The vascular depression hypothesis provides the conceptual background for studies that may have clinical and theoretical impact. Agents influencing dopamine, acetylcholine, and opioid neurotransmitters may be studied in vascular depression, since these are essential neurotransmitters of the frontostriatal circuitry. Drugs used for prevention and treatment of cerebrovascular disease may be shown to reduce the risk for vascular depression or improve its outcomes. The choice of antidepressants in vascular depression may depend on their effect on neurological recovery from ischemic lesions. Finally, identification of specific relationships between specific symptoms, cognitive deficits, and disability may lead to interventions that target the patients' deficits as well as their interactions with psychosocial factors known to contribute to depression.

Transcranial Direct Current Stimulation (tDCS) was found to be an adequate pharmacotherapy for managing symptoms of vascular depression during a double-blind randomized study, the findings of which were published in Brain Stimulation.
Researchers from the San Raffaele Scientific Institute in Italy recruited inpatients (N=93) over 60 years of age presenting with cerebral vascular disease who had been diagnosed with Major Depressive Disorder (n=77) or Bipolar Disorder (n=16). All patients were treated with sertraline for 2 weeks followed by a stabilized dose (100-200 mg/day) and randomized to receive 1 sham (n=31), 1 tDCS (n=31), or 2 tDCS (n=31) treatments Monday through Friday for 2 weeks. Patients were assessed by the Hamilton Depression Rating Scale (HDRS) and the Milan Overall Dementia Assessment

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