Electrical Brain Stimulation

A new treatment for depression is adding to the growing number of options for sufferers, and it comes at a reduced cost and with fewer side effects. It’s just not on the market yet.

A new clinical trial examined the safety and efficacy of an electrical current therapy called transcranial direct current stimulation (tDCS) versus treatment with medication for major depressive disorder, one of the most common mental disorders in the United States.

“We found that tDCS is as effective as the antidepressant sertraline, and when tDCS is combined with sertraline, it has greater efficacy,” said Andre R. Brunoni, M.D., Ph.D., of the University of Sao Paulo in Brazil. “This means that tDCS could be an alternative therapy to antidepressant drugs when the drugs are not well tolerated, present side effects, or cannot be prescribed. It can act as an augmentative (additive) therapy for antidepressants, which is also useful because antidepressants have limited efficacy in most cases.”

Brain stimulation therapies generally work by using electricity, magnets, or implants to stimulate specific areas of the brain. The most common and oldest of these options to treat severe cases of depression is electroconvulsive therapy (formerly known as electroshock treatment), which induces seizures in anesthetized patients.

These therapies tend to be an alternative to medication like SSRIs (selective serotonin reuptake inhibitors), which are the most commonly used antidepressant, but which can cause dry mouth, headaches, weight gain, and reduced sexual desire.

The new treatment instead uses small electrodes to deliver a constant, low-level current of electricity to the brain with a 9-volt battery. It was originally developed for patients with brain injuries like strokes, but U.S. military researchers discovered that tDCS can more than double the rate at which people learn skills, such as math and marksmanship.

Another option on the market is Transcranial Magnetic Stimulation (TMS), which gained FDA approval in 2008. This therapy involves placing an electromagnet on the scalp to create magnetic field pulses in order to stimulate the cerebral cortex.

The Potential Impact of Electrical Stimulation Treatments

Depression is a worldwide issue affecting about 121 million people. It can interfere with your relationships, work, and quality of life.

“More than half of the people with depression can get treatment with drugs or talk therapy," said Mark S. George, M.D., a professor of Psychiatry, Radiology and Neurosciences at the Medical University of South Carolina. “But for those people who don’t respond or respond slowly we need to come up with other treatments. tCDS is a newcomer on the block and it’s extremely simple and cost effective; this is the first well done study to show its antidepressant efficacy.”

While George said the study is quite exciting, he said it will likely take time for the therapy to reach the market and for therapists to begin recommending it.

“Future studies should validate our findings," Brunoni said. “If it is ultimately proven that tDCS is effective in treating depression, it could be used also as a home therapy, since tDCS devices are cheap, affordable, portable, and can be easily used with little training. If this eventually happens, this would represent a significant impact in the treatment of depression.”

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