Stimulating the brain with a weak electrical current is a safe and effective treatment for depression and could have other surprise benefits for the body and mind, a major Australian study of transcranial Direct Current Stimulation (tDCS) has found.
Medical researchers from the University of New South Wales (UNSW) and the Black Dog Institute have carried out the largest and most definitive study of tDCS and found up to half of depressed participants experienced substantial improvements after receiving the treatment.
A non-invasive form of brain stimulation, tDCS passes a weak depolarising electrical current into the front of the brain through electrodes on the scalp. Patients remain awake and alert during the procedure.
“We are excited about these results. This is the largest randomised controlled trial of transcranial direct current stimulation ever undertaken and, while the results need to be replicated, they confirm previous reports of significant antidepressant effects,” said trial leader, Professor Colleen Loo, from UNSW’s School of Psychiatry.
The trial saw 64 depressed participants who had not benefited from at least two other depression treatments receive active or sham tDCS for 20 minutes every day for up to six weeks.
“Most of the people who went into this trial had tried at least two other antidepressant treatments and got nowhere. So the results are far more significant than they might initially appear – we weren’t dealing with people who were easy to treat,” Professor Loo said.
If you’ve been treated for depression but your symptoms haven’t improved, you may have treatment-resistant depression. Taking an antidepressant or going to psychological counseling (psychotherapy) eases depression symptoms for most people. But with treatment-resistant depression, standard treatments aren’t enough. They may not help much at all, or your symptoms may improve only to keep coming back. Treatment-resistant depression symptoms can range from mild to severe and may require trying a number of approaches to identify what helps.
Your family doctor can prescribe antidepressants and give you advice. But if your depression symptoms continue despite treatment, see a medical doctor who specializes in diagnosing and treating mental health conditions (psychiatrist). You may also need to see a psychologist or other mental health professional for psychological counseling.
Significantly, results after six weeks were better than at three weeks, suggesting the treatment is best applied over an extended period. Participants who improved during the trial were offered follow up weekly ‘booster’ treatments, with about 85 percent showing no relapse after three months.
“These results demonstrate that multiple tDCS sessions are safe and not associated with any adverse cognitive outcomes over time,” Professor Loo said, adding tDCS is simple and cost effective to deliver, requiring a short visit to a clinic.
Medication strategies
Even if you’ve already tried an antidepressant and it didn’t work, don’t lose hope. You simply may not have found the right dose, medication or combination of medications that works for you. Here are some medication approaches you and your doctor may consider:
– Giving your current medications more time. Antidepressants and other medications for depression typically take four to eight weeks to become fully effective and for side effects to ease up. For some people, it takes even longer.
– Increasing your dose. Because people respond to medications differently, you may benefit from a higher dose of medication than is usually prescribed. Discuss with your doctor whether this is an option for you. Don’t alter your dose on your own.
– Switching antidepressants. For a number of people, the first antidepressant tried isn’t effective. You may need to try several before you find one that works for you. Your doctor may have you switch from one antidepressant to another in the same class. Or you may try a different type of antidepressant altogether.
– Adding another type of antidepressant. Your doctor may prescribe two different classes of antidepressants at the same time. That way they’ll affect a wider range of brain chemicals linked to mood (neurotransmitters that include dopamine, serotonin and norepinephrine).
– Adding a medication generally used for another condition. Your doctor may prescribe a medication that is generally used for another mental or physical health disorder, along with an antidepressant. This approach is known as augmentation. There are numerous medications that may be tried, including anti-anxiety medications, anti-seizure medications, mood stabilizers, beta blockers, antipsychotics and stimulants.
– Using the cytochrome P450 (CYP450) genotyping test. This test checks for specific genes that indicate how well your body can process (metabolize) a medication. It isn’t a sure way to tell which antidepressant will work, but for some people this test can indicate whether a particular antidepressant might be a good choice based on how likely it is to cause side effects. Your local hospital may not provide genetic tests, but laboratory testing may be available through national laboratories.
The study also turned up additional unexpected physical and mental benefits, including improved attention and information processing.
“One participant with a long-standing reading problem said his reading had improved after the trial and others commented that they were able to think more clearly.
“Another participant with chronic neck pain reported that the pain had disappeared during the trial. We think that is because tDCS actually changes the brain’s perception of pain. We believe these cognitive benefits are another positive aspect of the treatment worthy of investigation,” Professor Loo said.
The researchers are now looking at an additional trial to include people with bipolar disorder, with early results from overseas suggesting tDCS is just as effective in this group.
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University of New South Wales. “Safe And Effective New Treatment For Depression.