Daniel M. Blumberger, MD, MSc

Evidence has accumulated on the efficacy of transcranial direct current stimulation in major depression. The authors review its potential mechanism of action, findings from recent clinical trials, and potential role in the treatment of depressive disorders.

Clinicians can feel confident in the evidence base when referring patients with a moderate level of treatment resistance for rTMS. Preliminary results suggest that deep rTMS may be an effective option in patients who have failed to respond to more than one antidepressant treatment.

Seasonal affective disorder affects 1% to 3% of the North American population. Evidence exists for the efficacy of high-intensity bright, fluorescent light. Pharmacological management with SSRIs has shown equivalent efficacy to light therapy. How can these two therapies be combined? What other therapies are available?