Clinical Utility of Add-On tDCS in Schizophrenia: An Open Label Study of 50 Patients

Abstract

s / Brain Stimulation 8 (2015) 360e377 370 Methods: Treatment was applied to a 25-year-old right-handed married woman having schizophrenia (DSM-IV) predominated by auditory verbal hallucinations that were non-responsive to several antipsychotic treatment trials. In August 2013, she was treated with add-on tDCS that led to near total improvement in hallucinations. Over the next one year, she continued to maintain the clinical improvement and was on treatment with Iloperidone 12mg per day. In august 2014, during the 18th week of her first pregnancy, she presented with relapse of auditory hallucinations for a period of one month despite being on regular treatment with Iloperidone. In view of previous clinical benefit, she was treated with add-on tDCS with written informed consent. tDCS was administered using a standard equipment (TCT device model number M101-R-2012-V1.3; prefrontal anode; temporo-parietal cathode; left-sided; 2-mA; 20-minutes; 5-days twice-daily sessions) with stringent safety measures. The severity of auditory hallucinations was measured using the auditory hallucinations subscale (AHS) of PSYRATS. Results: Baseline AHS score was 29. Immediately after 5-days of tDCS, AHS score was 22. Over the period of the next week, the patient reported progressive reduction in hallucinations. AHS score at one month after tDCS was 2. Discussion: This is likely the first report of successful application of tDCS in a pregnant woman with schizophrenia.Rigorous evaluation of add-on tDCS for the treatment of auditory verbal hallucinations in pregnant patients will facilitate establishment of non-invasive and safer alternative to antipsychotic treatment in this special population.