Efficacy of taVNS Versus Sham Stimulation in Reduing Depressive Symptoms in Patients With Epilepsy: a Multi-center, Double-blinded, Randomized, 20-week, Parallel-arm, Superiority Study

Inclusion Criteria: * Adults age ≥18 * Confirmed diagnosis of epilepsy (based on 2014 definition by ILAE) * Having comorbidity with mild-moderate depression (confirmed diagnosis by a psychiatrist) * Willing and able to provide informed conset Exclusion Criteria: * Those experiencing status epilepticus or frequent seizures requiring emergency medication within the year prior to recruitment * Those with severe depression or anxiety who are in urgent need of psychiatric care * Those who are imminently suicidal or unable to keep themselves safe * Those experiencing severe cognitive difficulties with day-to-day memory, attention, and ability to learn basic information * Those having a pacemaker, a invasive vagus nerve stimulator, or a metal implant * The pinna is not suitable for earplugs * Pregnancy