A three-minute treatment involving magnetic stimulation of the brain works just as well as the standard form of such therapy for people with hard-to-treat depression, a new study has found.
Insurers are starting to cover TMS for depression (after determining that SSRIs or other medications aren’t working for the patient). A full course, 24-36 treatments, of TMS can cost well over $10k. Though this is purely conjecture on my part, one way tDCS might make it into the mainstream is as a method to ‘top up’ post-TMS treatment as effects begin to fade.
Published on Jun 19, 2017 | YouTube UCLA
As the number of people suffering from depression rises, doctors are looking for new, more targeted ways to treat it. One approach used by doctors at UCLA and a handful of other centers nationwide is to beam magnetic pulses deep into patients’ brains, a therapy known as transcranial magnetic stimulation (TMS). The therapy is time-consuming, and only a few hospitals or clinics offer it, but its ability to work in a fundamentally different way from medications is also what makes it so promising for people not helped by drugs.
Finnish company Sooma manufactures and supports a tDCS device for the treatment of depression (in Europe). They recently added clearance to treat pain in Canada, and I would assume, are aggressively working towards clearing their device for the treatment of depression in Canada and the U.S.
I would recommend muting the sound (captioned so not necessary) in these next two.
Excellent article on the state of prescribed tDCS for depression.
Full article: Treating Depression With tDCS: Startup Ybrain Aims for the Mainstream
In South Korea, Ybrain is betting that these benefits and its slick consumer-friendly design will speed adoption of its device. “It’s designed for home use,” says Ybrain CEO Lee, “so physician can electronically prescribe the device and patients can bring it to their homes.”
Analysing these high-standard studies revealed that tDCS seems to reliably improve the symptoms of depression, addiction and craving, and fibromyalgia. It also uncovered that the technique does not work for tinnitus, and that the evidence for using tDCS for stroke rehabilitation was not as strong as many had thought.
Full article: Zapping the brain really does seem to improve depression
I contacted a few people using tDCS to cure their depression via social media. Mario, 32 from Mexico, told me it was working for him.
“I think it is great. You can see a lot of improvements in your mood. The more you use it the better you feel.”
Another user, eagee, wrote, “I suffered from depression for almost 25 years, and after I started applying tDCS I’ve had two years so far without it.”
If tDCS really can be so life changing for depression patients, why isn’t it more widely available?
According to Dr. Williams, “the equipment is so simple that it cannot be patented in the US. And if no one can own the rights to tDCS, no one can make a profit on it.”
That’s why, according to its supporters, tCDS is being ignored by major drug companies.
Stumbled upon this device today, the Omni Stimulator, which seems to be mostly sold in Australia. That lead to this video where Brendan Morgan makes the case for the use of tDCS in the treatment of his depression. Again, I am not advocating the use of tDCS for the self-treatment of your depression. I’m simply collecting evidence, clinical and anecdotal, and making it available. That said, I know that if I myself were experiencing depression, I would be experimenting with tDCS. Especially in light of the fact that the efficacy of treatment of depression with SRRIs remains controversial, tDCS would definitely seem to be worth a try. [Highly recommended, Science VS podcast episode #11 Antidepressants.]
We developed a cellular brain stimulation device as part of our ELEC5622 Sensors, Signals & Health assessment at the University of Sydney. The technique, known as transcranial direct current stimulation (tDCS), uses weak electrical currents to modulate ongoing brain activity, and is a promising treatment for a range of neurological and psychiatric diseases. As the feasibility of administering tDCS at home has recently become an emerging area of research, there is a substantial need for a tDCS device which send data to the clinician in real time.
[Update 11/7/16 The video mentioned has been deleted.]
Now that TMS has been approved for the treatment of depression we’re seeing a lot more stories in the news. Naturally this is in part due to the marketing efforts of the four device makers currently FDA approved: Brainsway, Magstim, Magvita, and Neurostar. No doubt patients and doctors are eager to try an alternative where antidepressants didn’t work!
I will update this post as I find new and interesting news stories related to TMS and depression.
Fidel Vila-Rodriguez, an Assistant Professor of Psychiatry at the University of British Columbia, is exploring the effects of transcranial direct current stimulation combined with yoga, to see if it can be used to treat depression.
Market forces, the for-profit bias that imbues every aspect of health care in America, skew R&D towards solutions and products that are highly profitable. That’s one of the reasons I was so curious about tDCS. You can do it at home. It doesn’t cost a fortune. My initial curiosity was inspired by research papers that seemed to indicate the potential for cognitive enhancement, primarily memory and learning. Many papers later, I’m not so sure, but where it comes to tDCS and depression I’m much more confident. There does seem to be an overwhelming amount of both research and anecdotal evidence to support the use of tDCS in depression. If that were better known, perhaps someone like the woman featured in this NBC news clip would have had somewhere to turn when she was denied coverage for continuing TMS treatment for depression.
No mention of tDCS in his journey to find relief from severe depression, but some new to me and interesting information about treating his depression with Transcranial Magnetic Stimulation. Especially interesting is that a genome test recommended by his psychiatrist led to the awareness that many of the drugs typically used to treat depression would most likely be overwhelming to his system. Also that his insurer, Anthem Blue Cross (through the ACA, Obamacare) covered his TMS treatment. Links below to full article.
Transcranial Magnetic Stimulation, or TMS, is a depression treatment that was approved by the FDA in 2008. It involves placing a magnetic coil on the patient’s head, and stimulating neurons in a specific part of the brain known to be underactive in depression (the dorsolateral prefrontal cortex). Best of all, it has very few side effects: only some uncomfortable tapping on the head where treatment is applied. There are none of the standard side effects we’ve come to associate with medications.
There are a few more tDCS-related videos on Alex’s YT Channel but I thought these wereboth very interesting. Starting with what didn’t work, and followed by what worked for him.
Unfortunately the study found little to no benefit (no more than sham) using tDCS with two different montages to treat tinnitus. What is very interesting however, is that the study allowed participants to administer tDCS at home.
A Sooma tDCSTM device (Sooma Oy, Helsinki, Finland) was used in the study. The device is designed and approved for patient use with pre-programmed treatment parameters and hardware-level safety limits. Patients were given a package consisting of the stimulator unit and stimulation electrodes (consisting leads and pads) along with three pairs of sponge pouches for the electrode pads, a head cap with openings for the electrodes (Fig 1), a chinstrap and 0.9% saline solution.
In Europe, Sooma depression solution was approved for depression treatment in 2014.
Download the Sooma brochure (pdf)
Marom Bikson (no less!) demonstrating depression montage using the Soterix EasyStrap.
tDCS montage for depression multi-center trial. EasyStrap nicely secures rivet electrodes without obscuring contact. pic.twitter.com/IyUajrKqlr
— Marom Bikson (@MaromBikson) March 17, 2016
Another view of tDCS depression montage by EasyStrap. Note ruler, even electrode contact and access for adjustment. pic.twitter.com/Nb0GaPXX6c
— Marom Bikson (@MaromBikson) March 17, 2016
From a recent Marom Bikson slide deck (pdf).