Electronic Therapies to Treat Depression

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The gold standard treatments for depression are prescription medications and talk therapy.
What happens, though, when these don’t work? Are there any alternatives?

There is a burgeoning industry in non-medical alternatives to depression treatment. In these days of electronics providing solutions for everything, there is a lot of research and a lot of investment money behind such projects. Not all of the treatments listed are widely available, however.

Established Therapies

Electroconvulsive Therapy (ECT)
ECT is a long-time therapy, used when all other treatments have failed to resolve a patient’s depression. Electrodes are attached to the scalp and a current is passed through them, inducing a seizure in the patient. Treatments are given under general anesthesia, and occur two or three times each week for three or four weeks.

Some of the side effects of ECT include initial confusion, lasting from a few minutes to a few hours. Memory loss, which can be a problem for several months, is another major side effect. Short term effects include nausea, vomiting, headache and jaw pain on the day of the treatment.

Vagus Nerve Stimulation (VNS)
For VNS, patients undergo surgery to have a device implanted in the chest, attached to the vagus nerve. Once the device is activated it stimulates the vagus nerve for 30 seconds at a time, every five minutes. Pet scans tracking the effects of the device have noted changes in the brain metabolism, as well as evolving changes in brain structure in the area of dopamine production. The evidence of these changes often predates symptom relief by several months.

Approximately 75% of the patients who participated in research for this technology experienced improvement in their depression. Remission of depressive symptoms was generally long term.

Despite FDA approval in June 2008, this therapy remains relatively unused, because most physicians question the relative risks of surgery when other therapies might prove as effective.

Transcranial Magnetic Stimulation (TMS)
Approved by the FDA in 2008, this treatment causes magnetic waves to pass through and stimulate those parts of the brain that are part of mood regulation. Treatment involves several weeks of daily sessions during which a powerful magnet is positioned over the prefrontal cortex of the brain for short periods.

Not all patients benefit, but for those that do there are few side effects. Unlike ECT, there are rarely any seizures, no memory loss and no loss of cognition. The benefits appear to be long lasting for as many as half of patients, lasting more than a year.

Cranial Electrotherapy Stimulation (CES)
CES is an FDA-approved therapy for treatment of depression, insomnia, and anxiety. Treatment occurs when pulsed, low-intensity current is applied to the earlobes or the scalp. There are no side effects, other than an occasional residual tingling or mild pain on the scalp or skin areas.

CES devices are currently available from several companies for personal use therapy.

Experimental Therapy

Transcranial Direct Current Stimulation (tDCS)
tDCS is an experimental therapy that has a number of possible uses. Treatment is effected when a direct electrical current is passed through two electrodes that are placed over the head. There are two types of stimulation. The anodal electrodes stimulate neuronal activity and the cathodal electrodes reduce neuronal activity.

Potential uses include treatment of depression, anxiety, Parkinson’s disease, and chronic pain. There are no known side effects.

Sources: WebMD, PsychCentral, NY Times (TMS) and NY Times (tDCS)

Image courtesy: National Institute for Mental Health, NIH

 
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