clinical trial |
title_short |
The safety and efficacy of transcranial direct current stimulation as add-on therapy to fluoxetine in obsessive-compulsive disorder: a randomized, double-blind, sham-controlled, clinical trial |
title_full |
The safety and efficacy of transcranial direct current stimulation as add-on therapy to fluoxetine in obsessive-compulsive disorder: a randomized, double-blind, sham-controlled, clinical trial |
title_fullStr |
The safety and efficacy of transcranial direct current stimulation as add-on therapy to fluoxetine in obsessive-compulsive disorder: a randomized, double-blind, sham-controlled, clinical trial |
title_full_unstemmed |
The safety and efficacy of transcranial direct current stimulation as add-on therapy to fluoxetine in obsessive-compulsive disorder: a randomized, double-blind, sham-controlled, clinical trial |
title_sort |
safety and efficacy of transcranial direct current stimulation as add-on therapy to fluoxetine in obsessive-compulsive disorder: a randomized, double-blind, sham-controlled, clinical trial |
publisher |
BMC |
series |
BMC Psychiatry |
issn |
1471-244X |
publishDate |
2020-11-01 |
description |
Abstract Background Obsessive-compulsive disorder (OCD) is an anxiety disorder that causes impairment in daily activities. This study aimed to assess the safety and efficacy of transcranial direct current stimulation (tDCS) as adjunctive therapy with fluoxetine in individuals diagnosed with moderate to severe OCD. Methods This is a randomized, double-blind sham-controlled trial. Individuals with OCD who had baseline Yale-Brown obsessive-compulsive scale (Y-BOCS) of > 15 were enrolled. Eligible cases were randomly assigned in 1:1 ratio to receive either 20-min-period of stimulation with tDCS and fluoxetine (experimental arm) or fluoxetine only (sham control arm). The anodal electrode of tDCS was placed over the left dorsolateral prefrontal cortex (Fp3) and the cathodal electrode was placed over the right orbitofrontal cortex (F8). Two mA electrical stimulation with the tDCS was used for 20 min in individuals of experimental group. In the control group, electrodes were placed and stimulation was administered for 30 s to induce the same skin sensation as in experimental group. This procedure was performed three times per week for 8 weeks. Y-BOCS test was assessed at baseline, week 4 (after 12th stimulation), week 8 (after 24th stimulation), and 1 month after the last stimulation. The primary endpoints were the mean changes in Y-BOCS total score from baseline to the last visit. The secondary endpoints were the mean changes in obsession and compulsion sub-scores from baseline to the last visit. Adverse events were also assessed. Mixed design repeated measures analysis of variance assessed the endpoints. Results Sixty individuals (30 in each group) were participated. All individuals in control group and 28 cases in experimental arm completed the trial. The mean Y-BOCS (F(1.85) = 30.83; P < 0.001), OCD obsession (F(2.23) = 25.01; P < 0.001), and compulsion (F(2.06) = 10.81; P < 0.001) scores decreased significantly during the study. No statistical differences were, however, detected between experimental and control groups (P > 0.05). The tDCS was well tolerated and no major adverse events were reported. Conclusion This study showed that among individuals with moderate to severe OCD, there was no significant difference regarding OC symptoms between cases used tDCS as adjunctive therapy with fluoxetine and individuals used fluoxetine only. Trial registration IRCT2017030632904N1 . Registered 14 July 2017, http://irct.ir/user/trial/44193/view |
topic |
Obsessive-compulsive disorder Transcranial direct current stimulation Fluoxetine Yale-Brown obsessive-compulsive scale Anxiety |
url |
https://doi.org/10.1186/s12888-020-02979-1 |
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