Compareing the effectiveness of pharmacotherapy, transcranial direct current stimulation (TDCS), and combined treatment (TDCS and pharmacotherapy) on reducing major depression symptoms and improvement of working memory in veterans with PTSD

Background and Aim: Depression has a destructive impact on performance of working memory. The purpose of current study was to compare the effectiveness of pharmacotherapy, Transcranial Direct Current Stimulation (TDCS), and combined treatment (pharmacotherapy and TDCS) on reducing major depression symptoms, besides improvement of working memory in veterans with PTSD. Methods: This was a quasi-experimental study with pretest – posttest design and three-month follow- up.  This study was carried out in 2018 with statistical population of veterans from Tehran, in which 68 subjects were selected using a purposive sampling method and then randomly divided into three experimental (pharmacotherapy, TDCS, and combined treatment) and one-control groups (each group has 17 subjects). Research tools were included the PTSD-Checklist for DSM-5 (PCL-5), Beck Depression Inventory-II (BDI-II) and Daneman and Carpenter Working Memory Test (WMT). Results: In the posttest and follow-up phase, given the matching of groups, there was a significant difference between experimental (pharmacotherapy, TDCS, and combined treatment) and control groups in BDI-II and WMT mean scores. In the post-test phase, combined treatment, TDCS, and pharmacotherapy groups had the highest efficiency, respectively. In the follow-up phase, combined treatment had the maximum and pharmacotherapy had the minimum persistence of their effect. Conclusion: all three therapeutic methods had significant impact on reducing the symptoms of major depression and improving working memory, but they were different in the amount of their effectiveness and persistence.