The evidence on transcranial direct current stimulation (tDCS) for depression raises no major safety concerns. There is some evidence of efficacy but there are uncertainties about the specific mode of administration, the number of treatments needed and the duration of effect. Therefore, this procedure should only be used with special arrangements for clinical governance, consent and audit or research.
Clinicians wishing to do tDCS for depression should:
Inform the clinical governance leads in their NHS trusts.
Ensure that patients understand the uncertainty about the procedure's efficacy and provide them with clear written information. In addition, the use of NICE's information for the public is recommended.
Audit and review clinical outcomes of all patients having tDCS for depression (see NICE's interventional procedure outcomes audit tool).
NICE encourages further research into tDCS for depression, which should document how patients were selected and any other treatments they were having. It should describe the precise method and regime used for administering tDCS. Outcome measures should include the duration of effect. NICE may update the guidance on publication of further evidence.