An Open-label Study to Evaluate Tolerability of Add-on Transcranial Direct Current Stimulation (tDCS) in Adolescents with Schizophrenia or Other Psychotic Disorders

Introduction: Treatment of childhood-onset schizophrenia (COS) and related psychotic disorders is challenging due to limited options for effective interventions. Transcranial direct current stimulation (tDCS) is a noninvasive neuro-modulatory technique found to be safe and effective in adults for treating symptoms of schizophrenia. There is a paucity of studies of tDCS in adolescents regarding its safety and tolerability. We studied the tolerability of add-on tDCS in adolescents with schizophrenia and other psychotic disorders. Material and Methods: Fifteen adolescents with a diagnosis of schizophrenia and other psychotic disorders (ICD 10) with a mean age of 15.25 years, refractory to an adequate trial of antipsychotic and CGI-severity score of 4 (moderately ill) or more were recruited. All patients received 10 sessions of tDCS (2 mA current) with sponge electrodes of 25 sq cm. Adverse effects were measured during each session using a tDCS adverse effect questionnaire, local, general physical, and mental state examination. Results: The most common adverse effects reported were itching and burning sensations (33.3% each) followed by tingling sensation in 20% of subjects at the site of electrode application. Among study subjects, 86.6% had at least one adverse effect, and in 80%, the reported adverse effects were mild. 60% of the reported adverse effects were probably due to tDCS. Conclusion: Adverse effects reported with tDCS are transient. tDCS was tolerable, safe, easily acceptable, and feasible to administer in adolescents with schizophrenia or other psychotic disorders admitted to the hospital.