tDCS – a drug-free, scientifically sound alternative in the treatment of depression*
- Dr. Vanya S. Eckert
- Oct 31
- 6 min read
*This article was originally written in German and has been automatically translated into English.
Why conventional therapies are often insufficient for depression
Depression is among the most common and at the same time most serious mental illnesses worldwide.
In Germany, approximately one in five people experiences at least one depressive episode during their lifetime. The course is often recurrent or chronic – relapses are common. Relapses within a year after an improvement are not uncommon.
Depending on the severity of the symptoms, the guidelines recommend treatment with medication or psychotherapy. or a combination of both (S3 guideline, 2017). However, effectiveness remains limited: Less than Half of those affected respond adequately to initial drug treatment, and improvement often only occurs after several weeks.
In addition, many sufferers experience side effects such as emotional flattening, weight gain, sexual dysfunction, or sleep disorders. suffer. Combination therapies with several drugs increase the risk of interactions and undesirable effects, which in turn often leads to treatments being discontinued or continued irregularly.
Psychotherapy is not equally effective for everyone. Some patients Some benefit little, while others find the emotional confrontation or duration of treatment overwhelming. Furthermore, it is often difficult to secure a therapy slot – the number of available slots is limited, and waiting times are correspondingly long.
Approximately one third show no lasting improvement despite repeated treatment attempts.
Ketamine, psilocybin & Co. – Opportunities and limitations of modern depression treatments
These limitations of traditional approaches have sparked interest in new therapies in recent years – such as ketamine and psilocybin (from so-called "magic mushrooms"). Both substances can produce rapid mood improvements, particularly in treatment-resistant depression. However, their effects are usually short-lived (days to a few weeks) and carry the potential for abuse, psychological dependence, and other side effects.
Furthermore, psilocybin is classified as a narcotic in Germany and is therefore not approved for regular medical use in practice. In addition, the substance can trigger intense emotional experiences that must be carefully prepared for and therapeutically integrated; otherwise, there is a risk of flashbacks or emotional overwhelm.
All of this shows that new therapeutic approaches are urgently needed to further improve the treatment of depression.
However, for many affected individuals who want or need to explore new avenues, gentle, low-risk alternatives are available, such as tDCS (transcranial direct current stimulation) or neurofeedback.
tDCS: Treating depression directly where it originates – in the brain
The brain controls thinking, feeling, and acting via electrical signals. In depression, this electrical exchange is disrupted in the dorsolateral prefrontal cortex (DLPFC). disturbed – a region that controls emotional regulation, motivation and decision-making processes.
In people with depression, imaging techniques (fMRI) often show an imbalance between left and right DLPFC activity ( Grimm et al., 2008, Biological Psychiatry ). This imbalance can lead to negative mood, lack of motivation, and altered emotional processing.
Transcranial direct current stimulation (tDCS) addresses this issue by using a mild current to restore the activity in this area to balance – gently, precisely and without significant side effects.
Safe, well-tolerated and scientifically tested
tDCS is one of the best-studied non-invasive neuromodulation methods. More than 33,000 documented stimulation sessions demonstrate an outstanding safety profile, according to Bikson et al. (2016, Brain Stimulation) .
Typical, mild and temporary side effects may include a slight tingling or warming sensation under the electrodes, local skin reddening, short-term fatigue or headaches.
Since the method does not involve any pharmacological intervention in metabolism, no systemic side effects such as weight gain, nausea, or sexual dysfunction occur. Therefore, tDCS can be safely used in combination with antidepressants or psychotherapy without the risk of interactions.
Alternative to conventional therapies
While antidepressants work chemically on the brain, tDCS uses the brain's natural electrical language. This makes it particularly suitable for people who:
Do not tolerate medication or wish to avoid it,
have not experienced sufficient effects from classical therapies
or seek a complementary, physically gentle method.
While classic psychotropic drugs often take weeks to work, many patients undergoing tDCS show a significant improvement in their mood and concentration within 2-3 weeks.
This effect has been scientifically confirmed multiple times:
Woodham et al. (2025, Nature Medicine) found that after only 10 weeks of treatment with tDCS, more than half of the patients showed little or no depressive symptoms.
Brunoni et al. (2013, JAMA Psychiatry) demonstrated that tDCS can be as effective as antidepressants, but without systemic side effects.
Palm et al. (2016, European Archives of Psychiatry and Clinical Neuroscience) and Lefaucheur et al. (2017, Clinical Neurophysiology) confirmed the safety and efficacy even with prolonged use.
Lefaucheur et al. (2017) included the method in their guidelines as a recommended treatment option for major depression.
Can be used as a supplement or independently
tDCS can be used alone or in combination with psychotherapy or drug treatments.
Studies show that the combination of tDCS and cognitive behavioral therapy (CBT) or antidepressants achieves additive effects ( Zhou et al., 2024, Brain Stimul.; Aust et al., 2022, JAMA Psychiatry ).
Treatment with tDCS: uncomplicated, painless, safe
The treatment is straightforward: a very weak electrical current (comparable to a 9-volt battery) is applied to the scalp via two small electrodes. These are typically placed in the forehead region (above the DLPFC). This modulation restores the neuronal balance in the DLPFC – without medication, surgery, or pain. The current is so weak that the stimulation is usually barely noticeable. Only a slight tingling or itching sensation on the scalp may occasionally occur.
The application typically takes 20–30 minutes per session.
tDCS is generally very safe. However, the method should not be used if there are metal implants in the head area or if the skin in the area of the electrodes is acutely irritated or injured.
Non-drug treatment for depression, pain & stroke
Numerous studies prove that the method also works in can be used effectively in other medical fields.
The The neuromodulatory effects of tDCS open up a wide range of therapeutic applications – from chronic pain syndromes to neurological rehabilitation.
Chronic pain:
Fregni et al. (2006, Pain) reported in a pioneering study that tDCS over the motor cortex reduces pain in fibromyalgia and neuropathic pain.
Lefaucheur et al. (2017, Clinical Neurophysiology) confirmed in guidelines that tDCS can significantly contribute to pain relief – especially in chronic back pain.
Przeklasa-Muszynska et al. (2017, Pharmacological Reports) demonstrated the effective use of tDCS in migraine patients. Symptoms and medication use were significantly reduced with just 10 treatments.
Neurological rehabilitation:
Hummel et al. (2005, Brain) demonstrated that tDCS promotes motor recovery after stroke.
Elsner et al. (2020, Cochrane Review) evaluated over 50 randomized studies and concluded that tDCS produces significant functional improvements after neurological damage.
tDCS: Future-oriented neuromodulation for the treatment of depression
Over the past 15 years, tDCS has evolved from an experimental method to a clinically relevant, scientifically validated therapeutic tool for treating neuronal dysregulation directly at its source – without medication, without dependence, without serious side effects.
Their good tolerability, ease of use and high level of evidence make tDCS a promising alternative and complement in modern depression treatment.
If nothing has really helped so far – there are new ways.
If you have already endured a long period of suffering, tried various therapies and still have not experienced sufficient improvement, or if you would like to supplement your drug or psychotherapeutic treatment with a modern, scientifically sound method – then it is worth taking a look at the possibilities of transcranial direct current stimulation (tDCS).
Inquire whether tDCS treatments are offered in your area.
If you feel that this method could be a suitable alternative or valuable addition to your current therapy, I cordially invite you to get to know the neuromodulation practice in Mainz.
Here you can expect personal, individual support, based on the latest neuroscientific findings and driven by a genuine interest in your well-being.
Literature and further sources
Brunoni, AR et al. (2013). The sertraline vs. electrical current therapy for treating depression clinical study: results from a factorial, randomized, controlled trial. JAMA Psychiatry . 70(4), 383-91.
🔗 https://doi.org/10.1001/2013jamapsychiatry.32
Palm, U. et al. (2016). tDCS for the treatment of depression: a comprehensive review. Eur Arch Psychiatry Clin Neurosci . 266, 681–694 .
🔗 https://doi.org/10.1016/j.brs.2015.11.003
Woodham, A. et al. (2025). Home-based transcranial direct current stimulation treatment for major depressive disorder: a fully remote phase 2 randomized sham-controlled trial. Nat Med 31, 87–95.
🔗 https://doi.org/10.3389/fpsyt.2024.1345921
Bikson, M. et al. (2016). Safety of transcranial direct current stimulation: Evidence-based update 2016. Brain Stimulation , 9(5), 641–661.
🔗 https://doi.org/10.1016/j.brs.2016.06.004
Lefaucheur, J.-P. et al. (2017). Evidence-based guidelines on the therapeutic use of tDCS. Clinical Neurophysiology , 128(1), 56–92.
🔗 https://doi.org/10.1016/j.clinph.2016.10.087
Grimm, S. et al. (2008). Imbalance between left and right dorsolateral prefrontal cortex in major depression is linked to negative emotional judgment: An fMRI study. Biological Psychiatry , 63(4), 369–376.
🔗 https://doi.org/10.1016/j.biopsych.2007.05.033
Fregni, F. et al. (2006). A randomized, sham-controlled, proof of principle study of transcranial direct current stimulation for the treatment of pain in fibromyalgia . Arthritis & Rheumatology, 54(12), 3988-3998
🔗 https://doi.org/10.1016/j.pain.2006.01.028
Hummel, F. et al. (2005). Effects of non-invasive cortical stimulation on skilled motor function in chronic stroke. Brain , 128(3), 490–499.
🔗 https://doi.org/10.1093/brain/awh369
Elsner, B. et al. (2020). Transcranial direct current stimulation ( tDCS ) for improving activities of daily living, and physical and cognitive functioning, in people after stroke. Cochrane Database of Systematic Reviews , 11(11), CD009645.
🔗 https://doi.org/10.1002/14651858.CD009645.pub3
Zhou, Q. et al. (2024). Effect of add-on transcranial alternating current stimulation (tACS) in major depressive disorder: A randomized controlled trial. Brain stimulation. 17(4):760-768.
🔗 https://doi.org/10.1186/s12916-024-03164-4
Przeklasa-Muszynska, A. et al. (2017). Transcranial direct current stimulation (tDCS) and its influence on analgesics effectiveness in patients suffering from migraine headache. Pharmacol. Rep. 69(4), 714-721.
🔗 https://doi.org/10.3389/fnhum.2025.1462352
Aust, S. et al. (2022). Efficacy of Augmentation of Cognitive Behavioral Therapy With Transcranial Direct Current Stimulation for Depression: A Randomized Clinical Trial. JAMA Psychiatry . 79(6):528-537.
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