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We aimed to examine the efficacy and safety of transcranial direct current stimulation (tDCS) combined with quetiapine in bipolar patients as a suicidal intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a single\u2010center, double\u2010blind, treatment\u2010naive bipolar depression patients with suicidal ideation were randomly assigned to quetiapine in combination with either active (<jats:italic>n<\/jats:italic>\u2009=\u200916) or sham (<jats:italic>n<\/jats:italic>\u2009=\u200915) tDCS over the left dorsolateral prefrontal cortex for three consecutive weeks. The 30\u2010min, 2\u2010mA tDCS was conducted twice a day on the weekday of the first week and then once a day on the weekdays of the two following weeks. Primary efficacy outcome measure was the change in the Beck Scale for Suicidal Ideation (BSSI). Secondary outcomes included changes on the 17\u2010item Hamilton Depression Rating Scale (HDRS\u201017) and Montgomery\u2010Asberg Depression Rating Scale (MADRS). Outcome was evaluated on Day 3 and weekend. Safety outcome was based on the reported adverse reactions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Active tDCS was superior to sham tDCS on the BSSI at Day 3 and tended to sustain every weekend during the treatment process, compared to baseline. However, no difference between active and sham in HDRS\u201017 and MADRS was found. Response and remission rate also supported the antisuicide effect of tDCS, with higher response and remission rate in BSSI, but no antidepressant effect, compared to sham, over time. Regarding safety, active tDCS was well tolerated and all the adverse reactions reported were mild and limited to transient scalp discomfort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The tDCS was effective as an antisuicide treatment for acute bipolar depression patients with suicidal ideation, with minimal side effects reported.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cns.70077","type":"journal-article","created":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T14:03:22Z","timestamp":1728569002000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Efficacy and Safety of Transcranial Direct Current Stimulation as an Add\u2010On Trial Treatment for Acute Bipolar Depression Patients With Suicidal Ideation"],"prefix":"10.1111","volume":"30","author":[{"given":"Dandan","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Psychiatry, The First Affiliated Hospital 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